title: Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case-control study, February 2013 to July 2014.
abstract: Strongyloides stercoralis is a soil-transmitted helminth widely diffused in tropical and subtropical regions of the world. Autochthonous cases have been also diagnosed sporadically in areas of temperate climate. We aimed at defining the epidemiology of strongyloidiasis in immigrants and Italians living in three northern Italian Regions. Screening for S. stercoralis infection was done with serology, confirmation tests were a second serological method or stool agar culture. A case-control approach was adopted and patients with a peripheral eosinophil count ≥ 500/mcL were classified as cases. Of 2,701 individuals enrolled here 1,351 were cases and 1,350 controls; 86% were Italians, 48% women. Italians testing positive were in 8% (97/1,137) cases and 1% (13/1,178) controls (adjusted odds ratio (aOR) 8.2; 95% confidence interval (CI): 4.5-14.8), while positive immigrants were in 17% (36/214) cases and in 2% (3/172) controls (aOR 9.6; 95% CI: 2.9-32.4). Factors associated with a higher risk of infection for all study participants were eosinophilia (p < 0.001) and immigration (p = 0.001). Overall, strongyloidiasis was nine-times more frequent in individuals with eosinophilia than in those with normal eosinophil count.
authors.affiliation: Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar (Verona), Italy.
authors.forename: Dora
authors.initials: D
authors.lastname: Buonfrate
authors.forename: Mara
authors.initials: M
authors.lastname: Baldissera
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Abrescia
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caramaschi
authors.forename: Mario
authors.initials: M
authors.lastname: Giobbia
authors.forename: Marta
authors.initials: M
authors.lastname: Mascarello
authors.forename: Paola
authors.initials: P
authors.lastname: Rodari
authors.forename: Novella
authors.initials: N
authors.lastname: Scattolo
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Napoletano
authors.forename: Zeno
authors.initials: Z
authors.lastname: Bisoffi
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D016022:Case-Control Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004797:Enzyme-Linked Immunosorbent Assay; D004802:Eosinophilia / Q000453:epidemiology; D005243:Feces / Q000469:parasitology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D018571:Sentinel Surveillance; D017678:Sex Distribution; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth
keywords: Epidemiology; Italy; Strongyloides stercoralis; parasitic disease