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To evaluate the accuracy and reliability of urine assay for the diagnosis of strongyloidiasis, three different immunoassays were used to assess the diagnostic accuracy of anti-Strongyloides immunoglobulin G (IgG) in urine and compared with those in serum samples. Analyses by InBios enzyme-linked immunosorbent assay (ELISA) kit (recombinant NIE antigen), SciMedx ELISA kit (Strongyloides stercoralis antigen), and our in-house ELISA (Strongyloides ratti antigen) yielded comparable diagnostic performances between urine and serum assays. Levels of Strongyloides-specific IgG in urine significantly correlated with those in serum. Tests for diagnostic agreement between urine and serum IgG assays showed substantial to fair agreement (κ = 0.207–0.615). The observed quantitative and qualitative concordance between urine and serum assays in strongyloidiasis suggests that urine has similar diagnostic value to that for serum. Because of the ease and noninvasiveness of clinical sample collection, urine assay has a high potential for the initial diagnosis and mass screening of strongyloidiasis.
Authors’ addresses: Sirowan Ruantip and Chompunoot Wangboon, Faculty of Graduate School, KhonKaen University, Khon Kaen, Thailand, E-mails: firstname.lastname@example.org and email@example.com. Chatanun Eamudomkarn and Paiboon Sithithaworn, Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mails: firstname.lastname@example.org and email@example.com. Anchalee Techasen, Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand, and Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand, E-mail: firstname.lastname@example.org. Jiraporn Sithithaworn, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand, E-mail: email@example.com. Jeffrey M. Bethony, Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, DC, E-mail: firstname.lastname@example.org. Makoto Itoh, Department of Infection and Immunology, Aichi Medical University School of Medicine, Nagakute, Japan, E-mail: email@example.com.