Clinical features associated with strongyloidiasis in migrants and the potential impact of immunosuppression: a case control study
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- dc.contributor.author Martínez-Pérez, Angela
- dc.contributor.author Soriano-Pérez, Manuel Jesús
- dc.contributor.author Salvador, Fernando
- dc.contributor.author Gomez-Junyent, Joan
- dc.contributor.author Villar García, Judit
- dc.contributor.author Santín, Miguel
- dc.contributor.author Muñoz, Carme
- dc.contributor.author González-Cordón, Ana
- dc.contributor.author Salas-Coronas, Joaquín
- dc.contributor.author Sulleiro, Elena
- dc.contributor.author Somoza, Dolors
- dc.contributor.author Treviño, Begoña
- dc.contributor.author Pecorelli, Rosángela
- dc.contributor.author Llaberia-Marcual, Jaume
- dc.contributor.author Lozano-Serrano, Ana Belén
- dc.contributor.author Quinto, Llorenç
- dc.contributor.author Muñoz, José
- dc.contributor.author Requena-Méndez, Ana
- dc.contributor.author Strong-Semtsi Working Group
- dc.date.accessioned 2020-10-27T07:57:36Z
- dc.date.available 2020-10-27T07:57:36Z
- dc.date.issued 2020
- dc.description.abstract 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 < 0.001); along with a higher eosinophil count (483 vs. 224 cells/mL in cases and controls, p < 0.001) and the mean total Immunoglobulin E (IgE) (354 U/L vs. 157.9 U/L; p < 0.001) were associated with having strongyloidiasis. Finally, 98.2% percent of the cases were treated with ivermectin in different schedules, and 94.5% met the cure criteria at least six months after their first consultation. Abdominal pain, epigastralgia, eosinophilia, increased levels of IgE and Latin American origin remain the main features associated with 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.
- dc.format.mimetype application/pdf
- dc.identifier.citation Martinez-Pérez A, Soriano-Pérez MJ, Salvador F, Gomez-Junyent J, Villar-Garcia J, Santin M. et al. Clinical features associated with strongyloidiasis in migrants and the potential impact of immunosuppression: a case control study. Pathogens. 2020 Jun 23; 9(6):507. DOI: 10.3390/pathogens9060507
- dc.identifier.doi http://dx.doi.org/10.3390/pathogens9060507
- dc.identifier.issn 2076-0817
- dc.identifier.uri http://hdl.handle.net/10230/45585
- dc.language.iso eng
- dc.publisher MDPI
- dc.rights Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Strongyloides stercoralis
- dc.subject.keyword Case-control
- dc.subject.keyword Immunosuppression
- dc.subject.keyword Migration
- dc.subject.keyword Risk factors
- dc.title Clinical features associated with strongyloidiasis in migrants and the potential impact of immunosuppression: a case control study
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion