Human strongyloidiasis in rural villages of South Kalimantan, Indonesia: A case series

Priska PP. Kristi; Peni  Kusumasari; Puspawati Puspawati; Yurniah Tanzil; Dian Nurmansyah; Muhammad Syairaji; Rizqiani A. Kusumasari; Eti N. Sholikhah; Nina Buehler; Issa  Sy; Sophie  Schneitler; Sören L. Becker; Elsa H. Murhandarwati

doi:10.52225/narra.v5i3.2515

Authors

Priska PP. Kristi Master of Biomedical Science Study Program, Department of Parasitology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, Department of Parasitology, Faculty of Medicine; Universitas Atmajaya, Yogyakarta, Indonesia https://orcid.org/0009-0002-4769-6407
Peni Kusumasari Master of Biomedical Science Study Program, Department of Parasitology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia https://orcid.org/0009-0000-0134-3863
Puspawati Puspawati Department of Clinical Pathology, Ratu Zalecha General Hospital, Martapura, Indonesia
Yurniah Tanzil Department of Clinical Pathology, Ratu Zalecha General Hospital, Martapura, Indonesia
Dian Nurmansyah Department of Medical Laboratory Technology, Faculty of Health Sciences and Technology, Universitas Borneo Lestari, Banjarbaru, Indonesia https://orcid.org/0000-0003-1671-0720
Muhammad Syairaji Department of Health Services and Information Vocation School, Universitas Gadjah Mada, Yogyakarta, Indonesia
Rizqiani A. Kusumasari Department of Parasitology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia https://orcid.org/0000-0003-3854-8197
Eti N. Sholikhah Department of Pharmacology and Therapeutics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia https://orcid.org/0000-0002-6545-8691
Nina Buehler Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
Issa Sy Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany https://orcid.org/0000-0001-9103-8861
Sophie Schneitler Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
Sören L. Becker Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
Elsa H. Murhandarwati Department of Parasitology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia https://orcid.org/0000-0002-0374-8167

DOI:

https://doi.org/10.52225/narra.v5i3.2515

Keywords:

S. stercoralis, faecal samples, Baermann funnel method, qPCR, diagnosis

Abstract

Strongyloidiasis, caused by the nematode Strongyloides stercoralis, can lead to severe complications, including hyperinfection syndrome and disseminated disease, particularly in immunocompromised individuals. However, data on its epidemiology and clinical significance in Indonesia remain scarce and outdated. The aim of this study was to investigate the presence of S. stercoralis, identify potential sources of infection, and explore associated risk factors. A case series of strongyloidiasis was identified during a soil-transmitted helminth survey conducted in two villages in Banjar District, South Kalimantan, Indonesia, between May and July 2024. S. stercoralis larvae were detected in four individuals out of 224 fecal samples (1.8%) using the Baermann funnel method, with confirmation via quantitative polymerase chain reaction (qPCR). All infected individuals were female farmers who reported nonspecific clinical symptoms. Subsequent environmental sampling revealed viable S. stercoralis larvae in soil from one of the villages. The detection of asymptomatic, infected individuals suggests that humans serve as reservoirs for ongoing transmission. In the context of open defecation practices, sustained transmission is likely unless targeted interventions are implemented. Urgent actions are needed, including community education and the provision of basic sanitation infrastructure such as latrines and access to clean water. These interventions are especially critical given that ivermectin—the first-line treatment for strongyloidiasis—is not currently available in Indonesia.