Prevalence of Strongyloides stercoralis and Other Intestinal Parasite Infections in School Children in a Rural Area of Angola: A Cross-Sectional Study

María Luisa Aznar Ruiz de Alegría Hospital Nossa Senhora da Paz, Cubal, Angola;
Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Karen Colmenares Department of Epidemiology, Vall d’Hebron University Hospital, Barcelona, Spain;

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Mateu Espasa Department of Microbiology, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Arancha Amor National Center of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain;
Mundo Sano Foundation, Buenos Aires, Argentina

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Isabel Lopez Department of Microbiology, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Arlette Nindia Hospital Nossa Senhora da Paz, Cubal, Angola;

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Joaquina Kanjala Hospital Nossa Senhora da Paz, Cubal, Angola;

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Domingas Guilherme Hospital Nossa Senhora da Paz, Cubal, Angola;

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Elena Sulleiro Department of Microbiology, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Begoña Barriga Department of Epidemiology, Vall d’Hebron University Hospital, Barcelona, Spain;

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Eva Gil Hospital Nossa Senhora da Paz, Cubal, Angola;

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Fernando Salvador Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Cristina Bocanegra Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Teresa López Hospital Nossa Senhora da Paz, Cubal, Angola;

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Milagros Moreno Hospital Nossa Senhora da Paz, Cubal, Angola;

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Israel Molina Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Barcelona, Spain;

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Strongyloides stercoralis is widely distributed in the tropics and subtropics. The aim of this study was to determine the prevalence of S. stercoralis and other intestinal parasites and identify the risk factors for infection with S. stercoralis in a rural area of Angola. A cross-sectional study was conducted in school-age children (SAC) in Cubal, Angola. A questionnaire collecting clinical and epidemiological variables was used, and two stool samples were collected. A concentration technique (Ritchie) and a technique for detection of larvae migration (Baermann) were performed. Of 230 SAC, 56.1% were female and the mean age was 9.3 years (SD 2.45). Severe malnutrition, according to body mass index (BMI)-for-age, was observed in 20.4% of the SAC, and anemia was found in 59.6%. Strongyloides stercoralis was observed in 28 of the 230 (12.8%) SAC. Eggs of other helminths were observed in 51 (22.2%) students: Hymenolepis spp. in 27 students (11.7%), hookworm in 14 (6.1%), Schistosoma haematobium in four (1.7%), Enterobius vermicularis in four (1.7%), Ascaris lumbricoides in three (1.3%), Taenia spp. in two (0.9%), and Fasciola hepatica in one (0.4%). Protozoa were observed in 17 (7.4%) students. Detection of S. stercoralis was higher using the Baermann technique versus using formol-ether (11.3 vs. 3%). Overall prevalence of S. stercoralis in the school population of 16 studied schools in the municipal area of Cubal was greater than 10%. This fact must be considered when designing deworming mass campaigns. The use of specific tests in larvae detection is needed to avoid overlooking this parasite.

Author Notes

Address correspondence to Fernando Salvador, Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Vall d’Hebron 119-129, Barcelona, Spain 08035. E-mail: fmsalvad@vhebron.net

Financial support: Fundação Mundo Sano. The founder of the study had no role in study design, data collection, data interpretation, or writing of the report. The authors of this article had full access to all data in the study. The corresponding author had the final responsibility for the decision to submit for publication.

Authors’ addresses: María Luisa Aznar Ruiz de Alegría, Arlette Nindia, Joaquina Kanjala, Domingas Guilherme, Eva Gil, Teresa López, and Milagros Moreno, Hospital Nossa Senhora da Paz, Cubal, Angola, E-mails: maznarru@gmail.com, arlettenindia@yahoo.com, joaquinakanjala@yahoo.com, domingasguilherme@yahoo.com, evagilolivas@hotmail.com, materloga2@yahoo.es, and milamor14@yahoo.es. María Luisa Aznar Ruiz de Alegría, Fernando Salvador, Cristina Bocanegra, and Israel Molina, Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS, Passeig de la Vall d'Hebron, Barcelona, Spain, E-mails: maznarru@gmail.com, fmsalvad@vhebron.net, cristinabocanegra@gmail.com, and imolina@vhebron.net. Karen Colmenares and Begoña Barriga, Department of Epidemiology, Vall d’Hebron University Hospital, Passeig de la Vall d'Hebron, Barcelona, Spain, E-mails: karenlcolmenares@gmail.com and bbubed@gmail.com. Mateu Espasa, Isabel Lopez, and Elena Sulleiro, Department of Microbiology, Vall d’Hebron University Hospital, PROSICS, Passeig de la Vall d'Hebron, Barcelona, Spain, E-mails: mespasa@vhebron.net, maibel56@gmail.com, and esulleir@vhebron.net. Arancha Amor, National Center of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain, and Mundo Sano Foundation, Castellana 13, Madrid, Spain, E-mail: aranchazu@gmail.com.

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