SEROEPIDEMIOLOGY OF STRONGYLOIDIASIS IN THE PERUVIAN AMAZON

PABLO P. YORI Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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MARGARET KOSEK Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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ROBERT H. GILMAN Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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JULIANNA CORDOVA Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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CARYN BERN Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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CESAR BANDA CHAVEZ Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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MARIBEL PAREDES OLORTEGUI Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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CARMEN MONTALVAN Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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GRACIELA MEZA SANCHEZ Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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BEVELLE WORTHEN Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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JAMES WORTHEN Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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FAY LEUNG Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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CARLOS VIDAL ORÉ Asociacion Benefica PRISMA, Lima, Peru; Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Peruvian Health Ministry, Maynas, Peru

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A stool and serosurvey for Strongyloides stercoralis was conducted in a community in the Peruvian Amazon region. Strongyloidiasis stercoralis was identified in the stool of 69 (8.7%) of 792 participants. Six hundred nine sera were tested using by an enzyme-linked immunosorbent assay (ELISA), which had a sensitivity of 92% and a specificity of 94%; 442 (72%) were positive. In multivariable logistic regression models, having S. stercoralis in stool was associated with hookworm in the same specimen (odds ratio [OR] = 4.44, 95% confidence interval [CI] = 2.02–9.79), occasionally or never wearing shoes (OR = 1.89, 95% CI = 1.10–3.27), and increasing age (OR = 1.012 for each one-year increase, 95% CI = 1.00–1.03). Similarly, occasionally or never wearing shoes (OR = 1.54, 95% CI = 1.01–2.37) and increasing age (OR = 1.04 for each one-year increase, 95% CI = 1.02–1.06) were associated with an increased risk of a positive S. stercoralis ELISA result. The ELISA had a negative predictive value of 98% and is an excellent screening test for strongyloidiasis.

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