Strongyloides stercoralis: current perspectives

Strongyloides stercoralis is an intestinal nematode parasite with a global distribution. Most infected individuals have few or no symptoms. Strongyloidiasis is of primary medical importance, and fatal disease can occur in infected people who become immunosuppressed/immunocompromised through the administration of steroids or because of coinfection with human T-lymphotropic virus I. Often, misdiagnoses of strongyloidiasis in patients leads to expensive, nonspecific, invasive diagnostic techniques, including endoscopy, barium swallow, cancer biopsies, chest X-rays, and computerized tomography (CT) scans. Delayed treatment for strongyloidiasis brings in medical complications, such as vomiting, diarrhea, anemia, weight loss, pulmonary abnormalities, and septicemia. Chronic infection is difficult to diagnose by standard stool examination; hence, a reliable recombinant antigen-based serodiagnosis is important. Though albendazole and thiabendazole reduce the burden of the disease, they are not effective in an immunocompromised host. Ivermectin has the advantage of eradicating the disease, even in an immunocompromised host, with fewer side effects compared to albendazole. However, drug treatment is a temporary solution since reinfection can often occur. Thus, developing effective vaccine candidate antigens is imperative to stop the disease. Keywords: strongyloidiasis, hyperautoinfection, albendazole, thiabendazole septicemia, immunocompromised host, HTLV-1, ivermectin, gastrointestinal