Descriptive Epidemiology of Soil-Transmitted Helminth Infections in the United States: Using Big Data to Characterize Patients and Analyze Parasitic Disease Trends

Abstract

Soil-transmitted helminths (STH) include species responsible for hookworm disease, ascariasis, and trichuriasis. In the United States, STH infections have been greatly reduced with anthelmintic medications and improved hygiene and sanitation, however, cases still regularly occur, but limited epidemiological data exist. We investigated the occurrence of STH infections using big-data analytics of inpatient medical discharge records (1998–2020). Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample. We developed an algorithm to extract International Classification of Diseases codes for STH infections from over 805 million records. We report patient characteristics and other epidemiological data. We found a mean of 223 (SD = 70.1) cases annually over the 23 years. Ascariasis (total n = 2599) was the most common, followed by hookworm disease (n = 1809) and trichuriasis (n = 716). Mean annual cases were highest (p < 0.05) in males for hookworm disease (p = 0.0313), but equitable for ascariasis and trichuriasis. Age distributions were skewed towards older patients, with whites and Hispanics most common among records. Chronic anemia and heart disease were common comorbidities. This analysis serves as a case study for using patient record databases as a means of indirect parasitic disease surveillance for population-based studies.