Strongyloides Stercoralis Infection in Humans

Strongyloides stercoralis (S. stercoralis), commonly known as the threadworm, is a soil-transmitted helminth that infects humans and causes strongyloidiasis. Despite being a significant public health concern, it remains one of the most neglected tropical diseases. The infection is prevalent worldwide, except in Antarctica, and often results in asymptomatic chronic gut infections that can persist for decades. However, in immunocompromised individuals, particularly those on long-term corticosteroid therapy, hyperinfection syndrome can occur, leading to mortality rates as high as 87%. Challenges in managing strongyloidiasis include its wide range of clinical presentations, the lack of highly sensitive diagnostic tests, and the potential for fatal outcomes in immuno-compromised hosts. Despite understanding of the S. stercoralis life cycle and treatment options, strongyloidiasis remains underdiagnosed and poorly controlled due to several factors, including asymptomatic infections, limitations in diagnostic methods, and the potential for persistent infection. Additionally, the parasite is not sensitive to albendazole or mebendazole, rendering it unaffected by large-scale preventive treatment campaigns. This review comprehensively examines diagnostic methods, clinical manifestations, and treatment options for strongyloidiasis. Most importantly, this review demonstrates the clinical presentation, epidemiology, diagnosis, treatment, and control of the disease. It also discusses critical screening strategies and the importance of early detection. The review highlights the simplicity of treatment with a single dose of ivermectin or moxidectin, yet underscores the need for increased awareness among clinicians to prevent hyperinfection and disseminated disease. Active surveillance and advanced diagnostic tools are essential for effective management.