Strongyloides stercoralis and other intestinal parasites among the patients receiving immunosuppressive drugs in northern Iran; a closer look into risk factors.

Objectives The objective of this study was to evaluate the prevalence of Strongyloides stercoralis and other intestinal parasites among the patients receiving immunosuppressive drugs and related risk factors in northern Iran. Methods This cross-sectional study was conducted among 494 patients receiving immunosuppressive drugs including cancer patients undergoing chemotherapy (n=188) and those treated with prolonged corticosteroid administration (n=306). All fresh fecal samples were examined by direct wet-mount, formalin ethyl-acetate concentration, and agar plate culture techniques. Results In total, 16.8% of patients were positive for at least one intestinal parasite, so among those the helminthic and protozoan infection rates were 5.1% and 12.3%, respectively. The infection rate was significantly higher in corticosteroid treated individuals (19.6%) than cancer patients (12.2%) (P = 0.03). The prevalence rate of S. stercoralis among the patients receiving chemotherapy and those treated with corticosteroids were 4.3% and 5.2%, respectively. The prevalence rate of S. stercoralis infection was significantly higher in older patients (P=0.02). Conclusion Strongyloidiasis is one of most common parasites among the patients receiving immunosuppressive drugs in northern Iran. Early diagnosis and proper treatment of these patients are necessary to minimize complications of severe strongyloidiasis.