Pathog Glob Health. 2014 Apr;108(3):137-40. doi: 10.1179/2047773214Y.0000000134.
We aimed to determine the prevalence and risk factors for Strongyloides stercoralis infection in adult patients attending Siriraj Hospital, a tertiary hospital in Thailand.
A case-control study was carried out between July 2008 and April 2010. Case and control were identified from 6022 patients for whom results of faecal examination were available. A case was a patient who had S. stercoralis larva detected from faecal examination. Control was randomly selected from patients without S. stercoralis larvae detected in three consecutive faecal examinations. The proportion of control to case was 2 : 1. Demographic and clinical data for the day of diagnosis and retrospectively up to 15 days preceding the date of faecal examination were reviewed from their medical records.
Overall, 149 (2.47%) patients had S. stercoralis larvae positive. There were 105 males (70.5%), with the mean (SD) age of 53.9 (17.2) years. A total of 300 controls were selected. Male gender (odds ratio (OR) = 2.79, 95% confidence interval (CI) 1.78-4.27)), human immunodeficiency virus (HIV) infection (OR = 3.23, 95% CI 1.43-7.29), and eosinophilia (OR = 1.81, 95% CI 1.33-2.47) were found to be independent risk factors associated with S. stercoralis infection in this setting. Corticosteroid or other immunosuppressive treatment, and other concomitant illnesses were not associated with increased risk of S. stercoralis infection.
In this setting, strongyloidiasis was seen more often in male patients with eosinophilia and with HIV infection. Prevention of fatal complication caused by S. stercoralis by regular faecal examination, or serology for early detection and treatment of undiagnosed S. stercoralis infection, is warranted in these high-risk patients.
我们旨在确定在泰国 Siriraj 医院就诊的成年患者中 Strongyloides stercoralis 感染的流行率和危险因素。
2008 年 7 月至 2010 年 4 月期间进行了病例对照研究。从 6022 例粪便检查结果可用的患者中确定病例和对照。病例是从粪便检查中检测到 S. stercoralis 幼虫的患者。对照是从连续 3 次粪便检查中未检测到 S. stercoralis 幼虫的患者中随机选择的。病例与对照的比例为 2:1。从病历中回顾了诊断当天和粪便检查前 15 天的人口统计学和临床数据。
总体而言，有 149 例（2.47%）患者的粪便中存在 S. stercoralis 幼虫。其中 105 例为男性（70.5%），平均年龄（标准差）为 53.9（17.2）岁。共选择了 300 名对照。男性（比值比[OR] = 2.79，95%置信区间[CI] 1.78-4.27）、人类免疫缺陷病毒（HIV）感染（OR = 3.23，95%CI 1.43-7.29）和嗜酸性粒细胞增多症（OR = 1.81，95%CI 1.33-2.47）被发现是本研究中与 S. stercoralis 感染相关的独立危险因素。皮质类固醇或其他免疫抑制治疗以及其他并存疾病与 S. stercoralis 感染的风险增加无关。
在这种情况下，嗜酸性粒细胞增多症和 HIV 感染的男性患者中更常出现 Strongyloides stercoralis 感染。应定期进行粪便检查或血清学检查以早期发现和治疗未确诊的 S. stercoralis 感染，以预防由 S. stercoralis 引起的致命并发症。
