Human strongyloidiasis: complexities and pathways forward

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Tropical Medicine

Background:

• Strongyloidiasis is a neglected tropical disease caused by Strongyloides stercoralis, infecting 300-600 million people globally.
• The parasite's complex life cycle includes autoinfection, leading to chronic or asymptomatic infections and potential malnourishment.
• Immunosuppression can trigger fatal hyperinfection syndrome, complicating diagnosis and treatment.

Purpose of the Study:

• To review the epidemiology, clinical manifestations, and management strategies for Strongyloidiasis.
• To highlight challenges in diagnosis, particularly in immunocompromised individuals.
• To emphasize the need for improved diagnostics, treatment protocols, and research.

Main Methods:

• Review of existing literature on Strongyloides stercoralis.
• Analysis of diagnostic challenges, including serology and stool examination.
• Examination of current treatment guidelines and therapeutic alternatives.

Main Results:

• Strongyloidiasis affects a significant global population, with variable clinical presentations.
• Diagnostic sensitivity is limited by low larval output in stool; serology is useful but less sensitive in immunocompromised hosts.
• Ivermectin is effective for stable disease, while immunocompromised patients require multiple doses.

Conclusions:

• Effective management requires increased awareness, improved diagnostics, and targeted treatment programs.
• Further research is needed for therapeutic alternatives and medication safety, especially in immunocompromised populations.
• Clarifying the zoonotic potential of Strongyloides stercoralis is crucial for public health strategies.