{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:28:36Z","timestamp":1768253316074,"version":"3.49.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010179","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000}}],"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013844","name":"Fundaci\u00f3n Mundo Sano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013844","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\nBackground<\/jats:title>\nStrongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic> infections in villages with diverse prevalence levels for these parasites. Further understanding in the relationship between these Neglected Tropical Diseases of South America is relevant for the design of integrated control measures as well as exploring potential biologic interactions.<\/jats:p>\n<\/jats:sec>\n\nMethodology<\/jats:title>\nCommunity based cross-sectional studies were carried in different villages of the Chaco and Yungas regions in Argentina. Individuals were diagnosed by serology for S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic>. The association between S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic>, and between anemia and the two parasites was evaluated using two approaches: marginal (Ma) and multilevel regression (Mu).<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nA total of 706 individuals from six villages of northern Argentina were included. A total of 37% were positive for S<\/jats:italic>. stercoralis<\/jats:italic>, 14% were positive for T<\/jats:italic>. cruzi<\/jats:italic> and 5% were positive for both. No association was found between infection with S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic> in any of the models, but we found a negative correlation between the prevalence of these species in the different villages (r = -0.91). Adults (> 15 years) presented association with S<\/jats:italic>. stercoralis<\/jats:italic> (Ma OR = 2.72; Mu OR = 2.84) and T<\/jats:italic>. cruzi<\/jats:italic> (Ma OR = 5.12; Mu OR = 5.48). Also, 12% and 2% of the variance of infection with S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic>, respectively, could be explained by differences among villages. On the other hand, anemia was associated with infection with S<\/jats:italic>. stercoralis (<\/jats:italic>Ma OR = 1.73; Mu OR = 1.78) and was more prevalent in adults (Ma OR = 2.59; Mu OR = 2.69).<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nWe found that coinfection between S<\/jats:italic>. stercoralis<\/jats:italic> and T<\/jats:italic>. cruzi<\/jats:italic> is not more frequent than chance in endemic areas. However, the high prevalence for both parasites, raises the need for an integrated strategy for the control of STH and Chagas disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010179","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T18:39:21Z","timestamp":1643999961000},"page":"e0010179","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Strongyloides stercoralis and Trypanosoma cruzi coinfections in a highly endemic area in Argentina"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6574-4586","authenticated-orcid":true,"given":"Pedro E.","family":"Fleitas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6380-1206","authenticated-orcid":true,"given":"Noelia","family":"Floridia-Yapur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvia E.","family":"Nieves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Echazu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1588-5265","authenticated-orcid":true,"given":"Paola A.","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00e1s R.","family":"Caro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramiro","family":"Avelda\u00f1o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-3537","authenticated-orcid":true,"given":"Walter","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Fernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-9725","authenticated-orcid":true,"given":"Favio","family":"Crudo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4253-9077","authenticated-orcid":true,"given":"Rub\u00e9n O.","family":"Cimino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro J.","family":"Krolewiecki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"key":"pntd.0010179.ref001","volume-title":"First WHO report on neglected tropical diseases: working to overcome the global impact of neglected tropical diseases.","author":"WHO","year":"2010"},{"key":"pntd.0010179.ref002","doi-asserted-by":"crossref","first-page":"931","DOI":"10.3201\/eid1705.100490","article-title":"Strongyloidiasis in Man 75 Years after Initial Exposure","volume":"17","author":"V Prendki","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"pntd.0010179.ref003","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3390\/tropicalmed3020053","article-title":"The Unique Life Cycle of Strongyloides stercoralis and Implications for Public Health Action","volume":"3","author":"W Page","year":"2018","journal-title":"Trop Med Infect Dis"},{"key":"pntd.0010179.ref004","unstructured":"WHO. 2030 targets for soil-transmitted helminthiases control programmes. 2020; Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/330611"},{"key":"pntd.0010179.ref005","doi-asserted-by":"crossref","first-page":"e0008184","DOI":"10.1371\/journal.pntd.0008184","article-title":"The Strongyloides stercoralis-hookworms association as a path to the estimation of the global burden of strongyloidiasis: A systematic review.","volume":"14","author":"PE Fleitas","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010179.ref006","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/S0140-6736(10)60061-X","article-title":"Chagas disease","volume":"375","author":"A Rassi","year":"2010","journal-title":"Lancet."},{"key":"pntd.0010179.ref007","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S1473-3099(01)00065-2","article-title":"Clinical and epidemiological aspects of Chagas disease","volume":"1","author":"A Prata","year":"2001","journal-title":"Lancet Infect Dis."},{"key":"pntd.0010179.ref008","unstructured":"World Health Organisation. 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Stercoralis infection among patients with Chagas disease: A retrospective case-control study","volume":"12","author":"P Puerta-Alcalde","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010179.ref017","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4269\/ajtmh.16-0857","article-title":"Serologic Monitoring of Public Health Interventions against Strongyloides stercoralis","volume":"97","author":"P Cajal","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0010179.ref018","doi-asserted-by":"crossref","first-page":"e0006003","DOI":"10.1371\/journal.pntd.0006003","article-title":"Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study","volume":"11","author":"A Echaz\u00fa","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010179.ref019","unstructured":"Porto Tabiquen CE. 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Demidenko","year":"2004"},{"key":"pntd.0010179.ref032","volume-title":"Wiley StatsRef Stat. Ref. 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