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Strongyloidiasis
A Fact Sheet for the Lost Boys and Girls of Sudan
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What is strongyloidiasis?
Strongyloidiasis is an infection caused by the parasite Strongyloides stercoralis. Although found in the southern United States, Strongyloides is mainly found in the tropics. It is common in Africa, including Sudan, Kenya, and Ethiopia.
How can I get strongyloidiasis?
Infection occurs when your skin comes in contact with soil that contains Strongyloides. The parasite penetrates the skin and migrates to the lungs; then it travels up to the mouth and is swallowed into the intestinal tract. Once there, it matures and lays eggs. The resulting worms and eggs are then passed in the stool and can infect other persons via soil, or can re-infect the same person. This re-infection of the original host can cause infections that last for many years.
What are the symptoms of strongyloidiasis?
Many infected persons have no symptoms. Among persons who do have symptoms, the most common are abdominal pain, diarrhea, and rash. Less commonly, nausea, vomiting, weight loss, cough, or breathing problems can result. Because the infection can persist, a person can have symptoms on and off for many years.
How is strongyloidiasis diagnosed?
Blood testing can diagnose Strongyloides infection. A positive blood test means someone is infected with Strongyloides, and a negative test means they are not. If a person was once infected with Strongyloides and then cured, the blood test becomes negative about six months after the cure. Though less reliable, Strongyloides can also be diagnosed with stool tests.
What is the treatment for strongyloidiasis?
Several drugs can be used to treat Strongyloides. A drug called albendazole, taken twice a day for three days, is the treatment we recommend for the Lost Boys and Girls. Albendazole is safe, but may cause some side effects, including abdominal pain, nausea, vomiting, and hair loss. Rarely, it can cause abnormal blood tests involving the liver and blood cells. Lastly, someone infected with both Strongyloides and another parasite called cysticercosis may have a seizure if they take albendazole; infection with both of these parasites in someone from Sudan is unusual. All of these side effects would be rare with only three days of treatments. This treatment cures most persons infected with this disease. Pregnant women should not take albendazole.
It is difficult to tell if a person has been cured after taking albendazole. If a person’s immune system became weakened later in life ( for example, through an organ transplant, chemotherapy, or taking other drugs that weaken the immune system), ensuring the disease had been cured would be important. Cure could be confirmed by a repeat blood test, done at least six months after the treatment. Alternatively, a person can be treated with a different drug called ivermectin, which cures some persons not cured by albendazole.
Why should I be treated if I have strongyloidiasis?
If at any time an infected person’s immune system becomes weak (for example, through an organ transplant, chemotherapy, or other drugs that weaken the immune system), the infection can become fatal. Thus, it is important to treat this infection any time a person is diagnosed with it, even if they have no symptoms.