Epidemiol Health.  2021;43(1):e2021009. 10.4178/epih.e2021009.

Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran: a closer look at risk factors

• Mirzaei L
• Ashrafi K
• Atrkar Roushan Z
• Mahmoudi MR
• Shenavar Masooleh I
• Rahmati B
• Saadat F
• Mirjalali H
• Sharifdini M

• KMID: 2514969
• DOI: http://doi.org/10.4178/epih.e2021009

Abstract

OBJECTIVES
The objective of this study was to evaluate the prevalence of Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran and to investigate related risk factors.
METHODS
This cross-sectional study was conducted among 494 patients receiving immunosuppressive drugs, including cancer patients undergoing chemotherapy (n=188) and those treated with prolonged corticosteroid administration (n=306). All fresh fecal samples were examined using the direct wet-mount, formalin ethyl acetate concentration, and agar plate culture techniques.
RESULTS
In total, 16.8% of patients were positive for at least 1 intestinal parasite; the helminthic and protozoan infection rates were 5.1% and 12.3%, respectively. The infection rate was significantly higher in corticosteroid-treated individuals (19.6%) than cancer patients (12.2%) (p<0.05). The prevalence rate of S. stercoralis among patients receiving chemotherapy and those treated with corticosteroids were 4.3% and 5.2%, respectively. The prevalence rate of S. stercoralis infection was significantly higher in older patients (p<0.05).
CONCLUSIONS
Strongyloidiasis is one of the most common parasites among patients receiving immunosuppressive drugs in northern Iran. Early diagnosis and proper treatment of these patients are necessary to minimize the complications of severe strongyloidiasis.

Keyword

Strongyloidiasis, Immunocompromised patients, Risk factors, Iran