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08-Jul-2004
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Arch Hellen Med, 20(1), January-February 2003, 60-66 SHORT COMMUNICATION Is Strongyloides stercoralis endemic in Greece? K. TΖΑΝΕΤOU,1 I. GEROS,1
E. KALOGEROPOULOU,1 A. KARATHANASIS,1 |
OBJECTIVE The aims of this study were: (a) detection of an area endemic for Strongyloides stercoralis in Greece, and (b) investigation of existing forms of the parasite in the environment, the infectivity of the strains encountered in the soil and the transmission frequency of infection in the general population. The detection of ova and rhabditiform/L1 larvae in the urine sediment of a patient with nephrotic syndrome under corticosteroid, the repeatedly negative fecal examination for ova and parasites and the excellent clinical condition of the patient, created the suspicion of urine contamination from the soil.
METHOD Culture of the urine sediment with Harada-Mori tube filter paper method. Testing of a large quantity of soil from the area around where the urine selection pot was kept, using the Baerman method.
RESULTS The urine sediment culture showed all the stages of the indirect or heterogenic cycle (free living male and female worms, ova and rhabditiform/L1 larvae) except for the infective filariform/L3 larvae. The soil samples revealed rhabditiform/L1 larvae. Despite the detection of an endemic area of S. stercoralis in this country, autochthonous human infection is extremely rare, since among a large number of patients examined in this laboratory during the last 16 years only one case of asymptomatic enteric strongyloidiasis was diagnosed. The fecal culture (using the same method) of two patients from Egypt with enteric strongyloidiasis, showed only infective filariform/ L3 larvae (direct or homogenic cycle).
CONCLUSIONS (a) This restricted study provides evidence for the endemicity of S. stercoralis in Greece. (b) Autochthonous human infection is rare in this country, probably because of the existence of strains adapted to complete the indirect cycle in the environment without producing infective filariform/L3 larvae. In contrast, strains of S. stercoralis rhabditiform/L1 larvae detected in feces of patients from another country with strongyloidiasis, yielded only infective filariform/L3 larvae.
Key words: Epidemiology, Direct life cycle, Indirect life cycle, Strongyloides stercoralis..
