Strongyloides stercoralis Infection in Humans in West Africa, 1975–2024: Systematic Review and Meta-Analysis

Abstract

Strongyloidiasis is an underappreciated helminth infection that belongs to a group of neglected tropical diseases. The aim of this systematic review and meta-analysis was to determine the pooled prevalence of Strongyloides stercoralis infection in humans in 16 West African countries. We searched African Journals Online, Embase, Horizon, Google Scholar, ProQuest, PubMed, Scopus, and Web of Science to identify articles assessing S. stercoralis prevalence data. The search was restricted to articles published between 1 January 1975 and 31 December 2024 without language restriction. We followed the PRISMA guidelines. A total of 21,250 articles were identified, 336 of which met the inclusion criteria. The most frequently used diagnostic tools were Kato-Katz (35.1%) and formol-ether coprological methods (23.4%). Strongyloidiasis was reported in 15 of the 16 West African countries; Mali was the only country where it was absent. The S. stercoralis regional prevalence was 4.4%, ranging from 0.2% in Burkina Faso to 18.9% in The Gambia. S. stercoralis infection prevalence decreased from 14.0% (1975–1984) to 4.1% (2015–2024). S. stercoralis prevalence showed strong heterogeneity with the highest prevalence mainly observed in countries in the Gulf of Guinea. Most of the employed diagnostic techniques were inappropriate; the reported S. stercoralis prevalence is, thus, likely an underestimation of the true situa tion. Our observations call for more sensitive S. stercoralis diagnostic tools and strategies for strongyloidiasis control that are tailored to the different social-ecological settings of West Africa.