Prevalence and risk of having Strongyloides stercoralis infection in alcoholic patients: a systematic review and meta-analysis.

Strongyloides stercoralis infection affects approximately 600 million individuals worldwide. This parasite has the ability to exacerbate infection through internal autoinfection, which can lead to hyperinfection and/or dissemination, conditions associated with high morbidity and mortality, particularly in immunocompromised patients such as those with alcohol use disorder (AUD). In this study, we conducted a meta-analysis to assess the prevalence and risk of having S. stercoralis infection among individuals with AUD. Searches were performed in the PubMed, Embase, and LILACS databases to identify studies investigating the prevalence of S. stercoralis infection in individuals with AUD, with or without comparison to non-alcoholic groups. The pooled prevalence was calculated using the Probit Logit (PLOGIT) transformation, and the odds ratio (OR) was used for risk comparison. The initial search yielded 154 studies, of which seven were included in the systematic review and meta-analysis. The combined prevalence of S. stercoralis infection among patients with AUD was 16.9%. Risk analysis based on four studies showed that individuals with AUD had a 6.08-fold higher risk of infection compared with non-alcoholic individuals. These findings highlight chronic alcoholism as a significant risk factor for strongyloidiasis, likely due to a combination of environmental, physiological, and immunological factors. This meta-analysis underscores the critical need for routine screening for S. stercoralis infection in patients with AUD, even in the absence of clinical symptoms, to ensure early detection and timely intervention.