{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:42:17Z","timestamp":1790214137707,"version":"4.1.0"},"reference-count":33,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>People living in areas endemic for strongyloidiasis are at risk of latent <jats:italic>Strongyloides stercoralis<\/jats:italic> infection. Corticosteroid therapy is a well-established risk factor for life-threatening hyperinfection syndrome and disseminated disease owing to suppression of the immune system. There are limited data available on the efficacy and cost of providing oral ivermectin prophylaxis to all patients receiving high-dose corticosteroids for strongyloidiasis in endemic areas. We thus conducted this retrospective cohort study at Khon Kaen University\u2019s Srinagarind Hospital from 2015 to 2019. Inclusion criteria were as follows: age \u2265 18\u2009years, having received \u2265 0.5\u2009mg\/kg\/day of prednisolone or equivalent for at least 14\u2009days, and hospitalization during the study period. A total of 250 patients were included in the study: 125 in the empirical prophylaxis group (prescribed ivermectin even if fecal examination results were negative or nonexistent) and the remaining patients in the definite therapy group (prescribed ivermectin only if <jats:italic>S. stercoralis<\/jats:italic> was detected by fecal examination). The prevalence of strongyloidiasis at enrollment estimated by fecal examination was 5.5%. Ivermectin was given to 125 patients (100%) in the prophylaxis group compared with 12 (9.6%) in the definite therapy group (<jats:italic>P<\/jats:italic> value &lt; 0.001). During the 12-month follow-up period, <jats:italic>S. stercoralis<\/jats:italic> was detected in three patients, two in the prophylaxis group and one in the definite therapy group (<jats:italic>P<\/jats:italic> value = 1.000). No cases of hyperinfection syndrome or disseminated disease were found. The empirical prophylaxis strategy had a significantly higher cost than the definite therapy strategy (563 versus 254, <jats:italic>P<\/jats:italic> value &lt; 0.001) and did not demonstrate superior efficacy in strongyloidiasis prevention.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0712","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T19:29:59Z","timestamp":1682969399000},"page":"1183-1187","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of Oral Ivermectin as Empirical Prophylaxis for Strongyloidiasis in Patients Treated with High-Dose Corticosteroids: A Retrospective Cohort Study"],"prefix":"10.4269","volume":"108","author":[{"given":"Akedanai","family":"Yongbantom","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wantin","family":"Sribenjalux","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;"},{"name":"Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natapong","family":"Manomaiwong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atibordee","family":"Meesing","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;"},{"name":"Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Mol Allergy","first-page":"8","article-title":"Intestinal strongyloidiasis and hyperinfection syndrome","volume":"4","author":"Vadlamudi","year":"2006"},{"key":"b2","series-title":"Clin Microbiol Infect","first-page":"945","article-title":"Severe strongyloidiasis in corticosteroid-treated patients","volume":"12","author":"Fardet","year":"2006"},{"key":"b3","series-title":"Pathogens","first-page":"468","article-title":"The global prevalence of Strongyloides stercoralis infection","volume":"9","author":"Buonfrate","year":"2020"},{"key":"b4","series-title":"Parasit Vectors","first-page":"37","article-title":"Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, southwestern 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factors of acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in Thailand","volume":"108","author":"Jongwutiwes","year":"2014"},{"key":"b22","series-title":"Haematologica","first-page":"663","article-title":"Thiabendazole for the prophylaxis of strongyloidiasis in immunosuppressed patients with hematologic diseases: a randomized, double-blind placebo-controlled study","volume":"87","author":"Portugal","year":"2002"},{"key":"b23","series-title":"Trans R Soc Trop Med Hyg","first-page":"398","article-title":"Epidemiology of Strongyloides stercoralis in north-east Thailand: application of the agar plate culture technique compared with the enzyme-linked immunosorbent assay","volume":"97","author":"Sithithaworn","year":"2003"},{"key":"b24","series-title":"JMM Case Rep","first-page":"e005165","article-title":"Fatal strongyloidiasis after corticosteroid therapy for presumed chronic obstructive pulmonary 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