Strongyloides Stercoralis and Its Risk Factors: An Experience at a Tertiary Care Hospital

Abstract

Strongyloides stercoralis is one of the most neglected tropical parasitic infestations. The present study was carried out considering the paucity of data available from Indian context regarding the prevalence and risk factors associated with Strongyloides stercoralis infestation. METHODSThe present study was an observational, retrospective audit/analysis where the hospital records of stool specimens received in Parasitology division for detection of intestinal parasites over a period of three years (January 2011 to December 2013) were analysed. The clinical features and laboratory data of patients infected with larvae of Strongyloides stercoralis were recorded. Descriptive statistics was applied to represent the categories of risk factors in percentages and chi-square test for its association with parasitic infection. RESULTSLarvae of Strongyloides stercoralis were detected in 0.4% (65/15530) stool specimens with a male preponderance. The most common presenting complaints by patients were attributed to diarrhoea 26/65 (40%) and 14/65 (21.5%) patients were asymptomatic. Peripheral eosinophilia was seen in 10.8% (7/65) patients; 52/65 (80%) of patients were identified to have one or more of the known risk factors for Strongyloidiasis of which nearly half gave history of alcoholism (29/52,55.8%); 3/65 (4.6%) patients had hyperinfection of which one died. All three patients had two risk factors (alcoholism and steroids). Oral albendazole was used to treat the parasitic infestation in 31 (48.4%), whereas 34 (51.6%) received oral ivermectin. CONCLUSIONThe study findings of prevalence, clinical features and associated risk factors for Strongyloidiasis can be considered as preliminary report from Western Indian population. The presence of two risk factors in all cases of hyperinfection calls for further studies.