Anthelmintic treatment follow up in a rural community in Camamu, Bahia, Brazil.

Enteroparasites are an important public health problem and the treatment seeks to cure and reduce transmission. The aim of this study was to evaluate the therapeutic efficacy of anthelmintic treatment in individuals living in a rural community area in Camamu, Bahia, Brazil. The parasitological diagnosis was performed by spontaneous sedimentation, Baermann-Moraes and Agar Plate Culture methods. A total of 212 individuals were evaluated. The most frequent helminth was Trichuris trichiura, 24.5% (52/212), followed by Ascaris lumbricoides, 21.2% (45/212), hookworms, 16.5% (35/212), and S. stercoralis, 4.7% (10/212). In the anthelmintic treatment follow up, T. trichiura infection presented the lowest parasitological cure rate, only 60.6% (20/33). Hookworm, Ascaris lumbricoides and Strongyloides stercoralis infections demonstrated cure rates of 70.5 (12/17), 78.1 (25/32) and 100% (5/5), respectively. Individuals who remained infected underwent a new drug therapy. The second parasitological cure rate for T. trichiura was 38.5% (5/13), and 66.7% (2/3) and 75% (3/4) for hookworms and Ascaris lumbricoides, respectively. Trichuris trichiura infection presented the lowest parasitological cure rate at this second evaluation. This reinforces the need to perform a follow-up of all treated individuals. The possibility of drug resistance denotes the necessity for studies to clarify the mechanisms and to evaluate new therapeutic approaches.

Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load.

Strongyloides stercoralis infection in immunocompromised subjects, including chronic alcoholics, can lead to a severe disease. Moreover, its prevalence in alcoholic patients seems to be higher than that in the general population. The aims of this study were to evaluate the frequency of S. stercoralis infection in alcoholic patients and to investigate the influence of alcohol intake on the parasite load, as well as to evaluate the sensitivity of three different parasitological methods according to the larval output. Fecal samples of 1290 chronic alcoholic patients were examined by spontaneous sedimentation, Baermann-Moraes, and agar plate culture (APC) methods. S. stercoralis was the most frequent parasite found (14.5%; n = 187). Alcoholic individuals infected with Strongyloides stercoralis had a higher daily consumption of alcohol than those who were not infected, 528.6 and 403.0 g/day, respectively (p < 0.05). In addition, individuals with higher alcohol intake presented an increase in parasite load. The S. stercoralis diagnostic method with the highest sensitivity was APC, 97.9% (183/187). In conclusion, S. stercoralis seems to be the most frequent parasite found in alcoholic individuals from endemic areas and alcohol intake is positively associated with S. stercoralis larvae output. In addition, this study confirms that APC is the most sensitive parasitological method used for Strongyloides diagnosis.

Urinary Tract Infection by Strongyloides stercoralis: A Case Report.

The objective of this study was to report a case of a hydronephrotic patient with Strongyloides stercoralis infection, with discharge of rhabditoid larvae exclusively in urine. In 2013, a 72-yr-old male patient, hypertensive, obese, and diagnosed with hydronephrosis secondary to renal calculi, reported lumbar pain, polyuria, polaciuria, and dysuria, as well as frequent urinary tract infections. The microscopic analysis of urine sediment showed the presence of S. stercoralis rabditoid larvae. However, parasitological examinations by Baermann-Moraes, agar plate culture, and spontaneous sedimentation performed with 3 fecal samples on alternate days had negative results. The patient was treated with albendazole and to date has shown negative results in both parasitological and urine tests. This report deals with the unusual finding of S. stercoralis in a urine sample of an immunocompetent individual and absence of disseminated infection, but with hydronephrosis. Patients with nephropathies from S. stercoralis-endemic areas should be monitored periodically, as early detection may prevent the worsening of symptoms and renal failure.