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

Objectives: 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. © 2017 hays et al.