Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes

IF 6.3 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease Pub Date : 2025-05-14 DOI:10.1016/j.tmaid.2025.102866

Sung-Hsi Huang , Yen-Lin Chen , Hao-Yu Lin , Aristine Cheng , Lih-Yu Chang , Yi-Chia Huang , Po-Hsien Kuo , Yueh-Feng Wen , Chia-Jung Liu , Chia-Hao Chang , Wei-Shun Yang , Kai-Hsiang Chen , Pin-Ru Chu , Chi-Wei Tseng , Yi-Ching Su , Li-Hsin Su , Li-Ta Keng , Chi-Ying Lin , Un-In Wu , Hsin-Yun Sun , Kua-Eyre Su

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引用次数: 0

Abstract

Background

When and how to screen for strongyloidiasis in high-income countries remain to be elucidated. This study aimed to investigate the prevalence, associated factors, and outcome of strongyloidiasis in Taiwan and proposed clinical criteria for serological screening.

Methods

Adults who were immunocompromised or about to undergo iatrogenic immunosuppression (proactive-screening cohort) and those with clinical presentations suggesting strongyloidiasis (diagnosis-driven cohort) were prospectively enrolled at five hospitals in Taiwan. Serum anti-Strongyloides IgG was determined by two enzyme-linked immunosorbent assays (ELISAs). Stool samples were obtained for microscopy and cultures. Prevalence of confirmed/probable strongyloidiasis, as defined by identification of characteristic larvae from stool or testing positive for both ELISAs, was calculated. Factors associated with strongyloidiasis were identified in multivariable analysis. Six-month mortality was compared between participants with and without strongyloidiasis using Cox proportional hazards model.

Results

From January 2021 to June 2024, confirmed/probable cases of strongyloidiasis were identified in 1.9 % and 4.8 % of the participants in proactive-screening and diagnosis-driven cohorts, respectively. Multivariable analysis revealed that skin and skin structure infection (adjusted odds ratio [aOR] 3.180), gastrointestinal bleeding of unknown causes (aOR 3.229), and hemoglobin <10 g/dl (aOR 4.300) were independently associated with strongyloidiasis. Six-month mortality was 33.3 % in participants with confirmed/probable strongyloidiasis, higher than that in those without strongyloidiasis (11.4 %), but not statistically significant after adjusting for age, sex, and clinical severity (p = 0.09).

Conclusions

Strongyloidiasis continued to occur among at-risk populations in Taiwan. Screening strategies are needed to improve the detection of this neglected parasitic infection in Taiwan and other high-income countries.

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在台湾选定人群中筛检类圆线虫病：患病率、相关因素及结果

背景：在高收入国家，何时以及如何筛查类圆线虫病仍有待阐明。本研究旨在探讨台湾蛔虫病的流行、相关因素及转归，并提出血清学筛检的临床标准。方法前瞻性纳入台湾五家医院的免疫功能低下或即将接受医源性免疫抑制的成年人（主动筛查队列）和临床表现为类圆线虫病的成年人（诊断驱动队列）。采用两种酶联免疫吸附法（elisa）检测血清抗类圆线虫IgG。取粪便标本进行显微镜和培养。计算通过粪便特征幼虫鉴定或两种elisa检测均呈阳性来确定的确诊/可能的圆线虫病患病率。在多变量分析中确定了与圆线虫病相关的因素。使用Cox比例风险模型比较有和没有类圆线虫病的参与者的6个月死亡率。结果从2021年1月至2024年6月，在主动筛查和诊断驱动队列中，分别有1.9%和4.8%的参与者确诊/可能的类圆线虫病病例。多变量分析显示，皮肤及皮肤结构感染（调整比值比[aOR] 3.180）、不明原因消化道出血（aOR 3.229）和血红蛋白10 g/dl （aOR 4.300）与类圆线虫病独立相关。确诊或可能患有类圆线虫病的参与者的6个月死亡率为33.3%，高于未患类圆线虫病的参与者（11.4%），但在调整年龄、性别和临床严重程度后无统计学意义（p = 0.09）。结论在台湾地区，类圆线虫病在高危人群中持续存在。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Travel Medicine and Infectious Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-INFECTIOUS DISEASES

CiteScore

19.40

自引率

1.70%

发文量

211

审稿时长

49 days

期刊介绍： Travel Medicine and Infectious Disease Publication Scope: Publishes original papers, reviews, and consensus papers Primary theme: infectious disease in the context of travel medicine Focus Areas: Epidemiology and surveillance of travel-related illness Prevention and treatment of travel-associated infections Malaria prevention and treatment Travellers' diarrhoea Infections associated with mass gatherings Migration-related infections Vaccines and vaccine-preventable disease Global policy/regulations for disease prevention and control Practical clinical issues for travel and tropical medicine practitioners Coverage: Addresses areas of controversy and debate in travel medicine Aims to inform guidelines and policy pertinent to travel medicine and the prevention of infectious disease Publication Features: Offers a fast peer-review process Provides early online publication of accepted manuscripts Aims to publish cutting-edge papers