Hanoi Medical University, 01 Ton That Tung, Hanoi, Vietnam.
National Hospital of Tropical Diseases 78 Giai Phong, Hanoi, Vietnam.
Parasit Vectors. 2019 Nov 4;12(1):515. doi: 10.1186/s13071-019-3776-1.
Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. The aim of this study was to determine the prevalence, geographical distribution, epidemiological aspects, symptoms and other health indicators of Strongyloides stercoralis infections in patients from 27 provinces of northern Vietnam attending the Hanoi Medical University Hospital during 2016 and 2017.
Blood samples of 2000 patients were analyzed for S. stercoralis infection with an IgG ELISA test. Seroprevalence was analyzed by gender, age group, locality of origin (rural or urban areas) and symptoms. Stools from the seropositive patients were examined for the detection of worms which were subsequently used for species identification by morphology and rDNA ITS1 sequencing.
A seroprevalence of 20% was detected, showing an increasing prevalence from young to older age groups but without significant gender difference. Seroprevalence was higher in rural areas than in urban areas, both in general and individually in all provinces without exception, and lower in the mountainous areas than in the large valley lowlands. The follow-up of the 400 patients showed eosinophilia in 100% of cases, diarrhoea in 64.5%, digestion difficulties in 58.0%, stomachache in 45.5%, stomach and duodenal ulcers in 44.5%, itching in 28.0% and fever in 9.5%. The prevalence of symptoms and signs were also higher in older age groups than in younger age groups. Worms were detected in stools of 10.5% of the patients. Sequencing of a 501-bp nuclear ribosomal DNA ITS1 fragment allowed for the verification of infection by Strongyloides stercoralis.
To our knowledge, this study is the largest survey of human strongyloidiasis in Vietnam so far and the first molecular identification of this nematode species in this country. Long-term chronicity may probably be usual in infected subjects, mainly in the older age groups.
旋毛虫病是越南的一个健康问题，但相关信息仍然有限。本研究的目的是确定 2016 年至 2017 年期间来自越南北部 27 个省前往河内医科大学附属医院就诊的患者中 Strongyloides stercoralis 感染的流行率、地理分布、流行病学方面、症状和其他健康指标。
对 2000 名患者的血液样本进行了 S. stercoralis 感染 IgG ELISA 检测。通过性别、年龄组、原籍地（农村或城市地区）和症状分析血清阳性率。对血清阳性患者的粪便进行检查，以检测蠕虫，然后通过形态学和 rDNA ITS1 测序对蠕虫进行种属鉴定。
检测到 20%的血清阳性率，显示出从年轻到老年年龄组的患病率逐渐增加，但无显著的性别差异。农村地区的血清阳性率高于城市地区，所有省份无一例外，山区的血清阳性率低于大河谷低地。对 400 名患者的随访显示，100%的患者嗜酸性粒细胞增多，64.5%的患者腹泻，58.0%的患者消化不良，45.5%的患者胃痛，44.5%的患者胃和十二指肠溃疡，28.0%的患者瘙痒，9.5%的患者发热。年龄较大的患者中症状和体征的发生率也高于年龄较小的患者。在 10.5%的患者粪便中检测到蠕虫。对 501bp 核核糖体 DNA ITS1 片段的测序证实了 Strongyloides stercoralis 的感染。
据我们所知，这是迄今为止越南对人类旋毛虫病进行的最大规模调查，也是该国首次对这种线虫进行分子鉴定。感染患者可能长期处于慢性状态，主要是在年龄较大的患者中。
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