Human Strongyloidiasis in Hawaii: A Retrospective Review of Enzyme-Linked Immunosorbent Assay Serodiagnostic Testing
| Autor: | Joel D. Brown, Matthew J. Akiyama |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent 030231 tropical medicine Antibodies Helminth Enzyme-Linked Immunosorbent Assay Hawaii Serology Strongyloides stercoralis 03 medical and health sciences Young Adult 0302 clinical medicine Ivermectin Virology Internal medicine Eosinophilia medicine Animals Humans Disseminated disease Serologic Tests 030212 general & internal medicine Child Subclinical infection Aged Retrospective Studies Aged 80 and over Anthelmintics biology business.industry Articles Middle Aged biology.organism_classification medicine.disease Infectious Diseases Strongyloidiasis Immunoglobulin G Strongyloides Parasitology Female medicine.symptom business medicine.drug |
| Zdroj: | The American journal of tropical medicine and hygiene. 99(2) |
| ISSN: | 1476-1645 |
| Popis: | Human strongyloidiasis is widely prevalent in tropical and subtropical regions worldwide but is not endemic in Hawaii. Subclinical, chronic infections may be lifelong; immunosuppressive therapy, particularly with glucocorticoids, may lead to serious or fatal disseminated disease, which is preventable. We performed a retrospective analysis of patients tested for Strongyloides immunoglobulin G antibody in an academic medical center in Honolulu, Hawaii, from 2005 to 2012. Of the 475 patients tested, 78 (16%) were seropositive. The largest proportion of seropositive cases was found among Micronesians (30%), Polynesians (26%), Filipinos (13%), and Southeast Asians (11%). Among the seropositive patients, the most likely reason for clinicians to order testing was blood eosinophilia. Stool parasite examination results were available for 58% of seropositive patients of which 11% were positive for Strongyloides stercoralis larvae. Antihelminthic therapy, usually ivermectin, was ordered for 71% of patients. After treatment, blood eosinophilia and Strongyloides serology results were reassessed for 76% and 35% of patients, respectively; both tests tended to show improvement. Travelers and immigrants from Strongyloides-endemic areas, including Micronesia and Polynesia, should have serodiagnostic testing for latent strongyloidiasis, and if positive, treated empirically with ivermectin, particularly when corticosteroids or other immunosuppressive therapies are anticipated. |
| Databáze: | OpenAIRE |
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