Use of serology in a systematic screening programme for strongyloidiasis in an immigrant population

Abstract

Objectives: The aim of this cross-sectional study was to describe the results of a systematic serological screening programme for strongyloidiasis. Methods: Aprospective serological screeningprogramme for strongyloidiasis wasperformedbetween2009 and2014 for allimmigrantpatients attending theTropicalMedicineUnit. Three formalin-etherconcentrated stool samples and an ELISA for anti-Strongyloides stercoralis antibodies were used as screening tools. Results: Of 659 patients screened, 79 (12%) were positive for S. stercoralis regardless of the diagnostic method used. The prevalence of infection was 42.9% in East African patients, 16.3% in Central African patients,10.9% in those fromSouthAmerica, and 10% in the case ofWestAfrica. Univariate analysis showed thatinfection by S. stercoralis was significantly more frequentinpatients from CentralAfrica (p = 0.026; OR 1.72, 95% CI 1.03–2.85) and East Africa (p<0.001; OR 5.88, 95% CI 1.75–19.32). Taking West Africa as the reference (as the area of lowest prevalence among the positive prevalence areas), the statistical analysis showed that the risk of infection was higher in East Africa (p = 0.001; OR 6.750, 95% CI 2.127–21.423) and Central Africa (p = 0.065; OR 1.747, 95% CI 0.965–3.163). Conclusions: Due to the potential complications of strongyloidiasis infection, we recommend that immigrantpatients fromdevelopingcountriesbe routinelyscreenedfor S. stercoralis, especiallythose from East Africa. A serological test is a highly appropriate screening tool.