Parasite-specific IgG response and peripheral blood eosinophil count following albendazole treatment for presumed chronic strongyloidiasis

Background. In developed countries, asymptomatic chronic Strongyloides stercoralis infection occurs in immigrants from endemic regions of the world. Accurate and reliable means of diagnosis and follow-Lip are required for effective management. The role of S stercoralis enzyme-linked immunosorbent assay (ELISA) in this context was examined. Methods. In this study, 95 asymptomatic Laotian immigrants living, in Melbourne, Australia, for all average of 12 years, were screened for S stercoralis infection using stool microscopy, eosinophil count, and serology, by ELISA. Twenty-two patients with a positive ELISA were treated with albendazole, 400 in, twice dally for 3 days, and monitored with serology, fecal microscopy, and eosinophil counts at 2, 6, 12, and 36 months after treatment. Results. Patients with Moderately reactive baseline ELISA and no eosinophilia had no significant change in either Measure over the 36 months of follow-up. All patients with a strongly reactive baseline ELISA showed a reduction in reactivity over the first 6 months of treatment. However, in 50% of these patients, reactivity increased between H and 36 months, suggesting treatment failure and relapse of infection. One patient had confirmed treatment failure based oil the development of hyperinfection syndrome. Conclusion. The results support evidence that serology is a valuable tool in monitoring treatment responses in patients with suspected strongyloidiasis and highlights the need to ensure that S stercoralis is completely eradicated after treatment.