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Strongyloidiasis: A review of the evidence for Australian practitioners

Johnston, Fay H., Morris, Peter S., Speare, R., McCarthy, J., Currie, Bart J., Ewald, D., Page, W. and Dempsey, Karen (2005). Strongyloidiasis: A review of the evidence for Australian practitioners. Australian Journal of Rural Health,13(4):247-254.

Document type: Journal Article
Citation counts: Scopus Citation Count Cited 23 times in Scopus Article | Citations
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Title Strongyloidiasis: A review of the evidence for Australian practitioners
Author Johnston, Fay H.
Morris, Peter S.
Speare, R.
McCarthy, J.
Currie, Bart J.
Ewald, D.
Page, W.
Dempsey, Karen
Journal Name Australian Journal of Rural Health
Publication Date 2005
Volume Number 13
Issue Number 4
ISSN 1038-5282   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-23744452734
Start Page 247
End Page 254
Total Pages 8
Place of Publication Australia
Publisher Wiley-Blackwell Publishing Asia
Field of Research 1117 - Public Health and Health Services
1110 - Nursing
HERDC Category C1 - Journal Article (DEST)
Abstract Objective: To summarise the available evidence concerning the prevalence, clinical manifestations, diagnosis and management of strongyloidiasis in Northern Australia.

Methods: We searched Medline, Clinical Evidence and the Cochrane Library using MeSH terms and text words 'strongyloides OR strongyloidiasis'. For Australian studies we included text words '(parasite* OR parasitic OR helminth*) AND Australia*'. We examined references contained in retrieved studies or identified from direct contact with researchers. Studies consistent with our objective that described their methods were eligible for inclusion.

Results: The prevalence in some tropical Aboriginal communities is high. Infection can be asymptomatic, cause a range of clinical syndromes or death. It may become chronic. Infected patients are at risk of developing severe disseminated disease particularly with immune compromise. There is little information about the relative frequency of different clinical outcomes. Available diagnostic tools are imperfect. Stool examination has a low sensitivity. Serology may have a low specificity in high prevalence populations and has not been evaluated in Aboriginal populations. Antihelmintic drugs are relatively safe and effective. Community programs based on treatment of stool-positive cases have been associated with a reduced prevalence of strongyloidiasis. We found no studies examining alternative public health interventions.

Conclusion: There is a high prevalence in many Aboriginal communities. Strongyloides infection should be excluded prior to commencing immunosuppressive therapies in patients from endemic areas. Further studies examining the public health impact of strongyloidiasis, the role of the enzyme-linked immuno-sorbent assay serological test and population-based approaches to management of the disease in endemically infected Australian populations are needed.
Keywords Aboriginal health
Australia Strongyloides stercoralis
public health
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Additional Notes CDU Research RID# 2005000072
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