Epidemiological aspects of strongyloidiasis in Brazil

• Published in: Parasitology 2011-09, Vol.138 (11), p.1331-1340
• Main Authors: PAULA, F. M., COSTA-CRUZ, J. M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Animals; Antibodies, Helminth - blood; Antibodies, Helminth - immunology; Biological and medical sciences; Brazil - epidemiology; Child; Child, Preschool; Databases, Bibliographic; Enzyme-Linked Immunosorbent Assay; Feces - parasitology; Female; Fluorescent Antibody Technique, Indirect; Fundamental and applied biological sciences. Psychology; General aspects; General aspects and techniques. Study of several systematic groups. Models; Humans; Immunocompromised Host; Immunoglobulin G - blood; Invertebrates; Male; Middle Aged; Parasites; Prevalence; Sensitivity and Specificity; Seroepidemiologic Studies; Serologic Tests; Strongyloides stercoralis - physiology; Strongyloidiasis - diagnosis; Strongyloidiasis - epidemiology; Strongyloidiasis - immunology; Strongyloidiasis - parasitology; Urban areas
• ISSN: 0031-1820; 1469-8161
• DOI: 10.1017/S003118201100120X

The objective of this review was to outline an epidemiological profile of Strongyloides stercoralis by parasitological and serological diagnosis in inhabitants, and to associate this profile with different immunosupression situations, in Brazil, over 20 years (1990–2009). The occurrence of S. stercoralis using parasitological methods was 5·5%, being 4·8% in rural and 5·0% in urban areas, characterizing the country as hyperendemic. There was a diversity of techniques used as a diagnostic tool and only 39·1% of the studies presented results based on at least 1 specific method. The occurrence increased with age, being 12·1%, for those over 60 that suggests an epidemiological condition of concern for the elderly population. Of the seroepidemiological studies in the general population the mean positivity in serum samples was 21·7% and 29·2%, using an immunofluorescence antibody test and enzyme-linked immunosorbent assay (ELISA), respectively. The occurrence of strongyloidiasis in immunosuppressed individuals was 11·8% by parasitological methods and 19·5% using immunological methods. Considering that Brazil is a tropical country and that the character of chronicity and autoinfection of the parasite that can result in severe forms of hyperinfection or dissemination makes strongyloidiasis an important medically and socially neglected problem.