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Strongyloidiasis on the Thai-Cambodian border
1County of Riverside Department of Health, California.
Insights
Hyperinfective strongyloidiasis caused children's deaths in a Thai refugee camp. Investigations revealed Strongyloides stercoralis infections, often with hookworm, as the primary cause of severe illness and mortality in this vulnerable population.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Pediatrics
Background:
- Children in a Cambodian refugee camp in Thailand experienced unexplained deaths.
- The deaths were associated with symptoms of bloody diarrhea and severe abdominal pain.
Purpose of the Study:
- To investigate the cause of illness and death in children at the refugee camp.
- To identify the causative agents of severe gastrointestinal distress in pediatric populations in refugee settings.
Main Methods:
- Microscopical examination of stool and blood samples from 15 affected children (aged 1-7 years).
- Parasitological screening of 958 outpatients for helminthic infections.
Main Results:
- Hyperinfective strongyloidiasis was identified as the cause of illness in 15 children.
- Strongyloides stercoralis infection was confirmed in 9 of 14 cases, with 6 (42%) having concurrent hookworm infection.
- Mixed S. stercoralis and hookworm infections were found in only 4.8% of the general outpatient population of the same age group.
Conclusions:
- Strongyloides stercoralis, particularly hyperinfective forms, poses a significant threat to child health in refugee camps.
- Concurrent hookworm infections may exacerbate the severity of strongyloidiasis.
- The high prevalence of S. stercoralis in symptomatic children suggests a need for targeted diagnostic and treatment strategies.
Abstract:
A series of children's deaths at a Cambodian refugee camp in Thailand prompted an investigation of children suffering from bloody diarrhoea and severe abdominal pain. Microscopical stool and blood examinations of 15 cases aged 1-7 years revealed hyperinfective strongyloidiasis as the cause of illness. Nine of 14 cases were infected wtih Strongyloides stercoralis, and 6 (42%) had concurrent infection with hookworm. Examination of 958 outpatients at the camp's daily clinic showed that mixed infections of S. stercoralis and hookworm were present in only 4.8% of the outpatients of the same age group.