Strongyloidiasis in Auckland: A ten-year retrospective study of diagnosis, treatment and outcomes of a predominantly Polynesian and Fijian migrant cohort

This study aimed to describe the epidemiology and management of strongyloidiasis in Auckland, with a focus on migrants from Pacific Island Countries and Territories. MethodsThis study retrospectively reviewed clinical, laboratory and pharmacy records data for all people diagnosed with strongyloidiasis in the Auckland region between July 2012 and June 2022. People with negativeStrongyloides serology were included to estimate seropositivity rate by country of birth. FindingsOver ten years, 691 people were diagnosed with strongyloidiasis. Most diagnoses were made by serology alone (441, 64%). The median age was 63 years (range 15 –92), 500 (72%) were male, and the majority were born in Polynesia (350, 51%), Fiji (130, 19%) or were of Pasifika ethnicity (7%). Twelve participants (1.7%) had severe strongyloidiasis at diagnosis.The total proportion treated with ivermectin was only 70% (484/691), with no differences between im munocompromised and immunocompetent participants, nor by ethnicity. The outcome of treatment (based on a combination of serology and/or eosinophilia and/or stool microscopy) could only be determined in 50% of the treated cohort. One participant failed treatment with ivermectin, experiencing recurren t strongyloidiasis, and another participant died in association with severe strongyloidiasis.The rate of ‘positive’Strongyloides serology was highest among participants born in Samoa (48%), Fiji (39%), and Southeast Asian countries (34%). InterpretationStrong...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research