Ketzis Jennifer K, Conan Anne
Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Acta Trop. 2017 Jul;171:90-95. doi: 10.1016/j.actatropica.2017.03.037. Epub 2017 Apr 1.
Few data are available for the prevalence of Strongyloides stercoralis in the Caribbean region. This frequently under diagnosed soil-transmitted helminth (STH) can result in long-term low intensity chronic infections that are asymptomatic or can cause varied intestinal disturbances. With autoinfections, infections lasting over 60 years can occur and hyperinfections lead to high morbidity and mortality.
METHODOLOGY/PRINCIPAL FINDINGS: Historical literature was searched to determine the prevalence of S. stercoralis in the Caribbean island countries with some additional countries and islands included for comparative data. A previously published model was used to calculate prevalence taking in to account the sensitivity of the diagnostic methods used. Data for 17 islands/Caribbean countries were found and sufficient data were located to calculate prevalence for 14 locations. Prevalence ranges from <1% to 20.3% and while it has decreased in many islands it has not decreased at the same rate as other STHs in the last 40 years within the Caribbean region.
CONCLUSIONS/SIGNIFICANCE: S. stercoralis continues to be an important STH within the Caribbean. Potential reasons for the current prevalence include: long lasting infections, populations not targeted with mass drug administration (MDA) programs being infected, low efficacy of commonly used drugs in MDA programs, and under-diagnosis resulting in infections not being treated.
关于加勒比地区粪类圆线虫的流行情况，现有数据较少。这种常被漏诊的土源性蠕虫（STH）可导致长期低强度的慢性感染，这些感染可能无症状，或引起各种肠道不适。通过自身感染，感染可持续60多年，而重度感染会导致高发病率和死亡率。
方法/主要发现：检索历史文献以确定加勒比岛国粪类圆线虫的流行情况，并纳入一些其他国家和岛屿以获取比较数据。使用先前发表的模型，在考虑所用诊断方法敏感性的情况下计算流行率。共找到17个加勒比岛屿/国家的数据，并有足够的数据来计算14个地点的流行率。流行率范围从<1%到20.3%，虽然在许多岛屿上流行率有所下降，但在过去40年里，其下降速度与加勒比地区其他土源性蠕虫不同。
结论/意义：粪类圆线虫在加勒比地区仍然是一种重要的土源性蠕虫。当前流行的潜在原因包括：感染持续时间长、未接受群体药物给药（MDA）计划的人群受到感染、MDA计划中常用药物疗效低以及漏诊导致感染未得到治疗。
