Background. This study examines the predictive value of
eosinophilia for Strongyloides stercoralis
infection, as measured by
enzyme-linked
immunosorbent assay (ELISA) testing, in an endemic community. In remote communities,
eosinophilia is frequently used as a proxy test for the presence of helminth
infections. Past studies of
eosinophilia and Strongyloides
infection have been conducted in specific groups such as immigrants and refugees, or in subpopulations of nonendemic communities, rather than in endemic communities. Methods. We conducted a cross-sectional study of the relationship between
eosinophilia and Strongyloides ELISA serology, as part of a study into the relationship between S stercoralis
infection and
type 2 diabetes mellitus (T2DM) in an Indigenous community in northern Australia. Results. Two hundred thirty-nine adults had their eosinophil count and S stercoralis ELISA serology measured in 2012 and 2013, along with other biometric and metabolic data.
Eosinophilia was found to have a relatively poor sensitivity (60.9%), specificity (71.1%), positive predictive value (54.6%), and negative predictive value (76.1%) for S stercoralis ELISA positivity in this group. However, there was a more constant relationship between
eosinophilia and S Stercoralis ELISA positivity in patients with T2DM (negative predictive value 87.5%). Conclusion. This study suggests that the presence or absence of
eosinophilia is not an adequate proxy test for S stercoralis
infection in a community where the
infection is prevalent, and that the association between
eosinophilia and S stercoralis ELISA positivity is more constant in patients with T2DM.