The Strongyloides stercoralis-hookworms association as a path to the estimation of the global burden of strongyloidiasis: A systematic review

Fleitas, Pedro Emanuel; Travacio, Marina; Martí-Soler, Helena; Socías, M. Eugenia; López, Walter R.; Krolewiecki, Alejandro

doi:10.1371/journal.pntd.0008184

Cited by 33 publications

(28 citation statements)

References 28 publications

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“…S . stercoralis is among the most neglected NTDs, with a burden estimated in up to 400 million infected people worldwide [ 1 , 21 ], four times larger than previous estimates [ 22 ]. This difference in the global burden of S .…”

Section: Discussionmentioning

confidence: 99%

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Performance evaluation of Baermann techniques: The quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis

et al. 2021

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Background Soil-transmitted helminths (STH) are common in low and middle income countries where there is lack of access to clean water and sanitation. Effective diagnosis and treatment are essential for the control of STH infections. However, among STH parasites, Strongyloides stercoralis is the most neglected species, both in diagnostics and control strategies. Diagnostic methods cover different approaches, each with different sensitivities and specificities, such as serology, molecular techniques and microscopy based techniques. Of the later, the Baermann technique is the most commonly used procedure. In the literature, several ways have been described to perform the Baermann method, which illustrates the overall lack of a ‘(gold) reference standard’ method for the diagnosis of S. stercoralis infection. In this study we have evaluated the performance of three Baermann techniques in order to improve the reference standard for the microscopic diagnosis of S. stercoralis infection thereby facilitating individual case detection, mapping of the disease and proper evaluation of treatment responses. Methods/Principal findings A community based cross sectional study was conducted at Zenzelima, Bahir Dar Zuria Ethiopia. A total of 437 stool samples were collected and analyzed by the following procedures: conventional Baermann (CB), modified Baermann (MB), and modified Baermann with charcoal pre-incubation (MBCI). The diagnostic sensitivity and Negative Predictive Value (NPV) of each technique was calculated using the combination of all the three techniques as a composite reference standard. Our result indicated that larvae of S. stercoralis were detected in 151 (34.6%) stool samples. The prevalence of S. stercoralis infection based on the three diagnostic methods was 9.6%, 8.0%, and 31.3% by CB, MB, and MBCI respectively. The sensitivity and NPV for CB, MB, and MBCI were 26.7% and 70.8%, 22.1% and 69.6%, and 87.0% and 93.2%, respectively. The MBCI showed significant difference (P- value = <0.001) in the sensitivity and NPV values when compared with CB and MB values. The agreement between CB, MB, and MBCI with the composite reference standard was 31.8%, 26.7%, 89.6%, respectively. Conclusion/Significance Our results suggest the superior performance of MBCI. It is relatively easy to implement, simple to perform and comparatively cheaper. The CB is by far the commonly used method in routine diagnostic although this technique significantly underestimates the true burden of the disease and thereby contributing to the exclusion of S. stercoralis from the control strategies. Therefore, MBCI is recommended as a routine microscopy-based diagnostic test for S. stercoralis infection, particularly in settings where molecular procedures are not available.

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Section: Discussionmentioning

confidence: 99%

“…S . stercoralis is a helminthic parasite affecting an estimated 386 million people worldwide, with the true burden of disease still unknown [ 1 ]. The prevalence of S .…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of Baermann techniques: The quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis

et al. 2021

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“…Overall, none of the available diagnostic tests can be considered the gold standard for the diagnosis of strongyloidiasis. Recently, a paper estimated the prevalence of strongyloidiasis as a ratio to hookworm, in order to partly overcome the diagnostic issue [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Global Prevalence of Strongyloides stercoralis Infection

et al. 2020

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Strongyloidiasis is a common neglected tropical disease in tropical and sub-tropical climatic zones. At the worldwide level, there is high uncertainty about the strongyloidiasis burden. This uncertainty represents an important knowledge gap since it affects the planning of interventions to reduce the burden of strongyloidiasis in endemic countries. This study aimed to estimate the global strongyloidiasis prevalence. A literature review was performed to obtain prevalence data from endemic countries at a worldwide level from 1990 to 2016. For each study, the true population prevalence was calculated by accounting for the specificity and the sensitivity of testing and age of tested individuals. Prediction of strongyloidiasis prevalence for each country was performed using a spatiotemporal statistical modeling approach. The country prevalence obtained from the model was used to estimate the number of infected people per country. We estimate the global prevalence of strongyloidiasis in 2017 to be 8.1% (95% CI: 4.2–12.4%), corresponding to 613.9 (95% CI: 313.1–910.1) million people infected. The South-East Asia, African, and Western Pacific Regions accounted for 76.1% of the global infections. Our results could be used to identify those countries in which strongyloidiasis prevalence is highest and where mass drug administration (MDA) should be deployed for its prevention and control.

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“…S stercoralis can persist in the intestine for decades and approximately 400 million people are infected worldwide. 1 Immunosuppressive conditions (including ageing, immunosuppressive medication and Authors: A associate professor, University of the Ryukyus, Nishihara, Japan; B consultant gastroenterologist, University of the Ryukyus, Nishihara, Japan ABSTRACT co-infection with HTLV-1) can cause life-threatening hyperinfection syndrome, characterised by paralytic ileus and Gram-negative bacteraemia. 2,3 Co-infection of S stercoralis and HTLV-1 affects each…”

Section: Discussionmentioning

confidence: 99%