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Am. J. Trop. Med. Hyg., 80(5), 2009, pp. 788-791
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Management of Chronic Strongyloidiasis in Immigrants and Refugees: Is Serologic Testing Useful?

Beverley-Ann Biggs*, Sonia Caruana, Seema Mihrshahi, Damien Jolley, Jenne Leydon, Ley Chea, AND Sophy Nuon
Department of Medicine, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Monash Institute of Health Services Research, Clayton, Victoria, Australia; Serology Laboratory, Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia; Windsor Medical Centre, Springvale, Victoria, Australia; Medical Clinic, Springvale, Victoria, Australia

 

ABSTRACT

We assessed the usefulness of serologic testing in monitoring strongyloidiasis in immigrants after treatment with two doses of ivermectin. An observational study was conducted in a group of Cambodian immigrants residing in Melbourne who were treated for strongyloidiasis and followed-up in a general practice setting. Two doses of ivermectin (200 µg/kg) were administered orally. Periodic serologic enzyme-linked immunosorbent assay testing was undertaken for up to 30 months after treatment. Antibody titers for Strongyloides sp. decreased in 95% (38 of 40) of the patients, 47.5% (19 of 40) had a decrease in optical density to less than 0.5, and 65% (26 of 40) reached levels consistent with a cure during the follow-up period. Serologic testing for Strongyloides sp. is a useful tool for monitoring a decrease in antibody levels after effective treatment. This testing should be carried out 6–12 months after treatment to ensure a sustained downward trend suggestive of cure.

Received June 26, 2008. Accepted for publication December 20, 2008.

Acknowledgments: We thank the Cambodian community for their support and participation, Naysang Ouk for assistance with patient enrolment and follow-up, Michelle Sweidan for assistance with analysis and the manuscript, and Heath Kelly for technical advice.

Financial support: This study was supported by the University of Melbourne and the Victorian Infectious Diseases Reference Laboratory.

* Address correspondence to Beverley-Ann Biggs, Department of Medicine, University of Melbourne, 4th Floor Clinical Sciences Building, The Royal Melbourne Hospital, Victoria 3050, Australia. E-mail: babiggs{at}unimelb.edu.au

Authors’ addresses: Beverley-Ann Biggs, Sonia Caruana, and Seema Mihrshahi, Department of Medicine, University of Melbourne, 4th Floor Clinical Sciences Building, The Royal Melbourne Hospital, Victoria 3050, Australia, E-mails: babiggs{at}unimelb.edu.au, sonia2rose{at}yahoo.com.au, and seemam{at}unimelb.edu.au. Damien Jolley, Monash Institute of Health Services Research, Locked Bag 29, Clayton, Victoria 3168, Australia, E-mail: damien.jolley{at}med.monash.edu.au. Jenne Leydon, Serology Laboratory, Victorian Infectious Diseases Reference Laboratory, 10 Wreckyn Street, North Melbourne, Victoria 3051, Australia, E-mail: jennie.leydon{at}mh.org.au. Ley Chea, Windsor Medical Centre, Suite 1, 16–18 Windsor Avenue, Springvale, Victoria 3171, Australia. Sophy Nuon, Medical Clinic, Suite 4/14 Balmoral Avenue, Springvale, Victoria 3071, Australia, E-mail: sophynuon{at}hotmail.com.






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