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Surveillance for Soil Transmitted Helminths, Strongyloidiasis, Toxocariasis, Cryptosporidiosis and Other Parasitic Diseases in Mississippi
31 Pages Posted: 9 Oct 2020
More...Abstract
Background: Recently reports of foci of hookworm and strongyloidiasis in rural Alabama has highlighted the possibility of continued soil transmitted helminth (STH) transmission in the American South. However, very little active parasitic disease surveillance has been undertaken in this region since the second decade of the last century.
Methods: Convenience sampling was used for pilot surveillance of soil STH infection and strongyloidiasis in Mississippi. Microscopy and real-time PCR were performed on stool samples. Seroprevalence of other parasitic disease exposure, namely toxocariasis, cryptosporidiosis and giardiasis, was determined multiplex serology.
Findings: Real-time PCR testing of 594 fecal samples from Mississippi residents for Necator americanus and Strongyloides stercoralis identified one confirmed S. stercoralis positive. A subset of 224 samples were also tested by real-time PCR for Ancylostoma spp., Ascaris lumbricoides and Trichuris trichiura, yielding negative results. Saturated salt flotation microscopy on 507 of the fecal samples was negative.
Multiplex serology testing of 1,960 serum samples from Mississippi residents yielded a seroprevalence of Toxocara spp. antibodies (8.8%) notably higher than national averages. The seroprevalence of Cryptosporidium spp. antibodies was 27.4%, while 5.7% had antibodies to Giardia duodenalis. Four (0.3%) sera contained antibodies to S. stercoralis.
Interpretation: These data suggest that STH infection is not common and strongyloidiasis may still occur in Mississippi residents. Exposure to Toxocara appears to be common. These results are from testing of convenience samples and do not eliminate the possibility that isolated foci of hookworm and other STH transmission remain in Mississippi.
Funding Statement: This work was funded by the University of Mississippi Medical Center and the Centers for Disease Control and Prevention.
Declaration of Interests: None of the authors have commercial or other association that might pose a conflict of interest.
Ethics Approval Statement: This study was approved by the UMMC Institutional Review Board; on ethical review, CDC was determined to be non-engaged and therefore did not require a separate IRB review. All samples sent to CDC were de-identified.
Keywords: Soil-transmitted helminths, Toxocara, Cryptosporidium, pediatric, United States
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