Pathogens (Jun 2020)

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

  • Angela Martinez-Pérez,
  • Manuel Jesús Soriano-Pérez,
  • Fernando Salvador,
  • Joan Gomez-Junyent,
  • Judith Villar-Garcia,
  • Miguel Santin,
  • Carme Muñoz,
  • Ana González-Cordón,
  • Joaquín Salas-Coronas,
  • Elena Sulleiro,
  • Dolors Somoza,
  • Begoña Treviño,
  • Rosángela Pecorelli,
  • Jaume Llaberia-Marcual,
  • Ana Belén Lozano-Serrano,
  • Llorenç Quinto,
  • Jose Muñoz,
  • Ana Requena-Méndez,
  • on behalf of the STRONG-SEMTSI working group

DOI
https://doi.org/10.3390/pathogens9060507
Journal volume & issue
Vol. 9, no. 6
p. 507

Abstract

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Strongyloides stercoralis is a widely distributed nematode more frequent in tropical areas and particularly severe in immunosuppressed patients. The aim of this study was to determine factors associated with strongyloidiasis in migrants living in a non-endemic area and to assess the response to treatment and follow-up in those diagnosed with the infection. We performed a multicenter case-control study with 158 cases and 294 controls matched 1:2 by a department service. Participants were recruited simultaneously at six hospitals or clinics in Spain. A paired-match analysis was then performed looking for associations and odds ratios in sociodemographic characteristics, pathological background, clinical presentation and analytical details. Cases outcomes after a six-month follow-up visit were also registered and their particularities described. Most cases and controls came from Latin America (63%–47%) or sub-Saharan Africa (26%–35%). The number of years residing in Spain (9.9 vs. 9.8, p = 0.9) and immunosuppression status (30% vs. 36.3%, p = 0.2) were also similar in both groups. Clinical symptoms such as diffuse abdominal pain (21% vs. 13%, p = 0.02), and epigastralgia (29% vs. 18%, p p p S. stercoralis infection, although this association is less evident in immunosuppressed patients. The appropriate follow-up time to evaluate treatment response based on serology titers should be extended beyond 6 months if the cure criteria are not achieved.

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