Strongyloides stercoralis infection: a health issue regarding indigenous people in Taiwan.

Strongyloidiasis, caused by Strongyloides stercoralis, is endemic in tropical and subtropical regions. Whether or not the infection rate is higher among indigenous populations in Taiwan remains unclear. The aim of our study was to assess the racial demographics, diagnoses and clinical details of strongyloidiasis. A total of 41 patients (27 males and 14 females) with strongyloidiasis at a tertiary referral centre in eastern Taiwan in a 21-year period were investigated retrospectively. The majority (36/41, 88%) of these patients lived in rural townships. Common clinical symptoms were anorexia, abdominal pain, nausea, vomiting, fever, coughing and diarrhea. The laboratory abnormalities were anemia, eosinophilia, and leukocytosis. The average age of the indigenous patients was younger than that of the Hans Chinese patients. Alcoholism among the indigenous Taiwanese (all males) was significantly more frequent than in the Hans Chinese, which might be one of the reasons that the indigenous males had a higher infection rate than Hans Chinese males. The group of patients with intestinal strongyloidiasis exhibited a significant lower mortality and a higher recovery rate than those with hyperinfection syndrome. Leptospirosis should be considered as an underlying factor associated with strongyloidiasis, especially in indigenous patients. The relationship and mechanism of leptospira-induced overwhelming infection including strongyloidiasis remains to be elucidated.