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Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
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Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach

1
Internal Medicine Service, HLA Inmaculada Hospital, 18004 Granada, Spain
2
Public Health, Science History and Gynecology Department, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
3
Internal Medicine Service, Vega Baja Hospital-FISABIO, Orihuela, 03314 Alicante, Spain
4
Clinica Medicine Department, University Miguel Hernández de Elche, 03550 Sant Joan d’Alacant, Alicante, Spain
5
Internal Medicine Service, Marina Baixa Hospital, La Vila Joiosa, 03570 Alicante, Spain
6
Internal Medicine Service, General University Hospital of Alicante-ISABIAL, 03550 Alicante, Spain
7
Department of Parasitology, Universidad Miguel Hernández de Elche, 03550 Alicante, Spain
8
Internal Medicine Service, University Clinical Hospital Sant Joan d’Alacant-FISABIO, 03550 Alicante, Spain
9
Microbiology Service, General University Hospital of Alicante -ISABIAL, 03010 Alicante, Spain
10
Foundation Mundo Sano, 28046 Madrid, Spain
11
Parasitology Service, National Center of Microbiology, 28222 Madrid, Spain
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Members of the Corazones Sin Chagas Platform: María García-López, Cristina Bernal-Alcaraz, Pedro B. Guevara-Hernández, Jara Llenas-García, Joan Gregori-Colome, Ana Lucas-Dato, Esther Martínez-Birlanga & Estefanía García-Rodríguez (Hospital Vega Baja, Orihuela); José-Manuel Ramos Rincón, Diego Torrús-Tendero, Mª Paz Ventero-Martín, Adelina Gimeno-Gascón, Ares Sánchez-Sánchez, Roser Muñoz-Pérez, Carmen Almoedo Albero (Hospital General Universitario de Alicante), Concepción Gil-Anguita, Concepción Amador-Prous, Concepción Amador Prous, Ana-Isabel Pujades-Tárraga, Antonio Santonja, María Sánchez-Valera, & Rosa Sánchez-García (Hospital Marina Baixa Villajoyosa), Miriam Navarro Beltrá (Universidad Miguel Hernández), province of Alicante, Spain.
Pathogens 2020, 9(6), 511; https://doi.org/10.3390/pathogens9060511
Received: 20 May 2020 / Revised: 14 June 2020 / Accepted: 20 June 2020 / Published: 24 June 2020
(This article belongs to the Special Issue Prevalence of Strongyloidiasis and Schistosomiasis)
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. View Full-Text
Keywords: Strongyloidiasis; Strongyloides stercoralis; Chagas disease; Central and South America; Community-based intervention; migrants Strongyloidiasis; Strongyloides stercoralis; Chagas disease; Central and South America; Community-based intervention; migrants
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Ramos-Sesma, V.; Navarro, M.; Llenas-García, J.; Gil-Anguita, C.; Torrús-Tendero, D.; Wikman-Jorgensen, P.; Amador-Prous, C.; Ventero-Martín, M.-P.; Garijo-Sainz, A.-M.; García-López, M.; Pujades-Tárraga, A.-I.; Bernal-Alcaraz, C.; Santonja, A.; Guevara-Hernández, P.; Flores-Chávez, M.; Saugar, J.-M.; Ramos-Rincón, J.-M.; Corazones Sin Chagas Platform. Asymptomatic Strongyloidiasis among Latin American Migrants in Spain: A Community-Based Approach. Pathogens 2020, 9, 511.

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