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Available data on\n                      <jats:italic>Strongyloides stercoralis<\/jats:italic>\n                      infection in high-risk patients in Iran are limited. The aim of the present study was to determine the prevalence of\n                      <jats:italic>S. stercoralis<\/jats:italic>\n                      infection and associated risk factors among high-risk patients as well as to evaluate the sensitivity of the diagnostic tests used in the diagnose of\n                      <jats:italic>S. stercoralis<\/jats:italic>\n                      infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study was performed from 2019 to 2020 among 300 high-risk patients in Khuzestan Province, southwestern Iran. Patients with autoimmune diseases, uncontrolled diabetes, HIV\/AIDS, cancer, organ transplant, hematological malignancy, asthma and chronic obstructive pulmonary disease (COPD) were examined using direct smear examination, formalin-ether concentration, Baermann funnel technique, agar plate culture, and ELISA test. Since agar plate culture was considered the reference diagnostic test, culture-positive samples were confirmed by PCR amplification and the sequencing of the nuclear\n                      <jats:italic>18S<\/jats:italic>\n                      rDNA (\n                      <jats:italic>SSU<\/jats:italic>\n                      ) hypervariable region (HVRIV) of the parasite.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of\n                      <jats:italic>S. stercoralis<\/jats:italic>\n                      infection was 1%, 1.3%, 2%, 2.7%, and 8.7% using direct smear examination, formalin-ether concentration, Baermann funnel technique, agar plate culture, and ELISA test, respectively. All culture-positive samples were confirmed by\n                      <jats:italic>SSU<\/jats:italic>\n                      -PCR. According to the results, the most sensitive test was ELISA, with 100% sensitivity, followed by the Baermann funnel technique with the sensitivity of 75%. Direct smear examination, formalin-ether concentration technique, and Baermann funnel technique had the highest PPV (100%) while the ELISA test had the highest NPV (100%). Significant eosinophilia was observed in the patients whose culture test was positive (7\/8;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the present study, the majority of the positive cases by the agar plate culture had a history of prolonged exposure to soil and of asthma and COPD and were &gt; 60 years old.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Given that the ELISA test had the highest NPV, the screening of all high-risk patients for\n                      <jats:italic>S. stercoralis<\/jats:italic>\n                      infection in endemic areas is recommended prior to starting corticosteroid therapy with the ELISA test. The results indicate the importance of paying attention to patients with unknown eosinophilia in endemic areas. Ivermectin should be available to strongyloidiasis patients in the endemic areas.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13071-020-04549-6","type":"journal-article","created":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T05:06:49Z","timestamp":1610168809000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, Southwestern Iran"],"prefix":"10.1186","volume":"14","author":[{"given":"Alireza","family":"Ashiri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdollah","family":"Rafiei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8190-8349","authenticated-orcid":false,"given":"Molouk","family":"Beiromvand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdollah","family":"Khanzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Alghasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,9]]},"reference":[{"key":"4549_CR1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s12639-019-01090-x","volume":"43","author":"G Vasquez-Rios","year":"2019","unstructured":"Vasquez-Rios G, Pineda-Reyes R, Pineda-Reyes J, Marin R, Ruiz EF, Terashima A. 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IR.AJUMS.MEDICINE.REC.1398.039). All patients were informed of the study aim and the procedures, and written informed consent was obtained prior to enrollment. For patients < 15\u00a0years old, written informed consent was obtained from their parents. All agar plate culture-positive cases were treated with albendazole 400\u00a0mg\/day orally for 3\u20137\u00a0days (the only drug currently available in the studied region).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"37"}}