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**22** 

*Brazil* 

**Hyperinfection Syndrome in Strongyloidiasis** 

Strongyloidiasis is an intestinal parasitosis found in tropical and subtropical areas, where the warm climates are suitable for parasite survival (Barr, 1978). It is a common cause of morbidity and mortality, particularly in developing countries, and infects over one-quarter of the world's population (Genta, 1989). Approximately 52 species are known to infect mammals, birds, reptiles and amphibians (Speare, 1989). The most common globally distributed human pathogen of clinical importance is *Strongyloides stercoralis* (Schad, 1989). Another species, *Strongyloides fuelleborni,* is a zoonotic parasite that infects primates and is found sporadically in humans in Africa (Pampiglione & Ricciardi, 1972). *S. stercoralis* is a ubiquitous soil-transmitted intestinal nematode that was first reported in 1876 in French soldiers working in Vietnam. It is unique among helminths in that it completes its life cycle inside a single human host. A unique feature of strongyloidiasis is the ability of the parasite to autoinfect the host, which makes *S. stercoralis* a significant public health problem (Grove, 1989).

The epidemiology of *Strongyloides* infection is poorly understood because it is difficult to detect and can be underestimated (Albonico et al., 1999; Viney & Lok, 2007). However, it is estimated that from 30 a 100 million people are infected worldwide with *Strongyloides*, and can range from asymptomic to multiorgan failure (Genta, 1989). *Strongyloides* is found in tropical and subtropical areas and requires specific soil and climate conditions for its development. In North America, Latin America, Africa and Southeast Asia, the infection is endemic (Roxby et al., 2009). The risk of acquiring strongyloidiasis is higher in rural areas, among people who work with soil, and among lower socioeconomic groups *(*Vadlamudi et al., 2006; Viney & Lok, 2007*).* Walking barefoot in areas where human faeces containing the parasite are deposited increases the probability of acquiring the infection (Grove, 1994).

*S. stercoralis* has free-living and parasitic life cycles, and the morphology of each differs. Parasitic worms are female adults that reproduce by parthenogenesis and measure approximately 1 - 10 mm in length by 27 -95 μm in width. Free-living adults are

**1. Introduction** 

**2. Epidemiology** 

**3. Parasite** 

Cristiane Tefé-Silva1,\*, Eleuza R. Machado2, Lúcia H. Faccioli2 and Simone G. Ramos1

*1Department of Pathology, Faculty of Medicine of Ribeirão Preto* 

*Pharmaceutics Sciences of Ribeirão Preto, University of São Paulo* 

 *2Department of Clinical Analyses, Toxicology and Bromatology Faculty of* 

