Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies
Abstract Background Strongyloidiasis, caused by the nematodes Strongyloides stercoralis and Strongyloides fuelleborni, is estimated to affect over 600 million individuals worldwide. The disease is endemic in Southeast Asia, where a warm-humid climate and socio-economic conditions maintain the parasi...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Infectious Diseases of Poverty |
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| Online Access: | https://doi.org/10.1186/s40249-023-01138-4 |
| _version_ | 1797555693479264256 |
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| author | Abigail Hui En Chan Teera Kusolsuk Dorn Watthanakulpanich Wallop Pakdee Pham Ngoc Doanh Azlin Mohd Yasin Paron Dekumyoy Urusa Thaenkham |
| author_facet | Abigail Hui En Chan Teera Kusolsuk Dorn Watthanakulpanich Wallop Pakdee Pham Ngoc Doanh Azlin Mohd Yasin Paron Dekumyoy Urusa Thaenkham |
| author_sort | Abigail Hui En Chan |
| collection | DOAJ |
| description | Abstract Background Strongyloidiasis, caused by the nematodes Strongyloides stercoralis and Strongyloides fuelleborni, is estimated to affect over 600 million individuals worldwide. The disease is endemic in Southeast Asia, where a warm-humid climate and socio-economic conditions maintain the parasite’s life cycle and transmission. However, the current diagnostic methods may not be sufficiently sensitive, suggesting that the true prevalence of strongyloidiasis could be seriously underestimated in this. This study aims to determine the prevalence of strongyloidiasis in Southeast Asia through a systematic review and meta-analysis and to discuss the implications of the estimated prevalence on diagnostic approaches and control strategies. Methods Following PRISMA guidelines, we conducted a systematic literature search in PubMed and Google Scholar databases to identify studies reporting Strongyloides prevalence data in the 11 Southeast Asian countries up to December 2022. A random effects model was employed to estimate the pooled prevalence of S. stercoralis at both regional and country levels. Results Out of 3722 articles identified, 224 met our inclusion criteria. For S. stercoralis specifically, we found 187 articles, of which 52.4% were from Thailand. All Southeast Asian countries, except Brunei, had at least one study on Strongyloides prevalence. The estimated pooled prevalence of S. stercoralis regionally was 12.7% (95% CI 10.70–14.80%), ranging from 0.4 to 24.9% at the country level. Cambodia had the highest pooled prevalence (24.9%, 95% CI 15.65–35.38%), followed by Lao PDR (16.5%, 95% CI 9.50–24.95%). Moreover, we obtained a pooled prevalence of 10% (95% CI 7.06–13.52%) in a group comprising immigrants, workers, and veterans from Southeast Asian countries. S. stercoralis infects various host types, including nonhuman primates, domestic dogs and cats, rodents, and transport carriers such as cockroaches and vegetables. Conclusions A high prevalence of strongyloidiasis in Southeast Asia was revealed, highlighting the importance of the region’s ongoing research, surveillance, and control efforts. Factors contributing to the strongyloidiasis transmission include the role of animal hosts, the impact of global connectivity, and the significance of the co-endemicity of other Strongyloides species. Based on these findings, a multi-pronged One-Health approach is essential for sustainable intervention and control. |
| first_indexed | 2024-03-10T16:52:09Z |
| format | Article |
| id | doaj.art-b57aa14e8bb34c60a18d18b8c33a3862 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-03-10T16:52:09Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-b57aa14e8bb34c60a18d18b8c33a38622023-11-20T11:17:38ZengBMCInfectious Diseases of Poverty2049-99572023-09-0112111610.1186/s40249-023-01138-4Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategiesAbigail Hui En Chan0Teera Kusolsuk1Dorn Watthanakulpanich2Wallop Pakdee3Pham Ngoc Doanh4Azlin Mohd Yasin5Paron Dekumyoy6Urusa Thaenkham7Department of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityInstitute of Ecology and Biological Resources, Graduate University of Science and Technology, Vietnam Academy of Science and TechnologyDepartment of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Helminthology, Faculty of Tropical Medicine, Mahidol UniversityAbstract Background Strongyloidiasis, caused by the nematodes Strongyloides stercoralis and Strongyloides fuelleborni, is estimated to affect over 600 million individuals worldwide. The disease is endemic in Southeast Asia, where a warm-humid climate and socio-economic conditions maintain the parasite’s life cycle and transmission. However, the current diagnostic methods may not be sufficiently sensitive, suggesting that the true prevalence of strongyloidiasis could be seriously underestimated in this. This study aims to determine the prevalence of strongyloidiasis in Southeast Asia through a systematic review and meta-analysis and to discuss the implications of the estimated prevalence on diagnostic approaches and control strategies. Methods Following PRISMA guidelines, we conducted a systematic literature search in PubMed and Google Scholar databases to identify studies reporting Strongyloides prevalence data in the 11 Southeast Asian countries up to December 2022. A random effects model was employed to estimate the pooled prevalence of S. stercoralis at both regional and country levels. Results Out of 3722 articles identified, 224 met our inclusion criteria. For S. stercoralis specifically, we found 187 articles, of which 52.4% were from Thailand. All Southeast Asian countries, except Brunei, had at least one study on Strongyloides prevalence. The estimated pooled prevalence of S. stercoralis regionally was 12.7% (95% CI 10.70–14.80%), ranging from 0.4 to 24.9% at the country level. Cambodia had the highest pooled prevalence (24.9%, 95% CI 15.65–35.38%), followed by Lao PDR (16.5%, 95% CI 9.50–24.95%). Moreover, we obtained a pooled prevalence of 10% (95% CI 7.06–13.52%) in a group comprising immigrants, workers, and veterans from Southeast Asian countries. S. stercoralis infects various host types, including nonhuman primates, domestic dogs and cats, rodents, and transport carriers such as cockroaches and vegetables. Conclusions A high prevalence of strongyloidiasis in Southeast Asia was revealed, highlighting the importance of the region’s ongoing research, surveillance, and control efforts. Factors contributing to the strongyloidiasis transmission include the role of animal hosts, the impact of global connectivity, and the significance of the co-endemicity of other Strongyloides species. Based on these findings, a multi-pronged One-Health approach is essential for sustainable intervention and control.https://doi.org/10.1186/s40249-023-01138-4StrongyloidesStrongyloidiasisSoutheast AsiaPrevalenceSystematic review |
| spellingShingle | Abigail Hui En Chan Teera Kusolsuk Dorn Watthanakulpanich Wallop Pakdee Pham Ngoc Doanh Azlin Mohd Yasin Paron Dekumyoy Urusa Thaenkham Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies Infectious Diseases of Poverty Strongyloides Strongyloidiasis Southeast Asia Prevalence Systematic review |
| title | Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies |
| title_full | Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies |
| title_fullStr | Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies |
| title_full_unstemmed | Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies |
| title_short | Prevalence of Strongyloides in Southeast Asia: a systematic review and meta-analysis with implications for public health and sustainable control strategies |
| title_sort | prevalence of strongyloides in southeast asia a systematic review and meta analysis with implications for public health and sustainable control strategies |
| topic | Strongyloides Strongyloidiasis Southeast Asia Prevalence Systematic review |
| url | https://doi.org/10.1186/s40249-023-01138-4 |
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