International Survey on Screening and Management of Strongyloidiasis in Solid Organ Transplant Patients

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BACKGROUND: Strongyloides stercoralis infection can be associated with high mortality in solid organ transplant (SOT) recipients, yet global practices regarding screening and management remain poorly characterized. We conducted an international survey to evaluate knowledge, screening, and management practices among healthcare workers (HCWs) involved in SOT care. METHODS: We performed a cross-sectional, web-based survey of HCWs caring for SOT candidates and recipients. The survey assessed provider characteristics, knowledge of strongyloidiasis, as well as screening and management practices. Descriptive statistics were used to summarize responses. RESULTS: A total of 101 HCWs responded, including 65 (64%) infectious diseases (ID) providers and 36 (36%) non-ID providers. Knowledge gaps were identified regarding transmission and mortality, particularly among non-ID providers. Overall, 85% of respondents reported screening SOT candidates for S. stercoralis; among those who screen, serology is the most commonly used method. Screening strategies varied by geographic region, with universal screening more common in endemic areas and targeted screening in non-endemic regions. Management practices, including approaches to indeterminate or negative test results, showed substantial heterogeneity. CONCLUSIONS: This international survey demonstrates considerable variability in knowledge, screening, and management of strongyloidiasis among HCWs involved in SOT care. These findings highlight opportunities for improved education, clearer guidance, and greater standardization of practices related to Strongyloides infection to avoid unnecessary morbidity.

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