Vadlamudi RS , Chi DS , Krishnaswamy G , 2006. Intestinal strongyloidiasis and hyperinfection syndrome. Clin Mol Allergy 4: 8.
Fardet L , Généreau T , Cabane J , Kettaneh A , 2006. Severe strongyloidiasis in corticosteroid-treated patients. Clin Microbiol Infect 12: 945–947.
Buonfrate D et al., 2020. The global prevalence of Strongyloides stercoralis infection. Pathogens 9: 468.
Ashiri A , Rafiei A , Beiromvand M , Khanzadeh A , Alghasi A , 2021. Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, southwestern Iran. Parasit Vectors 14: 37.
Schär F , Trostdorf U , Giardina F , Khieu V , Muth S , Marti H , Vounatsou P , Odermatt P , 2013. Strongyloides stercoralis: global distribution and risk factors. PLoS Negl Trop Dis 7: e2288.
Wongsaroj T , Nithikathkul C , Rojkitikul W , Nakai W , Royal L , Rammasut P , 2014. National survey of helminthiasis in Thailand. Asian Biomed 8: 779–783.
Laoraksawong P , Sanpool O , Rodpai R , Thanchomnang T , Kanarkard W , Maleewong W , Kraiklang R , Intapan PM , 2018. Current high prevalences of Strongyloides stercoralis and Opisthorchis viverrini infections in rural communities in northeast Thailand and associated risk factors. BMC Public Health 18: 940.
Barros N , Montes M , 2014. Infection and hyperinfection with Strongyloides stercoralis: clinical presentation, etiology of disease, and treatment options. Curr Trop Med Rep 1: 223–228.
Vasquez-Rios G , Pineda-Reyes R , Pineda-Reyes J , Marin R , Ruiz EF , Terashima A , 2019. Strongyloides stercoralis hyperinfection syndrome: a deeper understanding of a neglected disease. J Parasit Dis 43: 167–175.
Shorman M , Al-Tawfiq JA , 2009. Strongyloides stercoralis hyperinfection presenting as acute respiratory failure and gram-negative sepsis in a patient with astrocytoma. Int J Infect Dis 13: e288–e291.
Requena-Méndez A , Chiodini P , Bisoffi Z , Buonfrate D , Gotuzzo E , Muñoz J , 2013. The laboratory diagnosis and follow up of strongyloidiasis: a systematic review. PLoS Negl Trop Dis 7: e2002.
Paragliola RM , Papi G , Pontecorvi A , Corsello SM , 2017. Treatment with synthetic glucocorticoids and the hypothalamus-pituitary-adrenal axis. Int J Mol Sci 18: 2201.
Suputtamongkol Y et al., 1999. Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis 29: 408–413.
Suputtamongkol Y , Premasathian N , Bhumimuang K , Waywa D , Nilganuwong S , Karuphong E , Anekthananon T , Wanachiwanawin D , Silpasakorn S , 2011. Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Negl Trop Dis 5: e1044.
Muñoz J , Gomez-Junyent J , Bisoffi Z , Buonfrate D , Zammarchi L , Requena-Méndez A , 2017. Evidence-based guidelines for screening and management of strongyloidiasis in non-endemic countries. Am J Trop Med Hyg 97: 645–652.
Carnino L , Schwob JM , Gétaz L , Nickel B , Neumayr A , Eperon G , 2021. A practical approach to screening for Strongyloides stercoralis. Trop Med Infect Dis 6: 203.
Czeresnia JM , Weiss LM , 2022. Strongyloides stercoralis. Lung 200: 141–148.
Prabha N , Chhabra N , 2018. Prevention of Strongyloides stercoralis hyperinfection in leprosy patients on long-term steroid therapy. Indian J Dermatol Venereol Leprol 84: 709–711.
Mejia R , Nutman TB , 2012. Screening, prevention, and treatment for hyperinfection syndrome and disseminated infections caused by Strongyloides stercoralis. Curr Opin Infect Dis 25: 458–463.
Roxby AC , Gottlieb GS , Limaye AP , 2009. Strongyloidiasis in transplant patients. Clin Infect Dis 49: 1411–1423.
Jongwutiwes U , Waywa D , Silpasakorn S , Wanachiwanawin D , Suputtamongkol Y , 2014. Prevalence and risk factors of acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in Thailand. Pathog Glob Health 108: 137–140.
Portugal R , Schaffel R , 2002. Thiabendazole for the prophylaxis of strongyloidiasis in immunosuppressed patients with hematologic diseases: a randomized, double-blind placebo-controlled study. Haematologica 87: 663–664.
Sithithaworn P , Srisawangwong T , Tesana S , Daenseekaew W , Sithithaworn J , Fujimaki Y , Ando K , 2003. Epidemiology of Strongyloides stercoralis in north-east Thailand: application of the agar plate culture technique compared with the enzyme-linked immunosorbent assay. Trans R Soc Trop Med Hyg 97: 398–402.
Khadka P , Khadka P , Thapaliya J , Karkee DB , 2018. Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease. JMM Case Rep 5: e005165.
Maslamani MAA , Soub HAA , Khattab JA , Chacko KC , 2009. Strongyloides stercoralis hyperinfection after corticosteroid therapy: a report of two cases. Ann Saudi Med 29: 397–401.
Buonfrate D , Requena-Mendez A , Angheben A , Muñoz J , Gobbi F , Van Den Ende J , Bisoffi Z , 2013. Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13: 78.
Bisoffi Z , Buonfrate D , Angheben A , Boscolo M , Anselmi M , Marocco S , Monteiro G , Gobbo M , Bisoffi G , Gobbi F , 2011. Randomized clinical trial on ivermectin versus thiabendazole for the treatment of strongyloidiasis. PLoS Negl Trop Dis 5: e1254.
Watts L , Meis G , Conger N , Lindholm DA , Glenn K , 2017. Case report: a case of recurrent Strongyloides stercoralis colitis in a patient with multiple myeloma. Am J Trop Med Hyg 97: 1619–1622.
Krishnan S , Barger G , Chandrasekar P , 2006. Recurrent Strongyloides stercoralis hyperinfection syndrome: case report and a brief review. Infect Dis Clin Pract 14: 240–243.
Keiser PB , Nutman TB , 2004. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 17: 208–217.
Prendki V , Fenaux P , Durand R , Thellier M , Bouchaud O , 2011. Strongyloidiasis in man 75 years after initial exposure. Emerg Infect Dis 17: 931–932.
Luvira V , Watthanakulpanich D , Pittisuttithum P , 2014. Management of Strongyloides stercoralis: a puzzling parasite. Int Health 6: 273–281.
Zaha O , Hirata T , Kinjo F , Saito A , Fukuhara H , 2002. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 8: 94–98.
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People living in areas endemic for strongyloidiasis are at risk of latent Strongyloides stercoralis infection. Corticosteroid therapy is a well-established risk factor for life-threatening hyperinfection syndrome and disseminated disease owing to suppression of the immune system. There are limited data available on the efficacy and cost of providing oral ivermectin prophylaxis to all patients receiving high-dose corticosteroids for strongyloidiasis in endemic areas. We thus conducted this retrospective cohort study at Khon Kaen University’s Srinagarind Hospital from 2015 to 2019. Inclusion criteria were as follows: age ≥ 18 years, having received ≥ 0.5 mg/kg/day of prednisolone or equivalent for at least 14 days, and hospitalization during the study period. A total of 250 patients were included in the study: 125 in the empirical prophylaxis group (prescribed ivermectin even if fecal examination results were negative or nonexistent) and the remaining patients in the definite therapy group (prescribed ivermectin only if S. stercoralis was detected by fecal examination). The prevalence of strongyloidiasis at enrollment estimated by fecal examination was 5.5%. Ivermectin was given to 125 patients (100%) in the prophylaxis group compared with 12 (9.6%) in the definite therapy group (P value < 0.001). During the 12-month follow-up period, S. stercoralis was detected in three patients, two in the prophylaxis group and one in the definite therapy group (P value = 1.000). No cases of hyperinfection syndrome or disseminated disease were found. The empirical prophylaxis strategy had a significantly higher cost than the definite therapy strategy (563 versus 254, P value < 0.001) and did not demonstrate superior efficacy in strongyloidiasis prevention.
Authors’ addresses: Akedanai Yongbantom and Natapong Manomaiwong, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mails: Akedanai@kkumail.com and Natapong.man@hotmail.com. Wantin Sribenjalux and Atibordee Meesing, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, and Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand, E-mails: wantinmd34@gmail.com or wantsr@kku.ac.th and Atibordee@hotmail.com.
Vadlamudi RS , Chi DS , Krishnaswamy G , 2006. Intestinal strongyloidiasis and hyperinfection syndrome. Clin Mol Allergy 4: 8.
Fardet L , Généreau T , Cabane J , Kettaneh A , 2006. Severe strongyloidiasis in corticosteroid-treated patients. Clin Microbiol Infect 12: 945–947.
Buonfrate D et al., 2020. The global prevalence of Strongyloides stercoralis infection. Pathogens 9: 468.
Ashiri A , Rafiei A , Beiromvand M , Khanzadeh A , Alghasi A , 2021. Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, southwestern Iran. Parasit Vectors 14: 37.
Schär F , Trostdorf U , Giardina F , Khieu V , Muth S , Marti H , Vounatsou P , Odermatt P , 2013. Strongyloides stercoralis: global distribution and risk factors. PLoS Negl Trop Dis 7: e2288.
Wongsaroj T , Nithikathkul C , Rojkitikul W , Nakai W , Royal L , Rammasut P , 2014. National survey of helminthiasis in Thailand. Asian Biomed 8: 779–783.
Laoraksawong P , Sanpool O , Rodpai R , Thanchomnang T , Kanarkard W , Maleewong W , Kraiklang R , Intapan PM , 2018. Current high prevalences of Strongyloides stercoralis and Opisthorchis viverrini infections in rural communities in northeast Thailand and associated risk factors. BMC Public Health 18: 940.
Barros N , Montes M , 2014. Infection and hyperinfection with Strongyloides stercoralis: clinical presentation, etiology of disease, and treatment options. Curr Trop Med Rep 1: 223–228.
Vasquez-Rios G , Pineda-Reyes R , Pineda-Reyes J , Marin R , Ruiz EF , Terashima A , 2019. Strongyloides stercoralis hyperinfection syndrome: a deeper understanding of a neglected disease. J Parasit Dis 43: 167–175.
Shorman M , Al-Tawfiq JA , 2009. Strongyloides stercoralis hyperinfection presenting as acute respiratory failure and gram-negative sepsis in a patient with astrocytoma. Int J Infect Dis 13: e288–e291.
Requena-Méndez A , Chiodini P , Bisoffi Z , Buonfrate D , Gotuzzo E , Muñoz J , 2013. The laboratory diagnosis and follow up of strongyloidiasis: a systematic review. PLoS Negl Trop Dis 7: e2002.
Paragliola RM , Papi G , Pontecorvi A , Corsello SM , 2017. Treatment with synthetic glucocorticoids and the hypothalamus-pituitary-adrenal axis. Int J Mol Sci 18: 2201.
Suputtamongkol Y et al., 1999. Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis 29: 408–413.
Suputtamongkol Y , Premasathian N , Bhumimuang K , Waywa D , Nilganuwong S , Karuphong E , Anekthananon T , Wanachiwanawin D , Silpasakorn S , 2011. Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Negl Trop Dis 5: e1044.
Muñoz J , Gomez-Junyent J , Bisoffi Z , Buonfrate D , Zammarchi L , Requena-Méndez A , 2017. Evidence-based guidelines for screening and management of strongyloidiasis in non-endemic countries. Am J Trop Med Hyg 97: 645–652.
Carnino L , Schwob JM , Gétaz L , Nickel B , Neumayr A , Eperon G , 2021. A practical approach to screening for Strongyloides stercoralis. Trop Med Infect Dis 6: 203.
Czeresnia JM , Weiss LM , 2022. Strongyloides stercoralis. Lung 200: 141–148.
Prabha N , Chhabra N , 2018. Prevention of Strongyloides stercoralis hyperinfection in leprosy patients on long-term steroid therapy. Indian J Dermatol Venereol Leprol 84: 709–711.
Mejia R , Nutman TB , 2012. Screening, prevention, and treatment for hyperinfection syndrome and disseminated infections caused by Strongyloides stercoralis. Curr Opin Infect Dis 25: 458–463.
Roxby AC , Gottlieb GS , Limaye AP , 2009. Strongyloidiasis in transplant patients. Clin Infect Dis 49: 1411–1423.
Jongwutiwes U , Waywa D , Silpasakorn S , Wanachiwanawin D , Suputtamongkol Y , 2014. Prevalence and risk factors of acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in Thailand. Pathog Glob Health 108: 137–140.
Portugal R , Schaffel R , 2002. Thiabendazole for the prophylaxis of strongyloidiasis in immunosuppressed patients with hematologic diseases: a randomized, double-blind placebo-controlled study. Haematologica 87: 663–664.
Sithithaworn P , Srisawangwong T , Tesana S , Daenseekaew W , Sithithaworn J , Fujimaki Y , Ando K , 2003. Epidemiology of Strongyloides stercoralis in north-east Thailand: application of the agar plate culture technique compared with the enzyme-linked immunosorbent assay. Trans R Soc Trop Med Hyg 97: 398–402.
Khadka P , Khadka P , Thapaliya J , Karkee DB , 2018. Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary disease. JMM Case Rep 5: e005165.
Maslamani MAA , Soub HAA , Khattab JA , Chacko KC , 2009. Strongyloides stercoralis hyperinfection after corticosteroid therapy: a report of two cases. Ann Saudi Med 29: 397–401.
Buonfrate D , Requena-Mendez A , Angheben A , Muñoz J , Gobbi F , Van Den Ende J , Bisoffi Z , 2013. Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13: 78.
Bisoffi Z , Buonfrate D , Angheben A , Boscolo M , Anselmi M , Marocco S , Monteiro G , Gobbo M , Bisoffi G , Gobbi F , 2011. Randomized clinical trial on ivermectin versus thiabendazole for the treatment of strongyloidiasis. PLoS Negl Trop Dis 5: e1254.
Watts L , Meis G , Conger N , Lindholm DA , Glenn K , 2017. Case report: a case of recurrent Strongyloides stercoralis colitis in a patient with multiple myeloma. Am J Trop Med Hyg 97: 1619–1622.
Krishnan S , Barger G , Chandrasekar P , 2006. Recurrent Strongyloides stercoralis hyperinfection syndrome: case report and a brief review. Infect Dis Clin Pract 14: 240–243.
Keiser PB , Nutman TB , 2004. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 17: 208–217.
Prendki V , Fenaux P , Durand R , Thellier M , Bouchaud O , 2011. Strongyloidiasis in man 75 years after initial exposure. Emerg Infect Dis 17: 931–932.
Luvira V , Watthanakulpanich D , Pittisuttithum P , 2014. Management of Strongyloides stercoralis: a puzzling parasite. Int Health 6: 273–281.
Zaha O , Hirata T , Kinjo F , Saito A , Fukuhara H , 2002. Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart. J Infect Chemother 8: 94–98.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 515 | 515 | 62 |
Full Text Views | 404 | 404 | 38 |
PDF Downloads | 197 | 197 | 7 |