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Objectives  To assess the effect of treatment with ivermectin on the prevalence of  S .  stercoralis  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.    Methods  A three-year cohort study of 259 adult Australian Aboriginals living in a remote community in northern Australia.  S stercoralis  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.    Findings  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 2  = 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.    Interpretation  Control of  S .  stercoralis  infection in this cohort appears to be feasible using pharmacological treatment alone.

plos neglected tropical diseases

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