Primary Health Centre La Marina, Autonomous University of Barcelona, Barcelona, Spain.
Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain.
PLoS Negl Trop Dis. 2019 Mar 12;13(3):e0007230. doi: 10.1371/journal.pntd.0007230. eCollection 2019 Mar.
Strongyloides stercoralis infection, a neglected tropical disease, is widely distributed. Autochthonous cases have been described in Spain, probably infected long time ago. In recent years the number of diagnosed cases has increased due to the growing number of immigrants, travelers and refugees, but endemically acquired cases in Spain remains undetermined.
We systematically searched the literature for references on endemic strongyloidiasis cases in Spain. The articles were required to describe Strongyloides stercoralis infection in at least one Spanish-born person without a history of travel to endemic areas and be published before 31st May 2018. Epidemiological data from patients was collected and described individually as well as risk factors to acquisition of the infection, diagnostic technique that lead to the diagnosis, presence of eosinophilia and clinical symptoms at diagnosis.
Thirty-six studies were included, describing a total of 1083 patients with an average age of 68.3 years diagnosed with endemic strongyloidiasis in Spain. The vast majority of the cases were described in the province of Valencia (n = 1049). Two hundred and eight of the 251 (82.9%) patients in whom gender was reported were male, and most of them had current or past dedication to agriculture. Seventy percent had some kind of comorbidity. A decreasing trend in the diagnosed cases per year is observed from the end of last decade. However, there are still nefigw diagnoses of autochthonous cases of strongyloidiasis in Spain every year.
With the data provided by this review it is likely that in Spain strongyloidiasis might have been underestimated. It is highly probable that the infection remains undiagnosed in many cases due to low clinical suspicion among Spanish population without recent travel history in which the contagion probably took place decades ago.
作为一种被忽视的热带病，粪类圆线虫感染广泛分布。在西班牙曾有过本地感染病例的描述，可能是很久以前感染的。近年来，由于移民、旅行者和难民数量的增加，诊断出的病例数量有所增加，但在西班牙，地方性获得的病例仍不确定。
我们系统地搜索了关于西班牙地方性粪类圆线虫病病例的文献。这些文章必须描述至少一名在西班牙出生、无前往流行地区旅行史的人感染粪类圆线虫，并在 2018 年 5 月 31 日之前发表。我们单独收集并描述了患者的流行病学数据，以及获得感染的危险因素、导致诊断的诊断技术、嗜酸性粒细胞增多和诊断时的临床症状。
共纳入 36 项研究，描述了西班牙共 1083 例平均年龄为 68.3 岁的地方性粪类圆线虫病患者。绝大多数病例发生在巴伦西亚省（n=1049）。在报告了性别信息的 251 名患者中，有 208 名（82.9%）为男性，他们大多数从事或曾从事农业工作。70%的患者有某种合并症。从上个十年末开始，每年诊断出的病例呈下降趋势。然而，西班牙每年仍有新的粪类圆线虫病本地感染病例。
根据本次综述提供的数据，粪类圆线虫病在西班牙可能被低估了。由于西班牙人对没有近期旅行史的患者的感染的临床怀疑度较低，因此很可能有许多病例未被诊断。在这些患者中，感染很可能是几十年前发生的。
