Title : Prevalence of strongyloidiasis and its risk factors in pregnant women in Guilan Province, North of Iran
Abstract:
Strongyloidiasis is a neglected tropical and subtropical disease affecting humans worldwide While often asymptomatic, it can cause hyperinfection syndrome in immunocompromised individuals, leading to disseminated infection, frequently , fatal outcomes. Chronic strongyloidiasis poses a significant risk of malnutrition, particularly in vulnerable populations such as pregnant women, infants, and children. Pregnancy-induced immunosuppression heightens susceptibility to hyperinfection and disseminated strongyloidiasis. Therefore, this study aimed to assess the prevalence of strongyloidiasis among pregnant women attending Al-Zahra Hospital in Rasht (Guilan Province ) in 2024.
Methods: This cross-sectional study was conducted between September 2024 and February 2025. Participants included pregnant women referred to Al-Zahra Hospital, a specialized obstetrics and gynecology center in Rasht. Following informed consent, blood samples and, where permitted, stool samples were collected alongside completed questionnaires documenting clinical symptoms. Stool samples , were cultured daily, and both serum and stool specimens were processed under standardized conditions. Serum samples were analyzed for Strongyloides stercoralis IgG antibodies using the NovaTec ELISA Kit(LOT:STRO-050N), while stool samples
underwent parasitological examination at the Strongyloidiasis Laboratory,School of Public Health, Tehran University of Medical Sciences. Data were statistically using SPSS 25, with Fisher’s exact test employed to assess associations.
Findings: The study included 384 pregnant women (gestational age: 1-8 months) aged 15-48 years, with 25% reporting a history of miscarriage. Seroprevalence of strongyloidiasis (S.stercoralis IgG antibodies) was 2.6%. No significant associations (P> 0.05) were found between infection and factors such as vegetable washing practices, residential location (urban/rural), education level, occupational exposure, soil contact, clinical symptoms, animal contact, or hypereosinophilia. However, a significant association (P < 0.05) was found between strongyloidiasis and underlying conditions (gestational diabetes was present in 30% of patients).
Conclusion: Given the overlap between strongyloidiasis symptoms and common pregnancy-related complaints, including gastrointestinal and respiratory symptoms, as well as other hematological manifestations may contribute to underdiagnosis. Hormonal changes, like high progesterone in the first trimester, mainly cause respiratory symptoms in pregnancy. Persistent symptoms in later trimesters may indicate infections. In this study, 50% of strongyloidiasis cases showed respiratory symptoms during the second or third trimesters. Serological screening for S.stercoralis is recommended as part of preconception care, complemented by health education on proper hygiene and animal contact practices. Additionally, further research incorporating genetic analyses of both parasites and hosts (humans, dogs, and cats) is critical to elucidating the zoonotic potential of strongyloidiasis in endemic regions.
