Thus extreme caution with respect to iatrogenic risks is crucial to avoiding deaths or other adverse consequences in treatment, that of course prefigures a correct diagnosis. People with high exposure to Strongyloides stercoralis may mitigate the risk of strongyloidiasis hyperinfection associated with corticosteroid treatment, with the presumptive use of ivermectin. Such hyperinfection has been a particular concern during the COVID-19 pandemic because of the use of corticosteroids for treatment of COVID-19 symptoms. The CDC and other international bodies recommend the use of ivermectin for refugees from areas which have a risk of strongyloidiasis.During the 1940s, the treatment of choice was enteric coated tablets of 60 mg gentian violet, three times daily, for 16 days. The cure rate was reported to be only about 50 to 70 percent, requiring repeat courses. It is possible the cure rate was even less than that published in the literature, due to the difficulty in positively diagnosing infection. Epidemiology
Low estimates postulate it to affect 30–100 million people worldwide, mainly in tropical and subtropical countries, while higher estimates conservatively extrapolate that infection is upwards to or above 370 million people. It belongs to the group of neglected tropical diseases, and worldwide efforts are aimed at eradicating the infection. History
The disease was first recognized in 1876 by the French physician Louis Alexis Normand, working in the naval hospital in Toulon; he identified the adult worms, and sent them to Arthur Réné Jean Baptiste Bavay, chief inspector for health, who observed that these were the adult forms of the larvae found in the stool.
An analogous male figure may also appear as a wicked uncle; like the stepmother, the fathers brother may covet the childs inheritance for his own children, and so maltreat his nephews or nieces. Modern films, however, seem to cast stepfathers in a somewhat kinder light, implying honorable men who marry divorced women or single mothers make good stepfathers. == References ==