Strongyloidiasis screening in migrants living in Spain: systematic review and meta‐analysis

Abstract

Objectives To provide information regarding the prevalence of strongyloidiasis among migrants coming from Strongyloides stercoralis‐endemic areas who reside in Spain. Methods Systematic review of the literature and meta‐analysis of studies showing prevalence of S. stercoralis infection among migrants from Latin America, Africa, Eastern Europe, Asia and Oceania who reside in Spain. We included articles published until 30 April 2019 without language restriction. The keywords used for the search included ‘Strongyloides stercoralis’, ‘strongyloidiasis’, ‘Spain’, ‘screening’ and ‘migrants’. Results Twenty‐four studies were included in the review and meta‐analysis, comprising 12 386 screened people. Eleven studies (7020 patients) evaluated the presence of S. stercoralis infection only through investigation of larvae in faeces, showing an overall prevalence of 1% (95%CI 1–1%). Thirteen studies (5366 patients) used a serological test, showing an overall prevalence of 14% (95%CI 11–17%). Strongyloidiasis seroprevalence was 20% (95%CI 15–24%) among migrants from sub‐Saharan Africa, 14% (95%CI 10–18%) among those from Latin America and 8% (95%CI 5–11%) among migrants from North Africa. Conclusions Migrants coming from strongyloidiasis‐endemic areas living in Spain had a high S. stercoralis infection prevalence, particularly those from sub‐Saharan Africa and Latin America. This population should be screened using serology as the most sensitive test for S. stercoralis infection. This could be easily implemented at primary care level.

Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study

“…These clinical and laboratory findings are consistent with other studies [ 20 ] showing that eosinophilia is a good correlator of the infection. Sociodemographic characteristics such as age, sex and country of origin are in accordance with those found in our non-community migrant population [ 21 ], except for a slightly higher presence of men, which might reflect the occupational nature of the infection [ 22 ]. On the other hand, we also found a weak association with the geographical area of origin being that the infection was more frequently reported in individuals coming from Latin American countries.…”

Effectiveness and Safety of a Single-Dose Ivermectin Treatment for Uncomplicated Strongyloidiasis in Immunosuppressed Patients (ImmunoStrong Study): The Study Protocol

“…A recent review of the literature showed a prevalence of S. stercoralis infection ranging from 10% to 20% in immigrant population living in Spain. These data support the active screening of populations coming from endemic areas given the potential risk of serious presentation in situations of immunosuppression [ 10 ]. The frequency of this parasitosis and its potentially deleterious consequences has led the European Center for Disease Control to include strongyloidiasis in the routine screening of migrants coming from endemic areas [ 11 ].…”

Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach

“…S. stercoralis infection is estimated to have a prevalence of between 7% and 40% among migrants, depending on the survey and patients’ country of origin [ 14 , 29 ]. In a recent meta-analysis of the prevalence of strongyloidiasis in migrants from endemic areas who reside in Spain, the authors found an overall prevalence of 14% in Latin Americans [ 30 ]. Our study showed a lower prevalence than that (6% in children and adolescents and 12% in adults; 11% overall), but a similar proportion as another study performed in Spain, where the prevalence was 10.9% in patients from South America [ 3 ].…”