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. 2020 Jun 24;9(6):511.
doi: 10.3390/pathogens9060511.

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

Violeta Ramos-Sesma  1 , Miriam Navarro  2 , Jara Llenas-García  3   4 , Concepción Gil-Anguita  5 , Diego Torrús-Tendero  6   7 , Philip Wikman-Jorgensen  8 , Concepción Amador-Prous  5 , María-Paz Ventero-Martín  9 , Ana-María Garijo-Sainz  5 , María García-López  3 , Ana-Isabel Pujades-Tárraga  5 , Cristina Bernal-Alcaraz  3 , Antonio Santonja  5 , Pedro Guevara-Hernández  3 , María Flores-Chávez  10   11 , José-María Saugar  11 , José-Manuel Ramos-Rincón  4   6 , Corazones Sin Chagas Platform
Affiliations

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

Violeta Ramos-Sesma et al. Pathogens. .

Abstract

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.

Keywords: Central and South America; Chagas disease; Community-based intervention; Strongyloides stercoralis; Strongyloidiasis; migrants.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Map of Spain, with Alicante city, Callosa d’en Sarrià and Orihuela.
Figure 2
Figure 2
Participants flow chart.
See this image and copyright information in PMC

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