Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: a systematic review and meta-analysis
- PMID: 34325063
- DOI: 10.1016/j.cmi.2021.07.016
Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: a systematic review and meta-analysis
Abstract
Background: The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined.
Objectives: The primary objective was to describe the pattern and frequency of clinical and laboratory characteristics associated with S. stercoralis infection. The secondary objectives were (a) comparison of characteristics reported in endemic versus non-endemic areas; and (b) the evaluation of the resolution of identified characteristics after treatment.
Methods: We searched PubMed, EMBASE, LILACS and CENTRAL up to May 2021. Eligible studies were randomized controlled trials (RCTs) for the treatment of S. stercoralis infection and prospective observational studies reporting data on symptoms caused by strongyloidiasis in individuals diagnosed with a highly specific test. Quality assessment was performed to assess the risk of bias. Demographic and clinical data were summarized using descriptive statistics. Meta-analysis was done by pooling the proportion of participants with symptoms with random effects model.
Results: Twenty studies were included: nine RCTs and 13 observational studies. Overall, symptoms were reported in 50.4% cases (95% CI 47.6-53.1), and were more often reported in non-endemic (58.6%, 95% CI 55.0-62.2) than in endemic (35.7%, 95% CI 31.4-39.9) areas. The removal of an article of lower quality did not impact on figures. Frequency of symptoms tended to reduce after treatment. Three studies reported the proportion of participants with eosinophilia before and after treatment: 76.9% of participants (95% CI 73.4-80.4) had eosinophilia at diagnosis, reducing to 27.4% (95% CI 24.0-30.7) after treatment.
Conclusions: About half of infected people complain at least of one symptom and almost 70% have eosinophilia. The frequency of symptoms and eosinophilia decreased after treatment, though the association with cure is not clearly defined. Providing relief from symptoms and eosinophilia is another reason, in addition to prevention of disseminated disease, for promoting screening and treatment of individuals with strongyloidiasis.
Keywords: Eosinophilia; Meta-analysis; Strongyloides; Strongyloidiasis; Symptoms; Systematic review.
Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Similar articles
-
Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies.Infect Dis Poverty. 2023 Sep 13;12(1):83. doi: 10.1186/s40249-023-01138-4. Infect Dis Poverty. 2023. PMID: 37705080 Free PMC article. Review.
-
A comprehensive review of Strongyloides stercoralis infection after solid organ and hematopoietic stem cell transplantation.Clin Transplant. 2022 Nov;36(11):e14795. doi: 10.1111/ctr.14795. Epub 2022 Sep 20. Clin Transplant. 2022. PMID: 35987856 Free PMC article. Review.
-
Strongyloides stercoralis infection: A systematic review of endemic cases in Spain.PLoS Negl Trop Dis. 2019 Mar 12;13(3):e0007230. doi: 10.1371/journal.pntd.0007230. eCollection 2019 Mar. PLoS Negl Trop Dis. 2019. PMID: 30860995 Free PMC article.
-
Usefulness of Strongyloides stercoralis serology in the management of patients with eosinophilia.Am J Trop Med Hyg. 2014 May;90(5):830-4. doi: 10.4269/ajtmh.13-0678. Epub 2014 Mar 10. Am J Trop Med Hyg. 2014. PMID: 24615124 Free PMC article.
-
Clinical and epidemiological features of 33 imported Strongyloides stercoralis infections.Trans R Soc Trop Med Hyg. 2010 Sep;104(9):613-6. doi: 10.1016/j.trstmh.2010.06.001. Epub 2010 Jul 16. Trans R Soc Trop Med Hyg. 2010. PMID: 20637483
Cited by
-
Strongyloidiasis.Nat Rev Dis Primers. 2024 Jan 25;10(1):6. doi: 10.1038/s41572-023-00490-x. Nat Rev Dis Primers. 2024. PMID: 38272922 Review.
-
Strongyloidiasis Mimicking Carcinoid Syndrome in an Immunocompetent Host.Cureus. 2023 Nov 10;15(11):e48608. doi: 10.7759/cureus.48608. eCollection 2023 Nov. Cureus. 2023. PMID: 38090419 Free PMC article.
-
Human strongyloidiasis: complexities and pathways forward.Clin Microbiol Rev. 2023 Dec 20;36(4):e0003323. doi: 10.1128/cmr.00033-23. Epub 2023 Nov 8. Clin Microbiol Rev. 2023. PMID: 37937980 Review.
-
Epidemiological, Clinical and Laboratory Features of Strongyloidiasis in 69 Attendees at a French Outpatient Clinic.Pathogens. 2023 Jul 27;12(8):983. doi: 10.3390/pathogens12080983. Pathogens. 2023. PMID: 37623943 Free PMC article.
-
Strongyloides stercoralis in the US Military Health System.Open Forum Infect Dis. 2023 Mar 18;10(3):ofad127. doi: 10.1093/ofid/ofad127. eCollection 2023 Mar. Open Forum Infect Dis. 2023. PMID: 37008572 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical