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Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study

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 trea...

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Autores principales: Martinez-Pérez, Angela, Soriano-Pérez, Manuel Jesús, Salvador, Fernando, Gomez-Junyent, Joan, Villar-Garcia, Judith, Santin, Miguel, Muñoz, Carme, González-Cordón, Ana, Salas-Coronas, Joaquín, Sulleiro, Elena, Somoza, Dolors, Treviño, Begoña, Pecorelli, Rosángela, Llaberia-Marcual, Jaume, Lozano-Serrano, Ana Belén, Quinto, Llorenç, Muñoz, Jose, Requena-Méndez, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350355/
https://www.ncbi.nlm.nih.gov/pubmed/32585975
http://dx.doi.org/10.3390/pathogens9060507
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author Martinez-Pérez, Angela
Soriano-Pérez, Manuel Jesús
Salvador, Fernando
Gomez-Junyent, Joan
Villar-Garcia, Judith
Santin, Miguel
Muñoz, Carme
González-Cordón, Ana
Salas-Coronas, Joaquín
Sulleiro, Elena
Somoza, Dolors
Treviño, Begoña
Pecorelli, Rosángela
Llaberia-Marcual, Jaume
Lozano-Serrano, Ana Belén
Quinto, Llorenç
Muñoz, Jose
Requena-Méndez, Ana
author_facet Martinez-Pérez, Angela
Soriano-Pérez, Manuel Jesús
Salvador, Fernando
Gomez-Junyent, Joan
Villar-Garcia, Judith
Santin, Miguel
Muñoz, Carme
González-Cordón, Ana
Salas-Coronas, Joaquín
Sulleiro, Elena
Somoza, Dolors
Treviño, Begoña
Pecorelli, Rosángela
Llaberia-Marcual, Jaume
Lozano-Serrano, Ana Belén
Quinto, Llorenç
Muñoz, Jose
Requena-Méndez, Ana
author_sort Martinez-Pérez, Angela
collection PubMed
description 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.
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spelling pubmed-73503552020-07-15 Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study Martinez-Pérez, Angela Soriano-Pérez, Manuel Jesús Salvador, Fernando Gomez-Junyent, Joan Villar-Garcia, Judith Santin, Miguel Muñoz, Carme González-Cordón, Ana Salas-Coronas, Joaquín Sulleiro, Elena Somoza, Dolors Treviño, Begoña Pecorelli, Rosángela Llaberia-Marcual, Jaume Lozano-Serrano, Ana Belén Quinto, Llorenç Muñoz, Jose Requena-Méndez, Ana Pathogens Article 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. MDPI 2020-06-23 /pmc/articles/PMC7350355/ /pubmed/32585975 http://dx.doi.org/10.3390/pathogens9060507 Text en © 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/).
spellingShingle Article
Martinez-Pérez, Angela
Soriano-Pérez, Manuel Jesús
Salvador, Fernando
Gomez-Junyent, Joan
Villar-Garcia, Judith
Santin, Miguel
Muñoz, Carme
González-Cordón, Ana
Salas-Coronas, Joaquín
Sulleiro, Elena
Somoza, Dolors
Treviño, Begoña
Pecorelli, Rosángela
Llaberia-Marcual, Jaume
Lozano-Serrano, Ana Belén
Quinto, Llorenç
Muñoz, Jose
Requena-Méndez, Ana
Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title_full Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title_fullStr Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title_full_unstemmed Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title_short Clinical Features Associated with Strongyloidiasis in Migrants and the Potential Impact of Immunosuppression: A Case Control Study
title_sort clinical features associated with strongyloidiasis in migrants and the potential impact of immunosuppression: a case control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350355/
https://www.ncbi.nlm.nih.gov/pubmed/32585975
http://dx.doi.org/10.3390/pathogens9060507
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