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

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  • 1 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

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.

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