Field survey for strongyloidiasis in eastern Uganda with observations on efficacy of preventive chemotherapy and co-occurrence of soil-transmitted helminthiasis/intestinal schistosomiasis

Journal of Helminthology - Tập 85 Số 3 - Trang 325-333 - 2011
José Carlos Sousa-Figueiredo1,2, Matthew Day3, Martha Betson2, C. H. F. Rowell4, Aidah Wamboko4, Moses Arinaitwe4, Francis Kazibwe4, N.B. Kabatereine4, J. Russell Stothard2
1Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, LondonWC1E 7HT, United Kingdom
2WHO Collaborating Centre Schistosomiasis, Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, LondonSW7 5BD, United Kingdom
3Faculty of Medicine, University of Dundee, Nethergate, DundeeDD1 4HH, United Kingdom
4Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda

Tóm tắt

AbstractFollowing our previous field surveys for strongyloidiasis in western Uganda, 120 mothers and 232 children from four villages in eastern Uganda were examined, with two subsequent investigative follow-ups. As before, a variety of diagnostic methods were used: Baermann concentration, Koga agar plate and strongyloidid enzyme-linked immunosorbent assay (ELISA), as well as Kato–Katz faecal smears for detection of eggs of other helminths. At baseline, the general prevalence ofStrongyloides stercoraliswas moderate: 5.4% as estimated by Baermann and Koga agar methods combined. A much higher estimate was found by ELISA (42.3%) which, in this eastern setting, appeared to be confounded by putative cross-reaction(s) with other nematode infections. Preventive chemotherapy using praziquantel and albendazole was offered to all participants at baseline. After 21 days the first follow-up was conducted and ‘cure rates’ were calculated for all parasites encountered. Eleven months later, the second follow-up assessed longer-term trends. Initial treatments had little, if any, effect onS. stercoralis,and did not alter local prevalence, unlike hookworm infections and intestinal schistosomiasis. We propose that geographical patterns of strongyloidiasis are likely not perturbed by ongoing praziquantel/albendazole campaigns. Antibody titres increased after the first follow-up then regressed towards baseline levels upon second inspection. To better define endemic areas forS. stercoralis, careful interpretation of the ELISA is warranted, especially where diagnosis is likely being confounded by polyparasitism and/or other treatment regimens; new molecular screening tools are clearly needed.

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Thông tin xuất bản

Journal of Helminthology

Tập 85 Số 3

325-333

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