Open AccessThe Strongyloides stercoralis-hookworms association as a path to the estimation of the global burden of strongyloidiasis: A systematic review
Author(s) -
Pedro Emanuel Fleitas,
Marina Travacio,
Helena Martí-Soler,
M. Eugenia Socías,
Walter López,
Alejandro Krolewiecki
Publication year - 2020
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0008184
Subject(s) - strongyloides stercoralis , strongyloidiasis , neglected tropical diseases , epidemiology , medicine , tropical disease , environmental health , helminths , public health , immunology , pathology , disease
Soil-transmitted helminths (STH) represent a significant public health problem. However, Strongyloides stercoralis is not yet integrated into the control strategy against STH, given limitations to accurately assess its burden. Considering that S . stercoralis shares biological and epidemiological characteristics with hookworms, we describe a new approach for an improved estimation of the burden of infections by S . stercoralis based on the prevalence and burden of hookworms and the relationship between these species. A systematic review of publications reporting prevalence rates for S . stercoralis and hookworms was carried out. The data was classified into two categories: 1) “Community”, with surveys including all age groups, and 2) “SAC”, with surveys limited to school-aged children. The relationship between S. stercoralis and hookworms was characterized in order to estimate the global burden of S . stercoralis infections. The study is registered in PROSPERO (CRD42019131127). Spearman correlation coefficient between S . stercoralis and hookworms was estimated and the global burden of S . stercoralis infections was estimated using a regression model. A total of 119 articles were included, and a significant positive correlation between the burden of S . stercoralis and hookworms was identified. Spearman’s coefficient for Community surveys was 0.94 and for SAC surveys it was 0.63. Based on the linear model, the global burden of S . stercoralis infections was estimated at 386 million (95%CI 324–449 million) people, including 22 million (95%CI 20–24 million) SAC. The significant relationship between S . stercoralis and hookworms allows an estimation of the global burden of S . stercoralis infections in most epidemiologic settings using hookworm burden and justifies the search of integrated control activities. Trial registration PROSPERO (registration code CRD42019131127 ).