Authors: Krolewiecki, Alejandro Javier; Lammie, Patrick; Jacobson, Julie; Gabrielli, Albis-Francesco; Levecke, Bruno; Socías, María Guillermina; Arias, Luis María; Sosa, Nicanor; Abraham, David; Cimino, Rubén Oscar; Echazú, Adriana; Crudo, Favio; Vercruysse, Josef; Albonico, Marco
Publication Date: 2013.
Language: English.
Abstract:
Strongyloides stercoralis infections have a worldwide distribution with a global burden in terms of prevalence and morbidity that is largely ignored. A public health response against soil-transmitted helminth (STH) infections should broaden the strategy to include S. stercoralis and overcome the epidemiological, diagnostic, and therapeutic challenges that this parasite poses in comparison to Ascaris lumbricoides, Trichuris trichiura, and hookworms. The relatively poor sensitivity of single stool evaluations, which is further lowered when quantitative techniques aimed at detecting eggs are used, also complicates morbidity evaluations and adequate drug efficacy measurements, since S. stercoralis is eliminated in stools in a larval stage. Specific stool techniques for the detection of larvae of S. stercoralis, like Baermann?s and Koga?s agar plate, despite superiority over direct techniques are still suboptimal. New serologies using recombinant antigens and molecular-based techniques offer new hopes in those areas. The use of ivermectin rather than benzimidazoles for its treatment and the need to have curative regimens rather than lowering the parasite burden are also unique for S. stercoralis in comparison to the other STH due to its life cycle, which allows reproduction and amplification of the worm burden within the human host. The potential impact on STH of the benzimidazoles/ivermectin combinations, already used for control/elimination of lymphatic filariasis, should be further evaluated in public health settings. While waiting for more effective single-dose drug regimens and new sensitive diagnostics, the evidence and the tools already available warrant the planning of a common platform for STH and S. stercoralis control.
Author affiliation: Krolewiecki, Alejandro Javier. Universidad Nacional de Salta. Sede Regional Oran. Instituto de Investigación de Enfermedades Tropicales; Argentina;
Author affiliation: Lammie, Patrick. Centers For Disease Control And Prevention. National Center For Infectious Diseases. Division Of Parasitic Diseases; Estados Unidos de América;
Author affiliation: Jacobson, Julie. BILL & MELINDA GATES FOUNDATION;
Author affiliation: Gabrielli, Albis-Francesco. WORLD HEALTH ORGANIZATION;
Author affiliation: Levecke, Bruno. Ghent University. Faculty of Veterinary Medicine. Parasitology and Immunology. Department of Virology, Bélgica;
Author affiliation: Socías, María Guillermina. Fundación Mundo Sano; Argentina;
Author affiliation: Arias, Luis María. Ministerio de Salud Pública de la Provincia de Salta; Argentina;
Author affiliation: Sosa, Nicanor. Ministerio de Salud Pública de la Provincia de Salta; Argentina;
Author affiliation: Abraham, David. Thomas Jefferson University. Department of Microbiology and Immunology. Kimmel Cancer; Argentina;
Author affiliation: Cimino, Rubén Oscar. Universidad Nacional de Salta. Sede Regional Oran. Instituto de Investigación de Enfermedades Tropicales; Argentina;
Author affiliation: Echazú, Adriana. Universidad Nacional de Salta. Sede Regional Oran. Instituto de Investigación de Enfermedades Tropicales; Argentina;
Author affiliation: Crudo, Favio. Municipio de Zárate. Subsecretaría de Salud; Argentina;
Author affiliation: Vercruysse, Josef. Department of Control of Neglected Tropical Diseases; Italia;
Author affiliation: Albonico, Marco. Ivo de Carneri Foundation; Italia;
Repository: CONICET Digital (CONICET). Consejo Nacional de Investigaciones Científicas y Técnicas
Authors: Amor, Aranzazu; Rodriguez, Esperanza; Saugar, José M.; Arroyo, Ana; López-Quintana, Beatriz; Abera, Bayeh; Yimer, Mulat; Yizengaw, Endalew; Zewdie, Derejew; Ayehubizu, Zimman; Hailu, Tadesse; Mulu, Wondemagegn; Echazú, Adriana; Krolewieki, Alejandro J.; Aparicio, Pilar; Herrador, Zaida; Anegagrie, Melaku; Benito, Agustín
Publication Date: 2016.
Language: English.
Abstract:
Background: Soil-transmitted helminthiases (hookworms, Ascaris lumbricoides and Trichuris trichiura) are extremely prevalent in school-aged children living in poor sanitary conditions. Recent epidemiological data suggest that Strongyloides stercoralis is highly unreported. However, accurate data are essential for conducting interventions aimed at introducing control and elimination programmes. Methods: We conducted a cross-sectional survey of 396 randomly selected school-aged children in Amhara region in rural area in north-western Ethiopia, to assess the prevalence of S. stercoralis and other intestinal helminths. We examined stools using three techniques: conventional stool concentration; and two S. stercoralis-specific methods, i.e. the Baermann technique and polymerase chain reaction. The diagnostic accuracy of these three methods was then compared. Results: There was an overall prevalence of helminths of 77.5%, with distribution differing according to school setting. Soil-transmitted helminths were recorded in 69.2%. Prevalence of S. stercoralis and hookworm infection was 20.7 and 54.5%, respectively, and co-infection was detected in 16.3% of cases. Schistosoma mansoni had a prevalence of 15.7%. Prevalence of S. stercoralis was shown 3.5% by the conventional method, 12.1% by the Baermann method, and 13.4% by PCR, which thus proved to be the most sensitive. Conclusions: Our results suggest that S. stercoralis could be overlooked and neglected in Ethiopia, if studies of soil-transmitted helminths rely on conventional diagnostic techniques alone. A combination of molecular and stool microscopy techniques yields a significantly higher prevalence. In view of the fact that current control policies for triggering drug administration are based on parasite prevalence levels, a comprehensive diagnostic approach should instead be applied to ensure comprehensive control of helminth infections.
Author affiliation: Amor, Aranzazu. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Rodriguez, Esperanza. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Saugar, José M.. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Arroyo, Ana. Hospital Universitario la Paz - Carlos III; España
Author affiliation: López-Quintana, Beatriz. Hospital Universitario la Paz - Carlos III; España
Author affiliation: Abera, Bayeh. Bahir Dar University; Etiopía
Author affiliation: Yimer, Mulat. Bahir Dar University; Etiopía
Author affiliation: Yizengaw, Endalew. Bahir Dar University; Etiopía
Author affiliation: Zewdie, Derejew. Bahir Dar University; Etiopía
Author affiliation: Ayehubizu, Zimman. Bahir Dar University; Etiopía
Author affiliation: Hailu, Tadesse. Bahir Dar University; Etiopía
Author affiliation: Mulu, Wondemagegn. Bahir Dar University; Etiopía
Author affiliation: Echazú, Adriana. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Author affiliation: Krolewieki, Alejandro J.. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Author affiliation: Aparicio, Pilar. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Herrador, Zaida. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Anegagrie, Melaku. Universidad Carlos III de Madrid. Instituto de Salud; España
Author affiliation: Benito, Agustín. Universidad Carlos III de Madrid. Instituto de Salud; España
Repository: CONICET Digital (CONICET). Consejo Nacional de Investigaciones Científicas y Técnicas