https://www.amjmed.com/article/S0002-9343(07)00271-9/pdf

Maltreatment of Strongyloides infection: Case series and worldwide physicians-in-training survey

Strongyloidiasis is a disease caused by soil transmitted helminths of the Strongyloides genus. Currently, it is predominately described as a neglected tropical disease. However, this description is misleading as it focuses on the geographical location of the disease and not the primary consideration, which is the socioeconomic conditions and poor infrastructure found within endemic regions. This classification may result in misdiagnosis and mistreatment by physicians, but more importantly, it influences how the disease is fundamentally viewed. Strongyloidiasis must be first and foremost considered as a disease of disadvantage, to ensure the correct strategies and control measures are used to prevent infection. Changing how strongyloidiasis is perceived from a geographic and clinical issue to an environmental health issue represents the first step in identifying appropriate long term control measures. This includes emphasis on environmental health controls, such as better infrastructure, sanitation and living conditions. This review explores the global prevalence of strongyloidiasis in relation to its presence in subtropical, tropical and temperate climate zones with mild and cold winters, but also explores the corresponding socioeconomic conditions of these regions. The evidence shows that strongyloidiasis is primarily determined by the socioeconomic status of the communities rather than geographic or climatic conditions. It demonstrates that strongyloidiasis should no longer be referred to as a "tropical" disease but rather a disease of disadvantage. This philosophical shift will promote the development of correct control strategies for preventing this disease of disadvantage.

https://www.mdpi.com/1660-4601/13/5/517/pdf

Strongyloidiasis: A Disease of Socioeconomic Disadvantage.

The stools of 697 cases were examined by agar plate technique at Tambon Makam Luang, Sun Pa Tong district, Chiang Mai; there were Strongyloides stercoralis 15.9%,Opisthorchis viverrini 5.1%, intestinal fluke 0.1%. Treatment with ivermectin 78 cases and albendazole 33 cases of strongyloidiasis gave cure rates at 98.7% and 78.7%, respectively. Alkaline phosphatase in some patients were increased at mild level after treatment. Side effects in ivermectin group were anorexia, nausia, diarrhea, diffuse itching and drowsiness; and in albendazole group were nausia and diarrhea. The efficacy of single dose and mild side effects suggest ivermectin as drug of choice for strongyloidiasis treatment.

Prevalence of strongyloides in northern Thailand and treatment with ivermectin vs albendazole

Strongyloides colitis is a lethal mimic of ulcerative colitis: the key morphologic differential diagnosis

We assessed the frequency and distribution of infection with opportunistic and non-op- portunistic intestinal parasites and the liver fluke, Opisthorchis viverrini, in HIV-seropositive and HIV- seronegative subjects. Age- and sex-matched HIV-seropositive (n=78) and HIV-seronegative pa- tients (n=78) from two hospitals in Khon Kaen Province, Thailand, participated in this study from November 1998 to August 2000. These subjects were divided according to the presence of diarrhea and CD4 counts. A single stool sample was obtained and analyzed by using specific techniques. Opisthorchis viverrini, was the most common parasite (19.2%) in each group. The prevalence rates of Cryptosporidium spp (11.5%) and Strongyloides stercoralis (17.9%) in the HIV-seropositive group were significantly (p<0.05) higher than those in the HIV-seronegative group (1.0% for Cryptosporidium spp and 7.7% for S. stercoralis infections). The prevalences of these two parasites were 28% for Cryptosporidium spp and 20% for S. stercoralis in HIV-seropositives with diarrhea and CD4 counts lower than 100 cells/mm 3 , and were higher compared with patients without diarrhea or with high CD4 counts. These results suggest that infection with these parasites increases during HIV infec- tion. The epidemiological distribution of Cryptosporidium and S. stercoralis may have implications for AIDS-related diseases.

Detection of opportunistic and non-opportunistic intestinal parasites and liver flukes in HIV-positive and HIV-negative subjects.

PEWPAN M INTAPAN, MD, MSc**, 
SOMSAK NILPAN, MSc***, 
SUPRANEE VEERAKUL, BSc*****, 
The prevalence of 
Strongyloides stercora/is 
infection was studied in the rural and urban popu- 
lations of 19 provinces of Northeastern Thailand. A total of 1233 fecal samples was collected from July 
to September 2002 and examined using agar plate culture method. The overall prevalence of 
S. sterco- 
ra/is 
was 23.5 per cent with the highest infection rate in Kalasin Province (61.0%), predominantly 
among 60 year olds and older (28.0%), and in males (32.8%). The factors associated with 
Strongyloides 
infection were sex (males) and age (the over 19 year-old age group). 
Conclusion : 
S. stercora/is 
infection remains highly prevalent among the population of north- 
eastern Thailand as confirmed by the agar plate culture method. The authors recommend that a pro- 
gram for effective strongyloidiasis control should have a justifiable priority. 
Key word : 
Strongyloides stercora/is, 
Northeastern Thailand, Agar Plate Culture

Prevalence of Strongyloides stercoralis infection in northeastern Thailand (agar plate culture detection).

The objective of this investigation was to assess the effectiveness of helminthiasis control in the year 2001, which was the final year of the 8 th Health Development Plan Data were collected to determine the prevalence and intensity of liverfluke and hookworm infections Thirty-cluster sampling was carried out in each of 12 public health regions, obtaining a total of 14,400 individual samples Kato’s thick smear and Kato-Katz’s methods were used to diagnose helminth infection Data concerning health behavior assessment were collected through interviews with the same sample group designated for stool examination The results obtained showed that the areas with liverfluke prevalence higher than the target set by the Ministry of Public Health were in regions 5, 6, 7, 9, and 10 with the average prevalences at 133, 161, 166, 206, and 263%, respectively The intensities of liverfluke infections in all regions were mostly at low and moderate levels The areas with higher prevalence of hookworm infections than the 8 th Health Development Plan were regions 3, 4, 7, 8, 9, 11, and 12 with averages of 129, 110, 116, 103, 116, 197, and 211%, respectively The intensities were mostly at low and moderate levels The health risk behavior among the population was the consumption of liverfluke risk foods, which were raw or improperly cooked freshwater fish The occasional consumption and frequent consumption rates were between 150-598%, while the percentage of hookworm health risk behaviors ie the habit of wearing inappropriate footwear, was 265, and the percentage of those who defecated outside the latrine, inducing hookworm transmission, was 391 In addition, it was also found that 682% of the samples had experience with stool examination and 716% of them had never before taken any anthelminthic drug The data obtained from this assessment firmly indicated that both liverfluke and hookworm infection remained significant public health problems in certain areas of Thailand A better targeted planning approach is strongly recommended, together with adequate resource allocation and sufficient staff development for effective implementation Community participation is also needed for the accomplishment of sustainable helminthiasis control Keywords : liverfluke infection, hookworm infection, prevalence rate, intensity, health risk behavior

Praphasri Jongsuksuntigul

Papers

Prevalence of Strongyloides stercoralis infection in northeastern Thailand (agar plate culture detection).

Evaluation of the Helminthiasis Control Program in Thailand at the End of the 8th Health Development Plan, 2001