Background

The clinical and laboratory characterization of Strongyloides stercoralis infection at diagnosis and after treatment is still poorly defined.

Objectives

The primary objective was to describe the pattern and frequency of clinical and laboratory characteristics associated with S. stercoralis infection. The secondary objectives were (a) comparison of characteristics reported in endemic versus non-endemic areas; and (b) the evaluation of the resolution of identified characteristics after treatment.

Methods

We searched PubMed, EMBASE, LILACS and CENTRAL up to May 2021. Eligible studies were randomized controlled trials (RCTs) for the treatment of S. stercoralis infection and prospective observational studies reporting data on symptoms caused by strongyloidiasis in individuals diagnosed with a highly specific test. Quality assessment was performed to assess the risk of bias. Demographic and clinical data were summarized using descriptive statistics. Meta-analysis was done by pooling the proportion of participants with symptoms with random effects model.

Results

Twenty studies were included: nine RCTs and 13 observational studies. Overall, symptoms were reported in 50.4% cases (95% CI 47.6–53.1), and were more often reported in non-endemic (58.6%, 95% CI 55.0–62.2) than in endemic (35.7%, 95% CI 31.4–39.9) areas. The removal of an article of lower quality did not impact on figures. Frequency of symptoms tended to reduce after treatment. Three studies reported the proportion of participants with eosinophilia before and after treatment: 76.9% of participants (95% CI 73.4–80.4) had eosinophilia at diagnosis, reducing to 27.4% (95% CI 24.0–30.7) after treatment.

Conclusions

About half of infected people complain at least of one symptom and almost 70% have eosinophilia. The frequency of symptoms and eosinophilia decreased after treatment, though the association with cure is not clearly defined. Providing relief from symptoms and eosinophilia is another reason, in addition to prevention of disseminated disease, for promoting screening and treatment of individuals with strongyloidiasis.

中文翻译：

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诊断和治疗后粪类圆线虫感染的临床和实验室特征：系统评价和荟萃分析

背景

诊断和治疗后粪类圆线虫感染的临床和实验室特征仍然不明确。

目标

主要目的是描述与S. stercoralis感染相关的临床和实验室特征的模式和频率。次要目标是 (a) 比较流行地区与非流行地区报告的特征；(b) 评估处理后已识别特征的分辨率。

方法

我们检索了截至 2021 年 5 月的 PubMed、EMBASE、LILACS 和 CENTRAL。符合条件的研究是用于治疗S. stercoralis感染的随机对照试验 (RCT)和前瞻性观察研究，这些研究报告了被诊断为具有高度特异性测试的个体的类圆线虫病引起的症状数据. 进行质量评估以评估偏倚风险。使用描述性统计总结人口统计学和临床​​数据。通过将有症状的参与者比例与随机效应模型进行汇总来进行荟萃分析。

结果

包括 20 项研究：9 项 RCT 和 13 项观察性研究。总体而言，50.4% 的病例（95% CI 47.6-53.1）报告了症状，并且在非地方性（58.6%，95% CI 55.0-62.2）中报告的症状比在地方性（35.7%，95% CI 31.4- 39.9) 领域。删除质量较低的文章对数据没有影响。治疗后症状的频率趋于减少。三项研究报告了治疗前后嗜酸性粒细胞增多的参与者比例：76.9% 的参与者（95% CI 73.4-80.4）在诊断时出现嗜酸性粒细胞增多，治疗后降至 27.4%（95% CI 24.0-30.7）。

结论

大约一半的感染者抱怨至少一种症状，近 70% 的人患有嗜酸性粒细胞增多症。治疗后症状和嗜酸性粒细胞增多的频率降低，但与治愈的关系尚不明确。除了预防播散性疾病外，缓解症状和嗜酸性粒细胞增多是促进对类圆线虫病患者进行筛查和治疗的另一个原因。