{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:56:22Z","timestamp":1791395782577,"version":"4.3.3"},"reference-count":37,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,7]]},"abstract":"<jats:p><jats:italic>Strongyloides stercoralis<\/jats:italic> affects 30\u2013100 million people worldwide. The burden is underestimated because of the paucity of studies, limited geographical areas surveyed, and poor quality of diagnostic tests. This study aimed at determining the epidemiology of strongyloidiasis using sensitive microscopy testing in rural populations living at different altitudes in Cusco, Peru. Data were collected from subjects aged &gt; 3 years living in Quellouno (elevation 2,600 ft) and Limatambo (elevation 8,379 ft) districts. Subjects provided one fresh stool sample and answer a standardized questionnaire. Fresh stool was tested on site using the Baermann\u2019s test and agar plate culture. Formalin-preserved stool was tested by rapid sedimentation. Eighty percent (585\/715) of eligible subjects consented to participate; after excluding subjects with missing data, 65% (462\/715) were included. Fifty-five percentage were female; the median age was 33 years (interquartile range 13\u201352), and 72% had government health insurance. Half had intestinal parasites, and <jats:italic>Strongyloides<\/jats:italic> was the most common (24.5%) followed by <jats:italic>Giardia<\/jats:italic> (15.5%), <jats:italic>Blastocystis<\/jats:italic> (14.9%), and hookworm (11.5%). The agar plate culture detected more cases of <jats:italic>Strongyloides<\/jats:italic> than Baermann\u2019s or sedimentation tests. <jats:italic>Strongyloides<\/jats:italic> infection was more common at low altitude (26.4%) than at high altitude (18.6%), but the difference was not statistically significant (<jats:italic>P<\/jats:italic> = 0.08). Older age, walking barefoot, bathing in rivers\/streams, and using municipal sewage were associated with strongyloidiasis. <jats:italic>Strongyloides<\/jats:italic> was the most prevalent parasite in the areas studied and was associated with demographic, socioeconomic, and sanitary factors.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0568","type":"journal-article","created":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T07:00:50Z","timestamp":1562050850000},"page":"422-427","source":"Crossref","is-referenced-by-count":15,"title":["Strongyloides stercoralis Infection at Different Altitudes of the Cusco Region in Peru"],"prefix":"10.4269","volume":"101","author":[{"given":"Maria Luisa","family":"Morales","sequence":"first","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Lopez","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Ly","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seher","family":"Anjum","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Vanessa","family":"Fernandez-Baca","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Maria","family":"Valdivia-Rodriguez","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frecia Maribel","family":"Mamani-Licona","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benicia","family":"Baca-Turpo","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nedhy","family":"Farfan-Gonzales","sequence":"additional","affiliation":[{"name":"Sede Administrativa de la Red de Servicios de Salud Cusco Norte, Ministerio de Salud, Cusco, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeshica","family":"Chaman-Illanes","sequence":"additional","affiliation":[{"name":"Centro de Salud de Putucusi, Red de Servicios de Salud Cusco Norte, Ministerio de Salud, Cusco, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Mauricio","family":"Cabada","sequence":"additional","affiliation":[{"name":"Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center\u2013Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;"},{"name":"Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Rev Infect Dis","first-page":"755","article-title":"Global prevalence of strongyloidiasis: critical review with epidemiologic insights into the prevention of disseminated disease","volume":"11","author":"Genta","year":"1989"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e2214","article-title":"Strongyloides stercoralis: a plea for action","volume":"7","author":"Bisoffi","year":"2014"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e2288","article-title":"Strongyloides stercoralis: global distribution and risk factors","volume":"7","author":"Sch\u00e4r","year":"2013"},{"key":"b4","series-title":"Int J Environ Res Public Health","first-page":"517","article-title":"Strongyloidiasis: a disease of socioeconomic disadvantage","volume":"13","author":"Beknazarova","year":"2016"},{"key":"b5","series-title":"Int J Environ Health 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