Abstract
BackgroundThere are no national prevalence studies of Strongyloides stercoralis infection in Australia, although it is known to be endemic in northern Australia and is reported in high risk groups such as immigrants and returned travellers. We aimed to determine the seropositivity (number positive per 100,000 of population and percent positive of those tested) and geographical distribution of S. stercoralis by using data from pathology laboratories.MethodologyWe contacted all seven Australian laboratories that undertake Strongyloides serological (ELISA antibody) testing to request de-identified data from 2012–2016 inclusive. Six responded. One provided positive data only. The number of people positive, number negative and number tested per 100,000 of population (Australian Bureau of Statistics data) were calculated including for each state/territory, each Australian Bureau of Statistics Statistical Area Level 3 (region), and each suburb/town/community/locality. The data was summarized and expressed as maps of Australia and Greater Capital Cities.Principal findingsWe obtained data for 81,777 people who underwent serological testing for Strongyloides infection, 631 of whom were from a laboratory that provided positive data only. Overall, 32 (95% CI: 31, 33) people per 100,000 of population were seropositive, ranging between 23/100,000 (95% CI: 19, 29) (Tasmania) and 489/100,000 population (95%CI: 462, 517) (Northern Territory). Positive cases were detected across all states and territories, with the highest (260-996/100,000 and 17–40% of those tested) in regions across northern Australia, north-east New South Wales and north-west South Australia. Some regions in Greater Capital Cities also had a high seropositivity (112-188/100,000 and 17–20% of those tested). Relatively more males than females tested positive. Relatively more adults than children tested positive. Children were under-represented in the data.Conclusions/SignificanceThe study confirms that substantial numbers of S. stercoralis infections occur in Australia and provides data to inform public health planning.
Highlights
Strongyloides stercoralis is a nematode parasite primarily of humans with a world-wide distribution, and is more common in areas of socioeconomic disadvantage [1]
The data represents 81,777 people who were tested for Strongyloides by serology in Australia during the five years 2012–2016 (Table 1)
There was an overall decline in the percent positive of those tested for Australia over the 5 year period (from an average of 12.7% in 2012 to 7.2%) in 2016
Summary
Strongyloides stercoralis is a nematode parasite primarily of humans with a world-wide distribution, and is more common in areas of socioeconomic disadvantage [1]. In Australia, S. stercoralis is endemic in many Aboriginal and Torres Strait Islander communities [3,4,5,6,7,8,9,10,11,12,13]. S. stercoralis is not a reportable infection and so the current prevalence in these high risk groups is uncertain. There are no national prevalence studies of Strongyloides stercoralis infection in Australia, it is known to be endemic in northern Australia and is reported in high risk groups such as immigrants and returned travellers. We aimed to determine the seropositivity (number positive per 100,000 of population and percent positive of those tested) and geographical distribution of S. stercoralis by using data from pathology laboratories
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