Diagnosis,clinical features,and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting

Background: infections with strongyloides stercoralis and other helminths represent important,yet often neglected issues in developing countries. indeed,strongyloidiasis can be fatal,but only a few studies provide information regarding its health relevance in africa. moreover,clinical data on symptomatology and typical recognition patterns mainly originate from western travel clinics. methodology: a cross-sectional epidemiological survey was carried out in a rural part of south-central côte d'ivoire. stool samples from 292 randomly selected individuals were examined for intestinal helminths,using a suite of diagnostic techniques (i.e.,kato-katz,baermann funnel,and koga agar plate). participants were interviewed with a pre-tested questionnaire and clinically examined. multivariate logistic regression analysis was done to relate perceived morbidity and clinical findings to helminth infection status. principal findings: the prevalence of hookworm and s. stercoralis was 51.0% and 12.7%,respectively. both infections were strongly associated with each other (adjusted odds ratio,6.73; p<0.001) and higher prevalences were observed with age. s. stercoralis-infected individuals expressed self-reported morbidity considerably more often than those with hookworm infection. clinical examination identified high prevalences of various pathologies and detected tendencies to worse health conditions in helminth-infected subjects. conclusions/significance: the use of multiple diagnostic tools showed that s. stercoralis and hookworm are co-endemic in rural côte d'ivoire and that each infection causes clinical symptoms and sequelae. our findings are important for (re-)estimating the burden of helminth infections,and highlight the need for integrating epidemiological surveys,rigorous diagnostic approaches,and clinical assessments in the developing world. © 2011 becker et al.