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Control of chronic Strongyloides stercoralis infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study.

AbstractOBJECTIVES:
To assess the effect of treatment with ivermectin on the prevalence of S. stercoralis infection in an Australian Aboriginal population over a three year period, and to assess the validity of using a lower ELISA cut-off in diagnosis.
METHODS:
A three-year cohort study of 259 adult Australian Aboriginals living in a remote community in northern Australia. S stercoralis infection was diagnosed using commercial ELISA testing, and employed a lower threshold for treatment than that recommended. Follow up was conducted at 6 months and 3 years following ivermectin treatment.
FINDINGS:
Treatment with ivermectin was highly effective and resulted in a sustained fall in the prevalence of infection in the study group (Initial prevalence 35.3%, 3 year prevalence 5.8%, McNemar's chi2 = 56.5, p<0.001). Results of treatment suggested use of a lower ELISA threshold for treatment was valid in this setting. Follow up identified a small group of subjects with persistently positive ELISA serology despite repeated treatment.
INTERPRETATION:
Control of S. stercoralis infection in this cohort appears to be feasible using pharmacological treatment alone.
AuthorsRussell Hays, Adrian Esterman, Robyn McDermott
JournalPLoS neglected tropical diseases (PLoS Negl Trop Dis) Vol. 11 Issue 7 Pg. e0005825 (Jul 2017) ISSN: 1935-2735 [Electronic] United States
PMID28759583 (Publication Type: Journal Article)
Chemical References
  • Ivermectin
Topics
  • Adult
  • Aged
  • Animals
  • Australia (epidemiology)
  • Chronic Disease
  • Enzyme-Linked Immunosorbent Assay
  • Feces (parasitology)
  • Female
  • Follow-Up Studies
  • Humans
  • Ivermectin (administration & dosage)
  • Logistic Models
  • Male
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander
  • Strongyloides stercoralis (isolation & purification)
  • Strongyloidiasis (diagnosis, drug therapy)
  • Treatment Outcome

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