Prevalence of Strongyloides stercoralis and other helminths in four districts of Madagascar

• Published in: Tropical Medicine and Health
• Main Authors: Salvatore Scarso, Rivo Andry Rakotoarivelo, Jana Christina Hey, Tahinamandranto Rasamoelina, Anjarasoa Ravo Razafindrakoto, Zaraniaina Tahiry Rasolojaona, Nantenaina Mathieu Razafindralava, Aaron Remkes, Njary Rakotozandrindrainy, Clara Fabienne Rasoamanamihaja, Norbert Georg Schwarz, Jürgen May, Raphael Rakotozandrindrainy, Valentina Marchese, Fabio Formenti, Francesca Perandin, Francesca Tamarozzi, Cristina Mazzi, Daniela Fusco, Dora Buonfrate
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2024
• Subjects: Strongyloides stercoralis; Strongyloidiasis; Helminth; Prevalence study; Madagascar; Ascaris lumbricoides; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-024-00619-y; https://doaj.org/article/8e2c65a2ed734a30a1b352d987aef62b

Abstract Background Estimation of prevalence of Strongyloides stercoralis infection is required in endemic areas, in order to identify areas in need of control programmes. Data on prevalence of strongyloidiasis in Madagascar are scant. Aim of this work was to estimate prevalence of S. stercoralis in four districts of Madagascar. Methods Fecal and serum samples collected in the context of a previous study on schistosomiasis were tested with S. stercoralis real-time PCR and serology, respectively. A multiplex real-time PCR for Ascaris lumbricoides, Ancylostoma duodenalis, Necator americanus, and Trichuris trichiura was done on fecal samples collected in the areas demonstrating higher prevalence of strongyloidiasis. Comparisons between proportions were made using Fisher exact test, with false discovery rate correction used for post-hoc comparisons. A multivariable Firth logistic regression model was used to assess potential risk factors for S. stercoralis infection. Results Overall, 1775 serum samples were tested, of which 102 of 487 (20.9%) and 104 of 296 (35.2%) were serological-positive in Marovoay and in Vatomandry districts (both coastal areas), respectively, compared to 28 of 496 (5.6%) and 30 of 496 (6.1%) in Tsiroanomandidy and in Ambositra districts (both highlands), respectively (adj. p < 0.001). PCR for S. stercoralis was positive in 15 of 210 (7.1%) and in 11 of 296 (3.7%) samples from Marovoay from Vatomandry, respectively, while was negative for all samples tested in the other two districts. High prevalence of A. lumbricoides (45.9%), hookworm (44.6%) and T. trichiura (32.1%) was found in Vatomandry. In the multivariable analysis, strongyloidiasis was associated with hookworm infection. Hookworm infection was also associated with male sex and lower education level. Conclusions S. stercoralis prevalence proved higher in coastal areas compared to highlands. Different climatic conditions may explain this distribution, along with previous rounds of anthelminthics distributed in the country, which may ...