Human strongyloidiasis : complexities and pathways forward
- Authors: Buonfrate, Dora , Bradbury, Richard , Watts, Matthew , Bisoffi, Zeno
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Clinical Microbiology Reviews Vol. 36, no. 4 (2023), p.
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- Description: Strongyloidiasis is a World Health Organization neglected tropical disease usually caused by Strongyloides stercoralis, a parasitic worm with a complex life cycle. Globally, 300-600 million people are infected through contact with fecally contaminated soil. An autoinfective component of the life cycle can lead to chronic infection that may be asymptomatic or cause long-term symptoms, including malnourishment in children. Low larval output can limit the sensitivity of detection in stool, with serology being effectivebut less sensitive in immunocompromise. Host immunosuppression can trigger catastrophic, fatal hyperinfection/dissemination, where large numbers of larvae pierce the bowel wall and disseminate throughout the organs. Stable disease is effectivelytreated by single-dose ivermectin, with disease in immunocompromised patients treated with multiple doses. Strategies for management include raising awareness, clarifying zoonotic potential, the development and use of effectivediagnostic tests for epidemiological studies and individual diagnosis, and the implementation of treatment programs with research into therapeutic alternatives and medication safety. © 2023 American Society for Microbiology. All rights reserved.
The diagnosis of human and companion animal Strongyloides stercoralis infection : challenges and solutions. A scoping review
- Authors: Buonfrate, Dora , Tamarozzi, Francesca , Paradies, Paola , Watts, Matthew , Bradbury, Richard , Bisoffi, Zweno
- Date: 2022
- Type: Text , Book chapter
- Relation: Advances in Parasitology: Advances in Automated Diagnosis of Intestinal Parasites of Animals and Humans Chapter 1 p. 1-84
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- Description: Strongyloidiasis is the infection caused by soil-transmitted nematodes of Strongyloides species, infecting humans and some animals. Strongyloides stercoralis is the species with most clinical and epidemiological relevance in humans and dogs, due to its high prevalence and its capacity of inducing a life-threatening hyperinfection. Diagnosis of strongyloidiasis is challenging, due to the absence of a single reference standard test with high sensitivity and specificity, which also hampers the estimation of the accuracy of other diagnostic tests. In this chapter, we review the deployment and performance of the parasitological, immunological, molecular tests for the diagnosis of strongyloidiasis in humans and in dogs. Further, we comment the available evidence from genotyping studies that have addressed the zoonotic potential of S. stercoralis. Finally, we discuss the use of different diagnostic methods in relation to the purpose (i.e., screening, individual diagnosis, inclusion in a clinical trial) and the setting (endemic/non-endemic areas) and report the accuracy figures reported by systematic reviews on either parasitological, serological or molecular techniques published in literature. © 2022 Elsevier Ltd