Seroprevalence of strongyloides stercoralis among cancer patients in an endemic region in Iran

Abstract

Introduction: Strongyloides stercoralis a globally widespread human intestinal nematode. Hyperinfection mainly appears in patients with defective immune systems . This study intended to investigate the prevalence of serum positive Strongyloides stercoralis in cancer patients who have never undergone chemotherapy and those who received at least one cycle of chemotherapy.

Materials and Methods: This study targeted cancer patients, referred to Rasht hospital, and assigned them to two groups of cancer patients with no history of chemotherapy and cancer patients with at least one cycle of chemotherapy. Patient’s demographic information, underlying diseases and chemotherapy regimen were recorded, and their serum sample was examined.

Results: 410 patients were included in this study. the majority were female ( 51/7% ). About 40 patients tested positive for serology, out of which 14 were in the chemotherapy-treated group and 26 in chemotherapy-untreated group, indicating that the prevalence of serum positive Strongyloides stercoralis was significantly higher in patients with no history of chemotherapy. Moreover, eosinophilia significantly correlated with the prevalence of seropositivity. The chemotherapy protocol containing high doses of corticosteroids could multiply the risk of positive serology by 12.7 times.

Conclusion: Before chemotherapy, in areas with a higher prevalence of Strongyloides stercoralis, especially in high corticosteroids protocols, it may make sense to study Strongyloides stercoralis . It becomes more vital in men and eosinophilic patients. Since serologic testing may display false negative rates in patients with defective immune systems, subsequently, alternative complementary methods such as fecal larval examination and fecal PCR test are highly suggested to be carried out along with serology.