Imported strongyloidiasis: Data from 1245 cases registered in the +REDIVI Spanish Collaborative Network (2009-2017)

PLoS Negl Trop Dis. 2019 May 16;13(5):e0007399. doi: 10.1371/journal.pntd.0007399. eCollection 2019 May.

Abstract

Background: Imported strongyloidiasis is increasingly being diagnosed in non-endemic areas. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients with imported strongyloidiasis in Spain.

Methodology: This is an observational retrospective study that included all patients diagnosed of strongyloidiasis registered in the +REDIVI Collaborative Network from 2009 to 2017. Demographic, epidemiological and clinical information was collected from the +REDIVI database, and extra information regarding microbiological techniques, treatment and follow-up was requested to participant centers.

Findings: Overall, 1245 cases were included. Most of them were immigrants (66.9%), and South America was the most frequent area of origin. Detection of larvae in stool samples was observed in 21.9% of the patients, and serological tests allowed making the diagnosis in the rest of the cases. Eosinophilia was present in 82.2% of cases. Treatment with ivermectin (compared with albendazole) was the most strongly associated factor to achieve the cure (OR 2.34).

Conclusions: Given the long latency of the infection and the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Albendazole / therapeutic use
  • Animals
  • Anthelmintics / therapeutic use*
  • Child
  • Child, Preschool
  • Emigrants and Immigrants / statistics & numerical data
  • Eosinophilia / etiology
  • Female
  • Humans
  • Infant
  • Ivermectin / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies
  • South America
  • Spain / epidemiology
  • Strongyloides stercoralis / drug effects
  • Strongyloides stercoralis / isolation & purification
  • Strongyloides stercoralis / physiology
  • Strongyloidiasis / complications
  • Strongyloidiasis / diagnosis
  • Strongyloidiasis / epidemiology*
  • Strongyloidiasis / parasitology
  • Travel
  • Young Adult

Substances

  • Anthelmintics
  • Ivermectin
  • Albendazole

Grants and funding

The authors received no specific funding for this work. This study was supported by the ISCIII-Collaborative Research Network on Tropical Diseases (RICET) and the European Regional Development Fund (ERDF): RD16/0027/0003 and RD16/0027/0020. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.