Naslov
Is strongyloidiasis currently endemic in Croatia?

Autori
Balen Topić, Mirjana ; Marjanović, Ena ; Tomasović, Domagoj ; Sviben, Mario

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract book 2020 / - , 2020, 846-846

Skup
30th ECCMID European congress of clinical microbiology and infectious diseases

Mjesto i datum
Pariz, Francuska, 18.04.2020. - 21.04.2020

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
strongyloidiasis ; Croatia

Sažetak
Background: Due to its low prevalence and various clinical presentations, the Strongyloides stercoralis infection in temperate zones can be easily overlooked. As the majority of symptomatic cases are diagonosed during the stage of chronic infection reactivation in immunosuppressed hosts, with unknown time of primoinfection, current endemicity in European countries is difficult to assess. The epidemiological and clinical burden of the disease in Europe has not been well studied and there have been no such studies in Croatia yet. Knowing local epidemiological circumstancies is important in managing immunosuppressed persons and in transplant medicine. This study explored the epidemiological and clinical features of patients with strongyloidiasis, with particular aim to find elements for current endemicity of the disease. Materials/methods: A retrospective descriptive study was performed that included patients of both genders and all ages treated for strongyloidiasis from January 2010 to May 2019 at the University Hospital for Infectious Diseases in Zagreb, Croatia. The diagnosis was made directly (by light microscopy of fecal samples after salinic provocation, three stool samples for parasites and ova, and/or tissue or duodenal aspirate samples), or indirectly by blood serology (in 83.1 and 16.9% of patients, respectively). Statistical analysis was done. Results: Among 65 patients with strongyloidiasis, 60% were men, and 78.5% were aged 50-79 (range 17- 82 y. ; average: 62 y.). The number of patients significantly increased over the study period (p=0.013). Clinical presentations were: asymptomatic eosinophilia (41.5%), chronic symptomatic disease (33.9%), hyperinfection (6.1%) and acute primoinfection (18.5%). Altogether 20 patients (30.8%) were immunosuppressed (9 by corticosteroids, 4 cytostatic drugs, 7 immune- debilitating illness) ; four developed hyperinfection, with two lethal outcomes. The initial therapy was: albendazole in 71.7% of patients, 13.3% thiabendazole, 13.3% ivermectin, 1.7% mebendazole. Six patients (9.2%) received repeated treatment. The parasitologic cure rate between albendazole and ivermectin group was equal (p=0.0878) (lost to follow up: 48.8% in albendazole and 25% in ivermectin group). Conclusions: Records of patients with acute primary infection confirm current endemicity for strongyloidiasis in continental Croatia, and immunosuppressed travellers to this region should be advised to take precaution measures. Patients undergoing immunosuppression and organ donors from Croatia should be screened.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA