Shield Jennifer M, Page Wendy
Aboriginal Resource and Development Services and Miwatj Health Aboriginal Corporation, Nhulunbuy, Northern Territory, Australia.
P N G Med J. 2008 Sep-Dec;51(3-4):105-19.
Strongyloides stercoralis is endemic in tropical and subtropical countries, and is prevalent particularly in economically impoverished people. Although an estimated 30 to 100 million people world-wide suffer from S. stercoralis infection and it is a life-long disease, it remains a neglected tropical disease. Faecal testing for S. stercoralis is very insensitive. The prevalence of S. stercoralis in Indigenous Australians (up to 60%) is much higher than previously thought, and its prevalence in Papua New Guinea is likely to be much higher than currently believed. When S. stercoralis and the HTLV-1 virus coexist in the one person, both diseases progress more quickly than when either infection is on its own. When people become infected with S. stercoralis, they develop acute strongyloidiasis which may be life threatening. At any time during the course of the disease, if the immune system is suppressed, most often by corticosteroid drugs, infected people may develop hyperinfective strongyloidiasis and they will die unless the underlying S. stercoralis infection is effectively treated. The use of serology for diagnosis, together with ivermectin treatment, has revealed that it is possible to eradicate S. stercoralis from the patient, and serology can also define the effectiveness of treatment. The reservoir of infection is humans; the free-living stages are short-lived. Mass treatment may be effective at eliminating S. stercoralis from a community. Safe water and effective sanitation alone do not lead to elimination of S. stercoralis. Up-to-date knowledge of S. stercoralis has been revealed through the workshops of the National Strongyloides Working Group in Australia and is summarized here. Much of this information is now available on the world wide web, and the addresses of relevant web sites are given.
粪类圆线虫在热带和亚热带国家呈地方性流行，尤其在经济贫困人群中普遍存在。尽管全球估计有3000万至1亿人感染粪类圆线虫，且这是一种终身疾病，但它仍然是一种被忽视的热带病。粪类圆线虫的粪便检测非常不敏感。澳大利亚原住民中粪类圆线虫的感染率（高达60%）比之前认为的要高得多，其在巴布亚新几内亚的感染率可能也比目前认为的要高得多。当粪类圆线虫和人类嗜T淋巴细胞病毒1型（HTLV - 1）在同一个人体内共存时，这两种疾病的进展都比单独感染时更快。当人们感染粪类圆线虫时，会患上急性粪类圆线虫病，这可能会危及生命。在疾病过程中的任何时候，如果免疫系统受到抑制，最常见的是通过皮质类固醇药物抑制，感染者可能会发展为超感染性粪类圆线虫病，除非潜在的粪类圆线虫感染得到有效治疗，否则他们将会死亡。血清学诊断与伊维菌素治疗相结合，已表明有可能从患者体内根除粪类圆线虫，血清学也可以确定治疗效果。感染源是人类；自由生活阶段寿命短暂。大规模治疗可能对从社区中消除粪类圆线虫有效。仅靠安全的饮用水和有效的卫生设施并不能消除粪类圆线虫。通过澳大利亚国家粪类圆线虫工作组的研讨会揭示了关于粪类圆线虫的最新知识，并在此进行总结。现在许多此类信息可在万维网上获取，文中给出了相关网站的地址。
