Article type
Abstract
Human infection by Strongyloides stercoralis in West Africa, 1974-2023: systematic review and meta-analysis
Rufin Kouassi Assaré1,2, Fidèle Kouakou Bassa1, Rose Diakité Nana1, Mamadou Ouattara1, Eliézer Kouakou N’Goran1, Jürg Utzinger2
1Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire; 2Swiss Tropical and Public Health Institute, Kreuzstrasse 2, P.O. Box, CH-4123 Allschwil, Switzerland
Background
Strongyloidiasis is a neglected soil-transmitted helminthiasis due to roundworm Strongyloides stercoralis. Recent estimate revealed that S. stercoralis infection affects more than 600 million people worldwide, mainly in tropical and subtropical areas. The infection leads to chronic morbidity and can be fatal if untreated.
Objectives
We pursued a systematic review and meta-analysis to estimate the pooled prevalence of strongyloidiasis in West African countries over the past five decades and to determine its associated risk factors.
Methods
Published studies between January 1, 1974 and December 31, 2023 were searched in African Online Journals, Embase, Google Scholar, Horizon, ProQuest, PubMed, Scopus and Web of Sciences. We followed the PRISMA guidelines and included articles published in English or French. Heterogeneity of included studies was assessed using Cochran’s Q test and I2 test statistics. Publication bias was assessed using funnel plot and Egger’s regression test.
Results
Overall, 332 studies were included in the analysis (Figure 1) and 138,630 individuals participated in the selected studies. Most of the studies were carried out using Kato-Katz technique (118 studies). The pooled prevalence estimate of strongyloidiasis was 4.6% (95% confidence interval (CI): 4.2-5.0%). The highest prevalence of strongyloidiasis was reported in Gambia (18.9%, 95% CI: 11.1-26.8%) following by Liberia (14.9%, 95% CI: 9.8-19.9%) and Togo (10.7%, 95% CI: 6.9-14.6%). S. stercoralis infection was more prevalent in Gulf of Guinea countries (Figure 2). The pooled prevalence of S. stercoralis prevalence was 5.2% in male and in female. HIV patients were at higher odds of S. stercoralis infection (Odds ratio (OR) = 1.21, 95% CI: 0.91-1.50).
Conclusion
Current review revealed that strongyloidiasis is a public health problem in West Africa, particularly in Gulf of Guinea countries. This finding confirms that strongyloidiasis should be included in soil-transmitted helminthiasis control programs in order to shorten the burden of the disease.
Rufin Kouassi Assaré1,2, Fidèle Kouakou Bassa1, Rose Diakité Nana1, Mamadou Ouattara1, Eliézer Kouakou N’Goran1, Jürg Utzinger2
1Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire; 2Swiss Tropical and Public Health Institute, Kreuzstrasse 2, P.O. Box, CH-4123 Allschwil, Switzerland
Background
Strongyloidiasis is a neglected soil-transmitted helminthiasis due to roundworm Strongyloides stercoralis. Recent estimate revealed that S. stercoralis infection affects more than 600 million people worldwide, mainly in tropical and subtropical areas. The infection leads to chronic morbidity and can be fatal if untreated.
Objectives
We pursued a systematic review and meta-analysis to estimate the pooled prevalence of strongyloidiasis in West African countries over the past five decades and to determine its associated risk factors.
Methods
Published studies between January 1, 1974 and December 31, 2023 were searched in African Online Journals, Embase, Google Scholar, Horizon, ProQuest, PubMed, Scopus and Web of Sciences. We followed the PRISMA guidelines and included articles published in English or French. Heterogeneity of included studies was assessed using Cochran’s Q test and I2 test statistics. Publication bias was assessed using funnel plot and Egger’s regression test.
Results
Overall, 332 studies were included in the analysis (Figure 1) and 138,630 individuals participated in the selected studies. Most of the studies were carried out using Kato-Katz technique (118 studies). The pooled prevalence estimate of strongyloidiasis was 4.6% (95% confidence interval (CI): 4.2-5.0%). The highest prevalence of strongyloidiasis was reported in Gambia (18.9%, 95% CI: 11.1-26.8%) following by Liberia (14.9%, 95% CI: 9.8-19.9%) and Togo (10.7%, 95% CI: 6.9-14.6%). S. stercoralis infection was more prevalent in Gulf of Guinea countries (Figure 2). The pooled prevalence of S. stercoralis prevalence was 5.2% in male and in female. HIV patients were at higher odds of S. stercoralis infection (Odds ratio (OR) = 1.21, 95% CI: 0.91-1.50).
Conclusion
Current review revealed that strongyloidiasis is a public health problem in West Africa, particularly in Gulf of Guinea countries. This finding confirms that strongyloidiasis should be included in soil-transmitted helminthiasis control programs in order to shorten the burden of the disease.