472 - Strongyloides on the Go! - Describing Strongyoides Exposure and Risk Factors Among Pediatric Patients Visiting a Mobile Clinic

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 472
Publication Number: 472.217

Lynda C. Aririguzo, Baylor College of Medicine, Houston, TX, United States; Aditi Gupta, Baylor College of Medicine, Houston, TX, United States; Cassandra Duran, Baylor College of Medicine, Houston, TX, United States; Norma Castillo, Baylor College of Medicine, Houston, TX, United States; Ankona Banerjee, Baylor College of Medicine, Houston, TX, United States; Eva H. Clark, Baylor College of Medicine, Houston, TX, United States; Jill Weatherhead, Baylor College of Medicine, Houston, TX, United States; Sanghamitra Misra, Texas Children's Hospital, Houston, TX, United States

Presenting Author(s)

Lynda C. Aririguzo, MD, MPH (she/her/hers)

Assistant Professor of Pediatrics
Baylor College of Medicine
Houston, Texas, United States

Background: Though the prevalence of strongyloidiasis among US children is unknown, the American Academy of Pediatrics recommends that pediatric providers test or empirically treat children from endemic countries for strongyloidiasis to prevent future complications. The test of choice, Strongyloides IgG, may not be readily available in low resource areas. The treatment of choice, ivermectin, may be difficult to obtain for under- or uninsured families. A better understanding of strongyloidiasis epidemiology would improve pediatric providers’ decision making in resource limited settings. Our 2 mobile clinics provide care to an underserved population primarily comprised of Latin American immigrants.

Objective:

We aim to (1) describe the frequency of Strongyloides IgG positivity and (2) capture medical and social data to describe strongyloidiasis risk factors among pediatric patients presenting for well child care (WCC) on our mobile clinics.

Design/Methods: From October to November 2022, we invited patients aged 0-18 years presenting for WCC on the mobile clinics to participate in this ongoing cross-sectional study. Participants completed a written survey about demographics, travel history, symptoms, medication use, and epidemiologic exposures. We obtained Strongyloides IgG and CBC with differential (for absolute eosinophil count [AEC]) from each participant. We then descriptively analyzed the data.

Results: 70 patients presented for WCC; 50 consented to participate. 30 (60%) were male. 49 (98%) were Hispanic. 48 (96%) had lived in or visited countries considered endemic for Strongyloides. The most common countries of birth were Honduras (n=14, 28%) and Venezuela (n=6, 12%). 35 (70%) moved to the US < 1 year prior to enrollment. 23 (46%) had taken an antiparasitic in their lifetime. 11 (22%) had lived in a house without running, potable water in their lifetime. 4 (8%) had abnormal Strongyloides IgG results (2 positive and 2 equivocal). The median AEC for all individuals was 250 cells/μL (range of 30 – 1270 cells/μL). 5 (10%) had AEC ≥500 cells/μL. 34 (68%) reported no symptoms within the last month, including 3 of 4 participants with abnormal Strongyloides IgG. Tables 1-3 provide details of demographics, travel history, and characteristics of participants with abnormal Strongyloides IgG.

Conclusion(s): More data is needed to establish strongyloidiasis prevalence and risk factors among the at-risk US pediatric population. Additional data will inform pediatric providers caring for underserved populations with few resources for testing and treating strongyloidiasis.