20 research outputs found

    Control of chronic <i>Strongyloides stercoralis</i> infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study

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    <div><p>Objectives</p><p>To assess the effect of treatment with ivermectin on the prevalence of <i>S</i>. <i>stercoralis</i> infection in an Australian Aboriginal population over a three year period, and to assess the validity of using a lower ELISA cut-off in diagnosis.</p><p>Methods</p><p>A three-year cohort study of 259 adult Australian Aboriginals living in a remote community in northern Australia. <i>S stercoralis</i> infection was diagnosed using commercial ELISA testing, and employed a lower threshold for treatment than that recommended. Follow up was conducted at 6 months and 3 years following ivermectin treatment.</p><p>Findings</p><p>Treatment with ivermectin was highly effective and resulted in a sustained fall in the prevalence of infection in the study group (Initial prevalence 35.3%, 3 year prevalence 5.8%, McNemar’s chi<sup>2</sup> = 56.5, p<0.001). Results of treatment suggested use of a lower ELISA threshold for treatment was valid in this setting. Follow up identified a small group of subjects with persistently positive ELISA serology despite repeated treatment.</p><p>Interpretation</p><p>Control of <i>S</i>. <i>stercoralis</i> infection in this cohort appears to be feasible using pharmacological treatment alone.</p></div

    Clinical characteristics of the study participants (N = 259).

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    <p><sup>a</sup> Median</p><p>Clinical characteristics of the study participants (N = 259).</p

    Outcomes for positive cases by diabetes status after adjusting for age, sex, initial titer, follow up period, days between first and second dose and eosinophilia.

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    <p><sup>a</sup>Based on log binomial generalized linear model.</p><p>Outcomes for positive cases by diabetes status after adjusting for age, sex, initial titer, follow up period, days between first and second dose and eosinophilia.</p

    Outcome for “low titre” subjects.

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    <p>Outcome for “low titre” subjects.</p

    Characteristics and outcomes for positive cases by diabetes status with 95% CI.

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    <p><sup>a</sup>Independent samples t-tests for continuous variables, Chi-squared tests for categorical variables, Mann-Whitney U-test for skewed continuous variables</p><p>Characteristics and outcomes for positive cases by diabetes status with 95% CI.</p
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