Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-29T07:26:18.978Z Has data issue: false hasContentIssue false
  • English
  • Français

Strongyloides stercoralis larvae excretion patterns before and after treatment

Published online by Cambridge University Press:  17 February 2014

F. SCHÄR ,
J. HATTENDORF ,
V. KHIEU ,
S. MUTH ,
M. C. CHAR ,
H. P. MARTI  and
P. ODERMATT
F. SCHÄR
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
J. HATTENDORF
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
V. KHIEU
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Cambodia
S. MUTH
Affiliation:
National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Cambodia
M. C. CHAR
Affiliation:
National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Cambodia
H. P. MARTI
Affiliation:
University of Basel, Basel, Switzerland Department of Medical Services and Diagnostics, Swiss Tropical and Public Health Institute, Basel, Switzerland
P. ODERMATT*
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland
*
*Corresponding author: Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach 4002 Basel, Switzerland. E-mail: peter.odermatt@unibas.ch
Get access Rights & Permissions [Opens in a new window]

Summary

The variability of larval excretion impedes the parasitological diagnosis of Strongyloides stercoralis in infected individuals. We assessed the number of larvae excreted per gram (LPG) stool in 219 samples from 38 infected individuals over 7 consecutive days before and in 470 samples from 44 persons for 21 consecutive days after ivermectin treatment (200 μg kg−1 BW). The diagnostic sensitivity of a single stool sample was about 75% for individuals with low-intensity infections (⩽1 LPG) and increased to 95% for those with high-intensity infections (⩾10 LPG). Doubling the number of samples examined per person increased sensitivity to more than 95%, even for low-intensity infections. There was no indication of a cyclic excretion of larvae. After treatment, all individuals stopped excreting larvae within 3 days. Larvae were not detected during any of the following 18 days (total 388 Baermann and 388 Koga Agar tests). Two stool samples, collected on consecutive days, are recommended in settings where low or heterogeneous infection intensities are likely. In this way, taking into account the possible biological variability in excretion, the efficacy of ivermectin treatment can be assessed as soon as 4 days after treatment.

Keywords

Strongyloides stercoralislarvae excretionsensitivitytreatmentivermectin
Type
Research Article
Information
Parasitology , Volume 141 , Issue 7 , June 2014 , pp. 892 - 897
Check for updates
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adenusi, A. A., Oke, A. O. and Adenusi, A. O. (2003). Comparison of ivermectin and thiabendazole in the treatment of uncomplicated Strongyloides stercoralis infection. African Journal of Biotechnology 2, 465–469.Google Scholar
Baermann, G. (1917). Eine einfache Methode zur Auffindung von Ankylostomum (Nematoden) Larven in Erdproben. Mededeel mit H. Geneesk Laboratories Weltevreden, Feestbundel, Batavia. 41–47.Google Scholar
Bethony, J., Brooker, S., Albonico, M., Geiger, S. M., Loukas, A., Diemert, D. and Hotez, P. J. (2006). Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367, 1521–1532. doi: 10.1016/S0140-6736(06)68653-4.CrossRefGoogle ScholarPubMed
Dreyer, G., Fernandes-Silva, E., Alves, S., Rocha, A., Albuquerque, R. and Addiss, D. (1996). Patterns of detection of Strongyloides stercoralis in stool specimens: implications for diagnosis and clinical trials. Journal of Clinical Microbiology 34, 2569–2571.CrossRefGoogle ScholarPubMed
Genta, R. M. (1989). Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease. Reviews in Infectious Diseases 11, 755–767.CrossRefGoogle ScholarPubMed
Grove, D. I. (1982). Treatment of strongyloidiasis with thiabendazole: an analysis of toxicity and effectiveness. Transactions of the Royal Society of Tropical Medicine and Hygiene 76, 114–118.CrossRefGoogle ScholarPubMed
Heukelbach, J., Wilcke, T., Winter, B., Sales de Oliveira, F. A., Saboia Moura, R. C., Harms, G., Liesenfeld, O. and Feldmeier, H. (2004). Efficacy of ivermectin in a patient population concomitantly infected with intestinal helminths and ectoparasites. Arzneimittelforschung 54, 416–421.Google Scholar
Igual-Adell, R., Oltra-Alcaraz, C., Soler-Company, E., Sanchez-Sanchez, P., Matogo-Oyana, J. and Rodriguez-Calabuig, D. (2004). Efficacy and safety of ivermectin and thiabendazole in the treatment of strongyloidiasis. Expert Opinion on Pharmacotherapy 5, 2615–2619. doi: 10.1517/14656566.5.12.2615.CrossRefGoogle ScholarPubMed
Jones, C. A. (1950). Clinical studies in human strongyloidiasis. I. Semeiology. Gastroenterology 16, 743–756.CrossRefGoogle ScholarPubMed
Jones, C. A. and Abadie, S. H. (1954). Studies in human strongyloidiasis. II. A comparison of the efficiency of diagnosis by examination of feces and duodenal fluid. American Journal of Clinical Pathology 24, 1154–1158.CrossRefGoogle Scholar
Khieu, V., Schär, F., Marti, H., Sayasone, S., Duong, S., Muth, S. and Odermatt, P. (2013). Diagnosis, treatment and risk factors of Strongyloides stercoralis in schoolchildren in Cambodia. PLoS Neglected Tropical Diseases 7, e2035. doi: 10.1371/journal.pntd.0002035.CrossRefGoogle ScholarPubMed
Knopp, S., Mgeni, A. F., Khamis, I. S., Steinmann, P., Stothard, J. R., Rollinson, D., Marti, H. and Utzinger, J. (2008). Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PLoS Neglected Tropical Diseases 2, e331. doi: 10.1371/journal.pntd.0000331.CrossRefGoogle ScholarPubMed
Koga, K., Kasuya, S., Khamboonruang, C., Sukhavat, K., Ieda, M., Takatsuka, N., Kita, K. and Ohtomo, H. (1991). A modified agar plate method for detection of Strongyloides stercoralis . American Journal of Tropical Medicine and Hygiene 45, 518–521.CrossRefGoogle ScholarPubMed
Leighton, P. M. and MacSween, H. M. (1990). Strongyloides stercoralis. The cause of an urticarial-like eruption of 65 years’ duration. Archives of Internal Medicine 150, 1747–1748.CrossRefGoogle ScholarPubMed
Lovis, L., Mak, T. K., Phongluxa, K., Aye Soukhathammavong, P., Vonghachack, Y., Keiser, J., Vounatsou, P., Tanner, M., Hatz, C., Utzinger, J., Odermatt, P. and Akkhavong, K. (2012). Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial. PLoS Neglected Tropical Diseases 6, e1726. doi: 10.1371/journal.pntd.0001726.CrossRefGoogle ScholarPubMed
Marti, H. and Koella, J. C. (1993). Multiple stool examinations for ova and parasites and rate of false-negative results. Journal of Clinical Microbiology 31, 3044–3045.CrossRefGoogle ScholarPubMed
Marti, H., Haji, H. J., Savioli, L., Chwaya, H. M., Mgeni, A. F., Ameir, J. S. and Hatz, C. (1996). A comparative trial of a single-dose ivermectin versus three days of albendazole for treatment of Strongyloides stercoralis and other soil-transmitted helminth infections in children. American Journal of Tropical Medicine and Hygiene 55, 477–481.CrossRefGoogle ScholarPubMed
Olsen, A., van Lieshout, L., Marti, H., Polderman, T., Polman, K., Steinmann, P., Stothard, R., Thybo, S., Verweij, J. J. and Magnussen, P. (2009). Strongyloidiasis – the most neglected of the neglected tropical diseases? Transactions of the Royal Society of Tropical Medicine and Hygiene 103, 967–972. doi: 10.1016/j.trstmh.2009.02.013.CrossRefGoogle ScholarPubMed
Ordonez, L. E. and Angulo, E. S. (2004). Efficacy of ivermectin in the treatment of children parasitized by Strongyloides stercoralis . Biomedica 24, 33–41.CrossRefGoogle ScholarPubMed
Requena-Mendez, A., Chiodini, P., Bisoffi, Z., Buonfrate, D., Gotuzzo, E. and Munoz, J. (2013). The laboratory diagnosis and follow up of strongyloidiasis: a systematic review. PLoS Neglected Tropical Diseases 7, e2002. doi: 10.1371/journal.pntd.0002002.CrossRefGoogle ScholarPubMed
Satoh, M. and Kokaze, A. (2004). Treatment strategies in controlling strongyloidiasis. Expert Opinion on Pharmacotherapy 5, 2293–2301. doi: 10.1517/14656566.5.11.2293.CrossRefGoogle ScholarPubMed
Schär, F., Trostdorf, U., Giardina, F., Khieu, V., Muth, S., Marti, H., Vounatsou, P. and Odermatt, P. (2013). Strongyloides stercoralis: global distribution and risk factors. PLoS Neglected Tropical Diseases 7, e2288. doi: 10.1371/journal.pntd.0002288.CrossRefGoogle ScholarPubMed
Suputtamongkol, Y., Premasathian, N., Bhumimuang, K., Waywa, D., Nilganuwong, S., Karuphong, E., Anekthananon, T., Wanachiwanawin, D. and Silpasakorn, S. (2011). Efficacy and safety of single and double doses of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS Neglected Tropical Diseases 5, e1044. doi: 10.1371/journal.pntd.0001044.CrossRefGoogle ScholarPubMed
Toma, H., Sato, Y., Shiroma, Y., Kobayashi, J., Shimabukuro, I. and Takara, M. (2000). Comparative studies on the efficacy of three anthelminthics on treatment of human strongyloidiasis in Okinawa, Japan. Southeast Asian Journal of Tropical Medicine and Public Health 31, 147–151.Google ScholarPubMed
Uparanukraw, P., Phongsri, S. and Morakote, N. (1999). Fluctuations of larval excretion in Strongyloides stercoralis infection. American Journal of Tropical Medicine and Hygiene 60, 967–973.CrossRefGoogle ScholarPubMed