Hays Russell, Esterman Adrian, McDermott Robyn
Kutjungka Clinics, Kimberley Aboriginal Medical Services Council, Broome, Australia.
Centre for Research Excellence in Chronic Disease Prevention, The Cairns Institute, James Cook University Cairns, Smithfield, Australia.
PLoS Negl Trop Dis. 2017 Jul 31;11(7):e0005825. doi: 10.1371/journal.pntd.0005825. eCollection 2017 Jul.
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.
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.
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 chi2 = 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.
Control of S. stercoralis infection in this cohort appears to be feasible using pharmacological treatment alone.
评估伊维菌素治疗对澳大利亚原住民人群三年内粪类圆线虫感染率的影响，并评估在诊断中使用较低酶联免疫吸附测定（ELISA）临界值的有效性。
对居住在澳大利亚北部一个偏远社区的259名成年澳大利亚原住民进行了为期三年的队列研究。使用商业ELISA检测诊断粪类圆线虫感染，并采用了比推荐阈值更低的治疗阈值。在伊维菌素治疗后的6个月和3年进行随访。
伊维菌素治疗非常有效，导致研究组感染率持续下降（初始感染率35.3%，3年感染率5.8%，McNemar卡方检验=56.5，p<0.001）。治疗结果表明，在这种情况下使用较低的ELISA阈值进行治疗是有效的。随访发现一小部分受试者尽管经过反复治疗，ELISA血清学仍持续呈阳性。
在该队列中，仅使用药物治疗控制粪类圆线虫感染似乎是可行的。
