Strongyloides stercoralis: Spatial distribution of a highly prevalent and ubiquitous soil-transmitted helminth in Cambodia

Abstract

Background Strongyloides stercoralis is a neglected soil-transmitted helminth that occurs worldwide, though it is particularly endemic in tropical and subtropical areas. It can cause long-lasting and potentially fatal infections due to its ability to replicate within its host. S . stercoralis causes gastrointestinal and dermatological morbidity. The objective of this study was to assess the S . stercoralis infection risk and, using geostatistical models, to predict its geographical distribution in Cambodia. Methodology / Principal findings A nation-wide, community-based parasitological survey was conducted among the Cambodian population, aged 6 years and older. S . stercoralis was diagnosed using a serological diagnostic test that detects IgG antibodies in urine. Data on demography, hygiene and knowledge about helminth infection were collected. S . stercoralis prevalence among 7,246 participants with a complete data record was 30.5%, ranging from 10.9% to 48.2% across provinces. The parasite was ubiquitous in Cambodia; only five south-eastern provinces had prevalence rates below 20%. Infection risk increased with age for both men and women, although girls under the age of 13 and women aged 50 years and over had lower odds of infection than their male counterparts. Open defecation was associated with higher odds of infection, while having some knowledge of the health problems caused by worms was a protective factor. Infection risk was positively associated with nighttime maximum temperature, minimum rainfall, and distance to water; it was negatively associated with land occupied by rice fields. Conclusions / Significance S . stercoralis infection is rampant in Cambodia. Control programs delivering ivermectin are needed to manage the parasite. However, the high cost of this drug in Cambodia currently precludes the implementation of control initiatives. Donations, subsidies or affordable generics are needed so that S . stercoralis , which infects almost a third of the Cambodian population, can be addressed through an adequate control program.

Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters

“…Certain demographic and socioeconomic factors (being male, being older, having education level lower than primary school and a history of alcohol intake) were significantly associated with S . stercoralis infection risk, similar to previous findings in Thailand [ 22 , 23 ] and other countries [ 33 , 34 ]. These same demographic and socioeconomic factors are commonly known to predispose people to infection and to reduce the efficiency of the immune response [ 35 ].…”

Prevalence of intestinal parasites and molecular characterization of Giardia intestinalis, Blastocystis spp. and Entamoeba histolytica in the village of Fortín Mbororé (Puerto Iguazú, Misiones, Argentina)

“…There were practically no cases of A. lumbricoides or T. trichiura ; these parasites are more influenced by fecal–oral hygiene habits, and tap water and hand washing could contribute to a lower prevalence detected in our study [ 6 ]. Although studies investigating risk factors for S. stercoralis infection have mostly reported a higher risk among men, generally attributed to men’s extensive exposure to soil during farming activities [ 44 ], in our study this parasite was associated more with females. We can only hypothesize on the reason for this, although it is important to note that there was no bias in sampling, since the participation between males and females was not statistically different.…”

Strongyloidiasis in Africa: Systematic Review and Meta‐Analysis on Prevalence, Diagnostic Methods, and Study Settings

“…This is consistent with an earlier report [ 7 ]. This high prevalence of strongyloidiasis in a rural community might be due to low sanitation and hygiene practice, limited knowledge on the transmission of Strongyloides infection, and absence of adequate water for sanitation and hygiene in the rural communities of African countries [ 102 , 103 ].…”