Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach

• Published in: Pathogens (Basel) Vol. 9; no. 6; p. 511
• Main Authors: Ramos-Sesma, Violeta, Navarro, Miriam, Llenas-García, Jara, Gil-Anguita, Concepción, Torrús-Tendero, Diego, Wikman-Jorgensen, Philip, Amador-Prous, Concepción, Ventero-Martín, María-Paz, Garijo-Sainz, Ana-María, García-López, María, Pujades-Tárraga, Ana-Isabel, Bernal-Alcaraz, Cristina, Santonja, Antonio, Guevara-Hernández, Pedro, Flores-Chávez, María, Saugar, José-María, Ramos-Rincón, José-Manuel
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 24.06.2020; MDPI
• Subjects: Adolescents; Adults; Central and South America; Chagas disease; Children; Community-based intervention; Confidence intervals; Consent; Hospitals; Immunoglobulin G; Infections; Men; Migrants; Population; Questionnaires; Serology; Statistical analysis; Strongyloides stercoralis; Strongyloidiasis; Studies; Vector-borne diseases; Viral diseases; South America; Ecuador; Bolivia; United States > US; Spain
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens9060511

Strongyloides stercoralis infection is frequently underdiagnosed since many infections remain asymptomatic. Aim: To estimate the prevalence and characteristics of asymptomatic S. stercoralis infection in Latin American migrants attending a community-based screening program for Chagas disease in Spain. Methodology: Three community-based Chagas disease screening campaigns were performed in Alicante (Spain) in 2016, 2017, and 2018. Serological testing for S. stercoralis infection was performed using a non-automatized IVD-ELISA detecting IgG (DRG Instruments GmbH, Marburg, Germany). Results: Of the 616 migrants from Central and South America who were screened, 601 were included in the study: 100 children and adolescents (<18 years of age) and 501 adults. Among the younger group, 6 participants tested positive (prevalence 6%, 95% confidence interval [CI] 2.5% to 13.1%), while 60 adults did so (prevalence 12%, 95% CI 9.3% to 15.3%). S. stercoralis infection was more common in men than in women (odds ratio adjusted [ORa] 2.28, 95% CI 1.289 to 4.03) and in those from Bolivia (ORa 2.03, 95% CI 1.15 to 3.59). Prevalence increased with age (ORa 1.02, 95% CI 0.99 to 1.05). In contrast, a university education had a protective effect (ORa 0.29, 95% CI 0.31 to 0.88). Forty-one (41/66; 62.1%) of the total cases of S. stercoralis infection were treated at the health care center. Positive stool samples were observed in 19.5% of the followed-up positive cases. Conclusion: Incorporating serological screening for S. stercoralis into community-based screening for Chagas disease is a useful intervention to detect asymptomatic S. stercoralis infection in Central and South American migrants and an opportunity to tackle neglected tropical diseases in a transversal way. The remaining challenge is to achieve patients’ adherence to the medical follow-up.