Strongyloidiasis in Ethiopia : Systematic review on risk factors, diagnosis, prevalence and clinical outcomes

Yitagele Terefe, Kirstin Ross, Harriet Whiley

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
4 Downloads (Pure)

Abstract

Background: Strongyloidiasis is a gastrointestinal infection caused by the parasitic nematode Strongyloides stercoralis. It is estimated to infect up to 370 million people globally and is predominately found in tropical and subtropical areas of socioeconomic disadvantage. Main body: This systematic literature review identified studies published in the last ten years on the risk factors, diagnosis, prevalence and/or clinical outcomes of strongyloidiasis in Ethiopia. The prevalence of S. stercoralis ranged from 0.2 to 11.1% in adults, 0.3% to 20.7% in children, 1.5% to 17.3% in HIV positive adults and 5% in HIV positive children. The identified studies primarily used microscopy based techniques that potentially underestimated the prevalence four fold compared with serology and PCR. Strongyloidiasis in children presents a particularly significant issue in Ethiopia as children often presented with anemia, which is associated with impaired mental and cognitive development. The most significant risk factor for strongyloidiasis was HIV status and although other risk factors were identified for helminth infections, none were statistically significant for S. stercoralis specifically. Several studies detected S. stercoralis in dogs and non-biting cyclorrhaphan flies. However, future research is needed to explore the role of these reservoirs in disease transmission. Conclusions: This review demonstrated that strongyloidiasis is an overlooked and neglected disease in Ethiopia. There is a need for a systematic approach using a combination of molecular and serology based diagnostic methods to ascertain the true incidence and burden of strongyloidiasis in Ethiopia. Further research is also needed to break the cycle of transmission by identifying environmental reservoirs, risk factors and exploring the potential for zoonotic transfer.

Original languageEnglish
Article number53
Number of pages11
JournalInfectious Diseases of Poverty
Volume8
Issue number1
DOIs
Publication statusPublished - 14 Jun 2019

Keywords

  • AIDS
  • Anemia
  • HIV
  • Neglected tropical disease
  • Public health
  • Soil transmitted helminth
  • Strongyloides stercoralis

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