The Lancet Global Health
Volume 7, Issue 2, 2019, Pages e236-e248

Prevalence of strongyloidiasis and schistosomiasis among migrants: a systematic review and meta-analysis (Article) (Open Access)

Asundi A. , Beliavsky A. , Liu X.J. , Akaberi A. , Schwarzer G. , Bisoffi Z. , Requena-Méndez A. , Shrier I. , Greenaway C.*
  • a Division of Infectious Diseases, Boston Medical Center, Boston, United States
  • b Department of Internal Medicine, McGill University, Montreal, QC, Canada
  • c Department of Internal Medicine, McGill University, Montreal, QC, Canada
  • d Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
  • e Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
  • f Centre for Tropical Diseases, Sacro Cuore—Don Calabria Hospital, Negrar, Verona, Italy, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
  • g Barcelona Institute for Global Health, Universitat de Barcelona—Hospital Clinic, Barcelona, Spain
  • h Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
  • i Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada, Division of Infectious Diseases and Clinical Epidemiology, SMBD Jewish General Hospital, McGill University, Montreal, QC, Canada

Abstract

Background: Global migration from regions where strongyloidiasis and schistosomiasis are endemic to non-endemic countries has increased the potential individual and public health effect of these parasitic diseases. We aimed to estimate the prevalence of these infections among migrants to establish which groups are at highest risk and who could benefit from screening. Methods: We did a systematic review and meta-analysis of strongyloidiasis and schistosomiasis prevalence among migrants born in endemic countries. Original studies that included data for the prevalence of Strongyloides or Schistosoma antibodies in serum or the prevalence of larvae or eggs in stool or urine samples among migrants originating from countries endemic for these parasites and arriving or living in host countries with low endemicity—specifically the USA, Canada, Australia, New Zealand, Israel, and 23 western European countries—were eligible for inclusion. Pooled estimates of the prevalence of strongyloidiasis and schistosomiasis by stool or urine microscopy for larvae or eggs or serum antibodies were calculated with a random-effects model. Heterogeneity was explored by stratification by age, region of origin, migrant class, period of study, and type of serological antigen used. Findings: 88 studies were included. Pooled strongyloidiasis seroprevalence was 12·2% (95% CI 9·0–15·9%; I2 96%) and stool-based prevalence was 1·8% (1·2–2·6%; 98%). Migrants from east Asia and the Pacific (17·3% [95% CI 4·1–37·0]), sub-Saharan Africa (14·6% [7·1–24·2]), and Latin America and the Caribbean (11·4% [7·8–15·7]) had the highest seroprevalence. Pooled schistosomiasis seroprevalence was 18·4% (95% CI 13·1–24·5; I2 97%) and stool-based prevalence was 0·9% (0·2–1·9; 99%). Sub-Saharan African migrants had the highest seroprevalence (24·1·% [95% CI 16·4–32·7]). Interpretation: Strongyloidiasis affects migrants from all global regions, whereas schistosomiasis is focused in specific regions and most common among sub-Saharan African migrants. Serological prevalence estimates were several times higher than stool estimates for both parasites. These data can be used to inform screening decisions for migrants and support the use of serological screening, which is more sensitive and easier than stool testing. Funding: None. © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

Author Keywords

[No Keywords available]

Index Keywords

Strongyloidiasis Strongyloides stercoralis antibody blood level parasitosis Embase human feces analysis Larva priority journal Medline meta analysis egg parasitoid migrant antiparasitic therapy false positive result Article parasite prevalence schistosomiasis serology microscopy endemic disease Urinalysis seroprevalence systematic review intestine parasite
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060276117&doi=10.1016%2fS2214-109X%2818%2930490-X&partnerID=40&md5=a24625e420385c026566eb13000579f4
DOI: 10.1016/S2214-109X(18)30490-X
ISSN: 2214109X
Cited by: 4
Original Language: English