Strongyloides stercoralis infection : A systematic review of endemic cases in Spain
Barroso Sevillano, María (Universitat Autònoma de Barcelona)
Salvador, Fernando (Hospital Universitari Vall d'Hebron)
Sánchez-Montalvá, Adrián (Hospital Universitari Vall d'Hebron)
Bosch-Nicolau, Pau (Hospital Universitari Vall d'Hebron)
Molina Romero, Israel (Hospital Universitari Vall d'Hebron)

Fecha:	2019
Resumen:	Strongyloides stercoralis infection, a neglected tropical disease, is widely distributed. Autochthonous cases have been described in Spain, probably infected long time ago. In recent years the number of diagnosed cases has increased due to the growing number of immigrants, travelers and refugees, but endemically acquired cases in Spain remains undetermined. We systematically searched the literature for references on endemic strongyloidiasis cases in Spain. The articles were required to describe Strongyloides stercoralis infection in at least one Spanish-born person without a history of travel to endemic areas and be published before 31st May 2018. Epidemiological data from patients was collected and described individually as well as risk factors to acquisition of the infection, diagnostic technique that lead to the diagnosis, presence of eosinophilia and clinical symptoms at diagnosis. Thirty-six studies were included, describing a total of 1083 patients with an average age of 68. 3 years diagnosed with endemic strongyloidiasis in Spain. The vast majority of the cases were described in the province of Valencia (n = 1049). Two hundred and eight of the 251 (82. 9%) patients in whom gender was reported were male, and most of them had current or past dedication to agriculture. Seventy percent had some kind of comorbidity. A decreasing trend in the diagnosed cases per year is observed from the end of last decade. However, there are still nefigw diagnoses of autochthonous cases of strongyloidiasis in Spain every year. With the data provided by this review it is likely that in Spain strongyloidiasis might have been underestimated. It is highly probable that the infection remains undiagnosed in many cases due to low clinical suspicion among Spanish population without recent travel history in which the contagion probably took place decades ago. S. stercoralis is a soil transmitted helminth that is common in many subtropical and tropical countries, but is also found in other regions of the world. In this study we reviewed all published material on endemic infection of S. stercoralis acquired in Spain issued before 31st May 2018. We collected data from these articles and reported clinical and epidemiological characteristics of patients. Our systematic review of the articles showed a clear geographical pattern; nearly 97% of the cases described had been acquired in the Valencia province. Most of them (82. 9%) were male, and most had current or past dedication to agriculture. Our results showed that 70. 3% had at least one condition or treatment that could have made them more vulnerable to suffer a severe form of this helminthic disease. Our data suggests that S. stercoralis infection probably remains underdiagnosed in Spanish population. Due to the scarce information available about endemic strongyloidiasis in Spain until now, we believe that the present work will be relevant and the conclusions derived from it might raise awareness about underdiagnosis. Transmission risk factors described in the people diagnosed may be key for prevention and control strategies implementation.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PLoS neglected tropical diseases, Vol. 13 (march 2019) , ISSN 1935-2735

DOI: 10.1371/journal.pntd.0007230
PMID: 30860995

12 p, 182.8 KB

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