Strongyloides stercoralis: A discussion about its coproparasitological diagnosis and its prevalence in patients positive for the human immunodeficiency virus (HIV)

Abstract

The prevalence of Strongyloides stercoralis usually is under estimated because direct smear of feces is an insensitive test for this parasite. For this reason other methods are recommended such as Baermann method and agar plate culture (APC). However, is ideal the sequential analysis at least of 7 stool samples.

In this report we analyze the prevalence of intestinal parasites in 100 VIH-positive patients. From each patient a stool sample was analyzed by direct smear, Baermann method and, ACP. Also the prevalence of Strongyloides was retrospectively

recorded during six months from the fecal samples remitted to analysis at the Clinical Laboratory of the Hospital San Juan de Dios.

Twenty one percent of the VIH-positive patients showed at least one kind of intestinal nematode or protozoa. Twelve of them (19%) had less than 200 cells CD4/ml and only 4 cases infected by nematode were detected, 2 of them had less tan 200 cells CD4/ml, one corresponded to Strongyloides diagno- sed by Baermann method and CPA. From September (1996) to March (1997) 1900 fecal samples were remitted to the clinical laboratory, 10 of them ((),5 %) was diagnosed Strongyloides by direct smear.

The low prevalence of Strongyloides in VIH-positive patients has been reported. Nevertheless, suspect of this parasite is important in any patient with a clinical condition associated with immunodeficiency.