Epidemiology of Strongyloides stercoralis and Opisthorchis viverrini infections in northern and northeastern Thailand: Insights from urine-ELISA surveys.

Abstract

Strongyloides stercoralis and Opisthorchis viverrini are helminth parasites responsible for significantly neglected tropical diseases. This study aimed to evaluate the prevalence of these parasites and the risk factors for S. stercoralis and O. viverrini infections in northern and northeastern Thailand where relevant epidemiological data are scarce and outdated. A cross-sectional study was conducted in 2016 in six sub-districts across five provinces. Urine samples were analyzed to detect S. stercoralis and O. viverrini infection using urine enzyme-linked immunosorbent assays (urine-ELISA). Demographic data of participants were collected using a questionnaire. Environmental data, including land-surface temperature (LST), normalized difference vegetation index (NDVI), normalized difference water index (NDWI), and soil pH, were obtained from remote-sensing sources. Multiple logistic regression analysis identified risk factors associated with infection. Complete data were obtained for 2613 individuals. The overall prevalence was 39.15% (95% CI: 37.27-41.02) for S. stercoralis and 37.46% (95% CI: 35.61-39.32) for O. viverrini. Male sex was significantly associated with S. stercoralis (AOR, 1.53; 95% CI, 1.29-1.80, p < 0.001) and O. viverrini infections (AOR, 1.69; 95% CI, 1.43-2.00, p < 0.001). The prevalence of S. stercoralis infection increased with age. Spatially, the odds of S. stercoralis infection decreased with higher LST and soil pH, while O. viverrini infection was associated with higher soil pH and proximity to water bodies. Strongyloides stercoralis and O. viverrini are highly prevalent in these regions, highlighting the need for surveillance.