Strongyloides seroprevalence in patients with advanced chronic kidney disease at a tertiary hospital in Malaysia: Epidemiological profiles and comparison of two assays

IF 2.4 Q3 INFECTIOUS DISEASES

Parasite Epidemiology and Control Pub Date : 2025-09-19 DOI:10.1016/j.parepi.2025.e00458

Emelia Osman , Rahmah Noordin , Rozita Mohd , Lydia Kamaruzaman , Siti Nor Azreen Abdul Manap , S. Izuddin Mohd. Zali , Nur Afrina Azhar , Nor Suhada Anuar

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引用次数: 0

Abstract

Strongyloides stercoralis infection poses significant risks to individuals with suppressed immune systems, including patients with chronic kidney disease (CKD). However, data on its prevalence in this population, particularly in Southeast Asia, remains scarce. This study aimed to determine the seroprevalence using two assays, as well as to describe its epidemiological characteristics and associated laboratory parameters among patients with advanced CKD at a tertiary hospital in Kuala Lumpur, Malaysia. A total of 220 patients with stages 4 and 5 CKD were recruited. Serum samples were screened using a commercial IgG-ELISA (Bordier) and an IgG4-based rapid diagnostic test (IgG4-RDT). Epidemiological and clinical data were collected through structured interviews and medical records. The overall S. stercoralis seroprevalence was 44 %, with 41.8 % detected by IgG4-RDT and 6.8 % by IgG-ELISA, showing only slight agreement (κ = 0.2). These findings suggest that, despite the impaired humoral immunity typically observed in advanced CKD patients, specific IgG4 responses remain sufficiently detectable. It may reflect both a relatively preserved IgG4 response and the higher sensitivity of the IgG4-based assay in this population. No significant associations were found between seropositivity and demographic, socioeconomic, lifestyle, or laboratory parameters. However, cough was significantly associated with seropositivity. The results highlight a potentially underrecognized burden of Strongyloides infection among Malaysian CKD patients. Incorporating serological screening, particularly with the IgG4-RDT, into nephrology care may facilitate early detection and better management. Future studies are warranted to assess treatment outcomes and preventive strategies, including ivermectin prophylaxis.

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马来西亚一家三级医院晚期慢性肾病患者的血清类圆线虫患病率：流行病学概况和两种检测方法的比较

粪类圆线虫感染对免疫系统受到抑制的个体，包括慢性肾脏疾病（CKD）患者具有重大风险。然而，在这一人群中，特别是在东南亚，关于其流行情况的数据仍然很少。本研究旨在通过两种检测方法确定马来西亚吉隆坡一家三级医院晚期CKD患者的血清患病率，并描述其流行病学特征和相关实验室参数。共招募了220名4期和5期CKD患者。使用商用IgG-ELISA （Bordier）和基于igg4的快速诊断试验（IgG4-RDT）筛选血清样本。通过结构化访谈和医疗记录收集流行病学和临床数据。血清总阳性率为44%，其中IgG4-RDT检测阳性率为41.8%，IgG-ELISA检测阳性率为6.8%，两者差异有统计学意义（κ = 0.2）。这些发现表明，尽管在晚期CKD患者中通常观察到体液免疫受损，但特异性IgG4反应仍然可以充分检测到。这可能反映了相对保存的IgG4反应和在该人群中基于IgG4的检测的更高灵敏度。血清阳性与人口统计学、社会经济、生活方式或实验室参数之间未发现显著关联。然而，咳嗽与血清阳性显著相关。结果强调了马来西亚CKD患者中潜在的未被充分认识的圆形线虫感染负担。将血清学筛查，特别是IgG4-RDT筛查纳入肾脏病护理可能有助于早期发现和更好的管理。未来的研究有必要评估治疗结果和预防策略，包括伊维菌素预防。

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.