Hemoglobin levels evaluation in alcoholic patients infected with intestinal parasites

Abstract

Introduction: Chronic alcoholism affects multiple physiological systems, including hematopoietic, and is frequently associated with anemia. Coinfection with enteroparasites—particularly Strongyloides stercoralis—is common among individuals with alcohol use disorder, which may exacerbate hematological alterations. This study aimed to investigate the prevalence of anemia in alcoholic patients and its association with enteroparasitic infections, as well as to explore the relationship between S. stercoralis parasite burden and hemoglobin levels. Methods: A cross-sectional study was conducted involving 341 male alcoholic inpatients at the Centro de Acolhimento e Tratamento de Alcoolistas (Center for the Care and Treatment of Alcoholics) (CATA) / Obras Sociais Irmã Dulce (Sister Dulce Social Works) (OSID). All participants underwent complete blood counts and stool parasitological examination using spontaneous sedimentation, Baermann-Moraes, and agar plate culture (APC) techniques. Parasite burden was assessed by the Baermann-Moraes method. Results: Anemia was observed in 60.4% of the study population (206/341). No significant difference in anemia prevalence or hemoglobin levels was detected between patients monoparasitized and uninfected with enteroparasites, 60% (66/110) and 62.3% (137/220) and 13.10 ± 1.45 g/dL and 13.09 ± 1.29 g/dL, respectively. However, individuals infected with S. stercoralis showed a higher frequency of anemia, 73% (44/60), and lower mean hemoglobin levels, 12.9 ± 1.48 g/dL, though not reaching statistical significance. A trend toward a negative correlation between S. stercoralis parasite burden and hemoglobin concentration was observed (r = -0.233; p = 0.052), suggesting that higher parasite loads may be associated with lower hemoglobin levels. This trend was further supported by the lower hemoglobin concentrations found in individuals with >100 larvae/g of feces (lpf) compared to those with <10 lpf (12.33 ± 1.28 vs. 13.13 ± 1.61 g/dL). Conclusion: These findings reinforce that anemia is a prevalent clinical condition among alcoholic patients, regardless of enteroparasitic infection. Nevertheless, the high frequency of anemia in individuals infected with S. stercoralis suggests a potential contribution of this parasite to hematological alterations in this population, particularly in cases of high parasite burden.