Abstract
Human strongyloidiasis is an important gastrointestinal disease with an estimated 30 to 100 million people infected. Prevalence is generally underestimated since many infections are asymptomatic, and traditional diagnostic tests based on parasitological examination of stool samples are not adequately sensitive. Serological tests are useful and supportive but are still only available in a reference research setting. We made an immunochromatographic test (ICT) kit for rapid serodiagnosis of human strongyloidiasis. The antigen used in the ICT kit was extracted from larvae of Strongyloides stercoralis. Diagnostic efficacy of the kit was evaluated using human serum samples from strongyloidiasis patients, healthy persons, and those with other parasitoses. When using a cutoff level of 0.5 or above, the diagnostic sensitivity, specificity, and positive and negative predictive values at the prevalence of infection of 34.4%, were 93.3%, 83.7%, 76.7%, and 95.6%, respectively. This ICT kit is easy to use at the point-of-care and a result can be obtained in 15 min. Sophisticated instruments and highly trained staff are not required. It can be used in several diagnostic and public-health settings, e.g., prevalence surveys in endemic areas, confirmation and monitoring of cure post-treatment, diagnosis and screening of infected but asymptomatic individuals, and populations “at risk” for hyperinfection syndrome or disseminated strongyloidiasis if they are given immunosuppressive treatment for other conditions.
Highlights
Human strongyloidiasis, a soil-transmitted helminthiasis, is a harmful intestinal parasitic disease that is distributed globally and infects an estimated 30 to 100 million people [1,2,3,4]
We developed an immunochromatographic test (ICT) using S. stercoralis larval extract as the antigen for detection of IgG antibodies
This is not likely to be a real problem in a clinical setting because the clinical presentation of each of these parasitoses differs from those of strongyloidiasis
Summary
A soil-transmitted helminthiasis, is a harmful intestinal parasitic disease that is distributed globally and infects an estimated 30 to 100 million people [1,2,3,4]. The disease is generally diagnosed by detecting parasites in stool samples using methods such as direct fecal smear examination, Baermann concentration, formalin-ethyl acetate concentration, Harada-Mori filter paper culture, and agar plate cultures [4, 7]. These methods are complicated, require skilled microscopists, and are time-consuming. Intermittent releases of worms in feces dictate the need for multiple stool examinations [8] Molecular techniques such as polymerase chain reaction (PCR) and real-time PCR, for the detection of Strongyloides DNA in stool or urine samples, have been reported [9,10,11,12,13,14]. Yunus et al [25] reported the developed lateral flow dipstick test using recombinant protein antigens for detection of human IgG4 antibody has been reported and the results showed high diagnostic
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