Original Article

Seroprevalence of Strongyloides stercoralis Infection in Patients with Hyperlipidemia: A Case-Control Study

Abstract

Background: Strongyloides stercoralis is one of the soil-transmitted helminths (STH) in tropical and subtropical regions. The role of lipid profile has been investigated in the survival of larval stages of helminths, but there is limited information about the role of lipid profiles and strongyloidiasis. Hence, we aimed to investigate the seroprevalence of S. stercoralis infection in patients with hyperlipidemia is compared with the non-hyperlipidemia.
Methods: In 2023, participants were selected from the laboratory of Porsina Hospital in Guilan Province, northern Iran and their lipid profiles including TG, CHOL, LDL, HDL, and VLDL were measured. They were divided into two groups of case and control and matched based on sex and age. S. stercoralis Ab (IgG) was measured by ELISA methods, using the NovaTec kit. Finally, statistical analysis was performed.
Results: Each case and control group consisted of 105 participants, from 13 to 80 years old. 56.66% were female and 43.33% were male. The sero-prevalence of S. stercoralis was found 4.76% in the case group compared to 0.95% in the control group. We found an association between TG fall and VLDL with sero-prevalence of S. stercoralis in hyperlipidemia group (P= 0.034), but other lipid profiles did not show a significant association. A significant relationship was found between contact with dogs and sero-prevalence of S. stercoralis (P=0.001).
Conclusion: The sero-prevalence of S. stercoralis in the case group was 5 times higher than the control group. A significant association between TG and VLDL fall with S. stercoralis Ab (IgG) was observed, but future studies with more sample sizes are suggested to investigate the anti-atherogenic effect of S. stercoralis. Also, a genetic assessment of S. stercoralis and the host (humane and dogs) is recommended to research zoonotic potential in epidemic areas.

1. Olsen A, van Lieshout L, Marti H, Polderman T, Polman K, Steinmann P, et al. Strongyloidiasis–the most neglected of the neglected tropical diseases? Trans R Soc Trop Med Hyg. 2009; 103(10):967–72.
2. Schär F, Trostdorf U, Giardina F, et al. Strongyloides stercoralis: global distribution and risk factors. PLoS Negl Trop Dis. 2013; 7(7):e2288.
3. Nutman TB. Human infection with Strongyloides stercoralis and other related Strongyloides species. Parasitology. 2017; 144(3):263–73.
4. Sharifdini M, Kia EB, Ashrafi K, et al. An analysis of clinical characteristics of Strongyloides stercoralis in 70 indigenous patients in Iran. Iran J Parasitol. 2014; 9(2):155-62.
5. Sharifdini M, Ghanbarzadeh L, Barikani A, Saraei M. Prevalence of intestinal parasites among rural inhabitants of Fouman, Guilan Province, Northern Iran with emphasis on Strongyloides stercoralis. Iran J Parasitol. 2020; 15(1):91-100.
6. Badparva E, Nayebzadeh H, Barkhordari MH, Ezatpour B. Epidemiological study of Strongyloides stercoralis with a comparative diagnostic approach, in lorestan, west of Iran. Arch Clin Infect Dis. 2014; 9(2): e16815.
7. Rasti S, Arbabi M, Hooshyar H. Prevalence of intestinal parasitic infections among the geriatric and disabled in Golabchi Center of Kashan during 2006-2007. Feyz Med Sci J. 2009; 12(4):78–82.
8. Muller R, Wakelin D. Worms and human disease. CABi. 2002.
9. Blatt JM, Cantos GA. Evaluation of techniques for the diagnosis of Strongyloides stercoralis in human immunodeficiency virus (HIV) positive and HIV negative individuals in the city of Itajai, Brazil. Braz J Infect Dis. 2003; 7(6):402–8.
10. Colosimo M, Caroleo MC, Caruso A, et al. Fatal Case of Autochthonous Strongyloides stercoralis Hyperinfection in an Immunosuppressed Calabrian Patient. Reports. 2022; 5(4):47.
11. Fan W, Fu Q, Yu Y. Pulmonary strongyloidiasis and hyperinfection in a Patient with idiopathic inflammatory myopathy: A case report. Heliyon. 2023; 10(1):e23484.
12. Carvalho EM, Da Fonseca Porto A. Epidemiological and clinical interaction between HTLV‐1 and Strongyloides stercoralis. Parasite Immunol. 2004; 26(11–12):487–97.
13. Mendonça SC, Maria do Rosário F, Rodrigues RM, Ferreira Jr A, Costa-Cruz JM. Is there an association between positive Strongyloides stercoralis serology and diabetes mellitus? Acta Trop. 2006; 99(1):102–5.
14. Ashiri A, Rafiei A, Beiromvand M, Khanzadeh A, Alghasi A. Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, Southwestern Iran. Parasit Vectors. 2021; 14(1):37.
15. Rafiei R, Rafiei A, Rahdar M, Keikhaie B. Seroepidemiology of Strongyloides stercoralis amongst immunocompromised patients in Southwest Iran. Parasite Epidemiol Control. 2016; 1(3):229–32.
16. Simons K, Toomre D. Lipid rafts and signal transduction. Nat Rev Mol Cell Biol. 2000; 1(1):31–9.
17. Doenhoff MJ, Stanley RG, Griffiths K, Jackson CL. An anti-atherogenic effect of Schistosoma mansoni infections in mice associated with a parasite-induced lowering of blood total cholesterol. Parasitology. 2002; 125(Pt 5):415–21.
18. Shepherd J. Lipids in health and disease. Biochem Soc Trans. 2004; 32(Pt 6):1051–6.
19. Wiedermann U, Stemberger H, Unfried E, et al. Intestinal worm burden and serum cholesterol or lipid concentration in a Shipibo population (Peru). Zentralbl Bakteriol. 1991; 275(2):279–86.
20. Elizabete de Jesus Inês, Silva MLS, de Souza JN, Galvão AA, Teixeira MCA, Soares NM. Alterations in serum paraoxonase-1 activity and lipid profile in chronic alcoholic patients infected with Strongyloides stercoralis. Acta Trop. 2017; 166:1–6.
21. Montresor A, Mupfasoni D, Mikhailov A, et al. The global progress of soil-transmitted helminthiases control in 2020 and World Health Organization targets for 2030. PLoS Negl Trop Dis. 2020; 14(8):e0008505.
22. Tietz NW. Clinical Guide to Laboratory Tests. 4 th [sup] ed. Philadelphia: WB Saunders Company; 2006.
23. Memar AR, Rezaian M, Mohraz M, Zahabioun F, Hadighi R, Kia EB. A comparative analysis of intestinal parasitic infections between HIV+/AIDS patients and non-HIV infected individuals. Iran J Parasitol. 2007; 2(1):1-6.
24. Huang J, Zhang H, Liu S, et al. Is Toxoplasma gondii infection correlated with nonalcoholic fatty liver disease? A population-based study. BMC Infect Dis. 2018; 18(1):629.
25. Ma’ani N, Jabir DM. Study of lipid profile alteration in the patients infected with Giardia lamblia and compare the results with healthy individuals. Qadisiah Med J. 2013; 9(15):119–29.
26. Linstead D. New defined and semi-defined media for cultivation of the flagellate Trichomonas vaginalis. Parasitology. 1981; 83(Pt 1):125–37.
27. Kalantari N, Darbandi Z, Bayani MA, Sharbatkhori M, Bayani M, Ghaffari S. Prevalence and associated risk factors of Strongyloides sp. infection in diabetic patients in the central part of Mazandaran, northern Iran. Arch Clin Infect Dis. 2019; 14(4): e86569.
28. Varzegar P, Bayani M, Kalantari N, et al. Seroprevalence of Strongyloides stercoralis among patients with leptospirosis in northern Iran: a descriptive cross-sectional study. J Helminthol. 2021; 95:e34.
29. Mido S, Fath EM, Farid AS, Nonaka N, Oku Y, Horii Y. Trichinella spiralis: Infection changes serum paraoxonase-1 levels, lipid profile, and oxidative status in rats. Exp Parasitol. 2012; 131(2):190–4.
30. Ramos TM de B, Vasconcelos AS de, Carvalho VCO de, Lima VL de M. Alterations in cholesterol, triglyceride and total phospholipid levels in plasma of Callithrix jacchus (sagüi) reinfected by Schistosoma mansoni. Rev Soc Bras Med Trop. 2004; 37(1):37–40.
31. Fadaei Tehrani M, Sharifdini M, Zahabiun F, Latifi R, Kia EB. Molecular characterization of human isolates of Strongyloides stercoralis and Rhabditis spp. based on mitochondrial cytochrome c oxidase subunit 1 (cox1). BMC Infect Dis. 2019; 19(1):776.
32. Jaleta TG, Zhou S, Bemm FM, et al. Different but overlapping populations of Strongyloides stercoralis in dogs and humans—Dogs as a possible source for zoonotic strongyloidiasis. PLoS Negl Trop Dis. 2017; 11(8):e0005752.
Files
IssueVol 19 No 3 (2024) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijpa.v19i3.16394
Keywords
Strongyloides stercoralis Hyperlipidemia Human Iran

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sari MA, Karimian P, Kia EB, Mohebali M, Aghakhani A, Darabi E, Fakhrieh Kashan Z. Seroprevalence of Strongyloides stercoralis Infection in Patients with Hyperlipidemia: A Case-Control Study. Iran J Parasitol. 2024;19(3):341-348.