Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes
Background: When and how to screen for strongyloidiasis in high-income countries remain to be elucidated. This study aimed to investigate the prevalence, associated factors, and outcome of strongyloidiasis in Taiwan and proposed clinical criteria for serological screening. Methods: Adults who were i...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | Travel Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1477893925000729 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850104338983157760 |
|---|---|
| author | Sung-Hsi Huang Yen-Lin Chen Hao-Yu Lin Aristine Cheng Lih-Yu Chang Yi-Chia Huang Po-Hsien Kuo Yueh-Feng Wen Chia-Jung Liu Chia-Hao Chang Wei-Shun Yang Kai-Hsiang Chen Pin-Ru Chu Chi-Wei Tseng Yi-Ching Su Li-Hsin Su Li-Ta Keng Chi-Ying Lin Un-In Wu Hsin-Yun Sun Yu-Tsung Huang Hong-Ming Hsu Chien-Ching Hung Kua-Eyre Su |
| author_facet | Sung-Hsi Huang Yen-Lin Chen Hao-Yu Lin Aristine Cheng Lih-Yu Chang Yi-Chia Huang Po-Hsien Kuo Yueh-Feng Wen Chia-Jung Liu Chia-Hao Chang Wei-Shun Yang Kai-Hsiang Chen Pin-Ru Chu Chi-Wei Tseng Yi-Ching Su Li-Hsin Su Li-Ta Keng Chi-Ying Lin Un-In Wu Hsin-Yun Sun Yu-Tsung Huang Hong-Ming Hsu Chien-Ching Hung Kua-Eyre Su |
| author_sort | Sung-Hsi Huang |
| collection | DOAJ |
| description | Background: When and how to screen for strongyloidiasis in high-income countries remain to be elucidated. This study aimed to investigate the prevalence, associated factors, and outcome of strongyloidiasis in Taiwan and proposed clinical criteria for serological screening. Methods: Adults who were immunocompromised or about to undergo iatrogenic immunosuppression (proactive-screening cohort) and those with clinical presentations suggesting strongyloidiasis (diagnosis-driven cohort) were prospectively enrolled at five hospitals in Taiwan. Serum anti-Strongyloides IgG was determined by two enzyme-linked immunosorbent assays (ELISAs). Stool samples were obtained for microscopy and cultures. Prevalence of confirmed/probable strongyloidiasis, as defined by identification of characteristic larvae from stool or testing positive for both ELISAs, was calculated. Factors associated with strongyloidiasis were identified in multivariable analysis. Six-month mortality was compared between participants with and without strongyloidiasis using Cox proportional hazards model. Results: From January 2021 to June 2024, confirmed/probable cases of strongyloidiasis were identified in 1.9 % and 4.8 % of the participants in proactive-screening and diagnosis-driven cohorts, respectively. Multivariable analysis revealed that skin and skin structure infection (adjusted odds ratio [aOR] 3.180), gastrointestinal bleeding of unknown causes (aOR 3.229), and hemoglobin <10 g/dl (aOR 4.300) were independently associated with strongyloidiasis. Six-month mortality was 33.3 % in participants with confirmed/probable strongyloidiasis, higher than that in those without strongyloidiasis (11.4 %), but not statistically significant after adjusting for age, sex, and clinical severity (p = 0.09). Conclusions: Strongyloidiasis continued to occur among at-risk populations in Taiwan. Screening strategies are needed to improve the detection of this neglected parasitic infection in Taiwan and other high-income countries. |
| format | Article |
| id | doaj-art-e6cfe0d072054ab098ec0614f376347a |
| institution | DOAJ |
| issn | 1873-0442 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Travel Medicine and Infectious Disease |
| spelling | doaj-art-e6cfe0d072054ab098ec0614f376347a2025-08-20T02:39:21ZengElsevierTravel Medicine and Infectious Disease1873-04422025-07-016610286610.1016/j.tmaid.2025.102866Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomesSung-Hsi Huang0Yen-Lin Chen1Hao-Yu Lin2Aristine Cheng3Lih-Yu Chang4Yi-Chia Huang5Po-Hsien Kuo6Yueh-Feng Wen7Chia-Jung Liu8Chia-Hao Chang9Wei-Shun Yang10Kai-Hsiang Chen11Pin-Ru Chu12Chi-Wei Tseng13Yi-Ching Su14Li-Hsin Su15Li-Ta Keng16Chi-Ying Lin17Un-In Wu18Hsin-Yun Sun19Yu-Tsung Huang20Hong-Ming Hsu21Chien-Ching Hung22Kua-Eyre Su23Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan; Center for International Health, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Corresponding author. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, TaiwanBackground: When and how to screen for strongyloidiasis in high-income countries remain to be elucidated. This study aimed to investigate the prevalence, associated factors, and outcome of strongyloidiasis in Taiwan and proposed clinical criteria for serological screening. Methods: Adults who were immunocompromised or about to undergo iatrogenic immunosuppression (proactive-screening cohort) and those with clinical presentations suggesting strongyloidiasis (diagnosis-driven cohort) were prospectively enrolled at five hospitals in Taiwan. Serum anti-Strongyloides IgG was determined by two enzyme-linked immunosorbent assays (ELISAs). Stool samples were obtained for microscopy and cultures. Prevalence of confirmed/probable strongyloidiasis, as defined by identification of characteristic larvae from stool or testing positive for both ELISAs, was calculated. Factors associated with strongyloidiasis were identified in multivariable analysis. Six-month mortality was compared between participants with and without strongyloidiasis using Cox proportional hazards model. Results: From January 2021 to June 2024, confirmed/probable cases of strongyloidiasis were identified in 1.9 % and 4.8 % of the participants in proactive-screening and diagnosis-driven cohorts, respectively. Multivariable analysis revealed that skin and skin structure infection (adjusted odds ratio [aOR] 3.180), gastrointestinal bleeding of unknown causes (aOR 3.229), and hemoglobin <10 g/dl (aOR 4.300) were independently associated with strongyloidiasis. Six-month mortality was 33.3 % in participants with confirmed/probable strongyloidiasis, higher than that in those without strongyloidiasis (11.4 %), but not statistically significant after adjusting for age, sex, and clinical severity (p = 0.09). Conclusions: Strongyloidiasis continued to occur among at-risk populations in Taiwan. Screening strategies are needed to improve the detection of this neglected parasitic infection in Taiwan and other high-income countries.http://www.sciencedirect.com/science/article/pii/S1477893925000729Soil-transmitted parasiteNeglected tropical diseaseImmunosuppressionEosinophiliaEnzyme-linked immunosorbent assay |
| spellingShingle | Sung-Hsi Huang Yen-Lin Chen Hao-Yu Lin Aristine Cheng Lih-Yu Chang Yi-Chia Huang Po-Hsien Kuo Yueh-Feng Wen Chia-Jung Liu Chia-Hao Chang Wei-Shun Yang Kai-Hsiang Chen Pin-Ru Chu Chi-Wei Tseng Yi-Ching Su Li-Hsin Su Li-Ta Keng Chi-Ying Lin Un-In Wu Hsin-Yun Sun Yu-Tsung Huang Hong-Ming Hsu Chien-Ching Hung Kua-Eyre Su Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes Travel Medicine and Infectious Disease Soil-transmitted parasite Neglected tropical disease Immunosuppression Eosinophilia Enzyme-linked immunosorbent assay |
| title | Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes |
| title_full | Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes |
| title_fullStr | Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes |
| title_full_unstemmed | Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes |
| title_short | Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes |
| title_sort | screening for strongyloidiasis among selected populations in taiwan prevalence associated factors and outcomes |
| topic | Soil-transmitted parasite Neglected tropical disease Immunosuppression Eosinophilia Enzyme-linked immunosorbent assay |
| url | http://www.sciencedirect.com/science/article/pii/S1477893925000729 |
| work_keys_str_mv | AT sunghsihuang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT yenlinchen screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT haoyulin screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT aristinecheng screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT lihyuchang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT yichiahuang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT pohsienkuo screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT yuehfengwen screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT chiajungliu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT chiahaochang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT weishunyang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT kaihsiangchen screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT pinruchu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT chiweitseng screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT yichingsu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT lihsinsu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT litakeng screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT chiyinglin screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT uninwu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT hsinyunsun screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT yutsunghuang screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT hongminghsu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT chienchinghung screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes AT kuaeyresu screeningforstrongyloidiasisamongselectedpopulationsintaiwanprevalenceassociatedfactorsandoutcomes |