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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

Internal Medicine Service, HLA Inmaculada Hospital, 18004 Granada, Spain
Public Health, Science History and Gynecology Department, Universidad Miguel Hernández, 03550 Sant Joan d’Alacant, Alicante, Spain
Internal Medicine Service, Vega Baja Hospital-FISABIO, Orihuela, 03314 Alicante, Spain
Clinica Medicine Department, University Miguel Hernández de Elche, 03550 Sant Joan d’Alacant, Alicante, Spain
Internal Medicine Service, Marina Baixa Hospital, La Vila Joiosa, 03570 Alicante, Spain
Internal Medicine Service, General University Hospital of Alicante-ISABIAL, 03550 Alicante, Spain
Department of Parasitology, Universidad Miguel Hernández de Elche, 03550 Alicante, Spain
Internal Medicine Service, University Clinical Hospital Sant Joan d’Alacant-FISABIO, 03550 Alicante, Spain
Microbiology Service, General University Hospital of Alicante -ISABIAL, 03010 Alicante, Spain
Foundation Mundo Sano, 28046 Madrid, Spain
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;
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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