Modeling strongyloidiasis risk in the United States
Rachael Singer, Sahotra Sarkar
Abstract
OBJECTIVES: To provide a spatial risk assessment for the neglected disease strongyloidiasis in the United States by prioritizing areas with high probability of Strongyloides stercoralis presence and to offer recommendations for targeted screening and surveillance. METHODS: The risk assessment was based on a species distribution model with parasite occurrence data and ecologically important environmental variables as input and local habitat suitability for the species as output. The model used a maximum entropy algorithm and occurrence records and environmental data from public sources. This ecological risk assessment was coupled to socioeconomic factors using multi-criteria analysis. RESULTS: The model predicts suitable habitat for the parasite in ten states beyond the southeastern United States where it has been recorded including states in the south, east and northeast, and west coasts. CONCLUSIONS: We recommend strongyloidiasis should be reportable in 16 states at high risk and uniform, near universal solid organ transplant screening should be implemented alongside approaches to heighten clinical suspicion.