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Multiple Stool Sampling and Specific Parasitological Technique are Crucial to Diagnose Strongyloidiasis in Alcoholic Patients

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Abstract

Purpose

Chronic alcoholism is a well-known risk factor for strongyloidiasis, in these patients the disease is potentially more severe, probably due to the breakdown of local protective barriers and immunosuppression caused by alcohol, which can lead to autoinfection and dissemination. The aim of this study was to evaluate multiple stool sampling and a specific parasitological assay agar plate culture (APC) for the diagnosis of Strongyloides stercoralis in alcoholics.

Methods

APC was compared to sedimentation technique (HPJ; Hoffman, Pons and Janer), as parasitological methods to detect S. stercoralis infection in alcoholic individuals. Three stool samples from 60 alcoholic and 60 non-alcoholic individuals were analyzed.

Results

S. stercoralis larvae were observed in 11 (18.3%) alcoholic individuals and 1 (1.7%) nonalcoholic individual (P = 0.0042). In view of the combined results, sensitivity for the APC method was 63.6% (CI 31.6–87.6%) with the first sample reaching 100% (CI 67.8–100%) after analyzing three fecal samples. The HPJ sensitivity was 36.4% (CI 12.4–68.4) in the first sample, reaching 72.7% (CI 39.3–92.7) after three samples analyzed.

Conclusion

The present results suggest that in alcoholic patients, it is important to repeat stool sampling with specific techniques, especially using the APC method, to avoid misdiagnosis in cases that could evolve to disseminated strongyloidiasis.

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Data availability

All data analysed during this study are included in this published article.

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Funding

This study was supported by the Programa de Apoio a Pós Graduação (PROAP) para o Programa de Pós Graduação em Ciência da Saúde (32006012008P3 to LCMO and AASG) from Universidade Federal de Uberlândia e pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), (Grant number 471331/2012-0 to JMCC), (Grant number CNPq2015-SAU021 to CAL). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. PostGraduate Program in Health Sciences, Medicine School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil

    Alana A. S. Gonçalves & Luiz Carlos M. Oliveira

  2. Laboratory of Parasitosis Diagnosis, Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil

    Camila A. Lopes, Marcelo A. Levenhagen, Henrique T. Gonzaga & Julia Maria Costa-Cruz

Authors
  1. Alana A. S. Gonçalves
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  2. Camila A. Lopes
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  3. Marcelo A. Levenhagen
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  4. Henrique T. Gonzaga
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  5. Luiz Carlos M. Oliveira
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  6. Julia Maria Costa-Cruz
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Correspondence to Henrique T. Gonzaga.

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Gonçalves, A.A.S., Lopes, C.A., Levenhagen, M.A. et al. Multiple Stool Sampling and Specific Parasitological Technique are Crucial to Diagnose Strongyloidiasis in Alcoholic Patients. Acta Parasit. 68, 718–722 (2023). https://doi.org/10.1007/s11686-023-00700-2

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  • DOI: https://doi.org/10.1007/s11686-023-00700-2

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