title: Use of dried blood spots to define antibody response to the Strongyloides stercoralis recombinant antigen NIE.
abstract: An approach to improve the diagnosis of Strongyloides stercoralis infection is the use of serologic assays utilising the NIE antigen from S. stercoralis, with good diagnostic sensitivity and excellent specificity reported. Detection of antibody eluted from dried blood spots (DBS) has shown utility in large-scale seroepidemiological studies for a range of conditions and is appealing for use with children where sample collection is difficult. We adapted an existing NIE-enzyme linked immunosorbent assay (ELISA) for the testing of strongyloides antibody response on DBS, and evaluated it in a population screening and mass drug administration programme (MDA) for strongyloidiasis conducted in an Australian indigenous community. Study participants were treated with 200 μg/kg ivermectin (>15 kg) or 3× 400 mg albendazole (<15kg). The sensitivity of the NIE DBS-ELISA was determined by receiver operator characteristic (ROC) analysis to be 85.7%. A total of 214 DBS were collected from 184 participants across two screening and MDA encounters. A total of 27 of 164 participants (16.5%) tested positive for S. stercoralis NIE-DBS prior to MDA treatment, and 6 of 50 participants (12.0%) tested positive after treatment. These prevalence values are similar to those documented by standard serology in the same community. For 30 participants where a DBS was collected at both MDA 1 and 2, a significant decline in ELISA values was evident post treatment (0.12-0.02, p=0.0012). These results are in agreement with previous studies documenting the high seroprevalence of S. stercoralis in remote Australian Indigenous communities, and suggest that collection of dried blood spots may be a useful approach for field diagnosis of S. stercoralis seroprevalence.
authors: School of Health & Sport Sciences, University of the Sunshine Coast, Locked Bag 4, Maroochydore, QLD 4558, Australia; QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia. Electronic address: kmounsey@usc.edu.au.
authors: Kate
authors: K
authors: Mounsey
authors: Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia. Electronic address: therese.kearns@menzies.edu.au.
authors: Therese
authors: T
authors: Kearns
authors: QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia. Electronic address: melanie_rampton@gmail.com.
authors: Melanie
authors: M
authors: Rampton
authors: QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia. Electronic address: stacey.llewellyn@qimr.edu.au.
authors: Stacey
authors: S
authors: Llewellyn
authors: QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia. Electronic address: mallory.king@qimr.edu.au.
authors: Mallory
authors: M
authors: King
authors: Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia. Electronic address: deborah.holt@menzies.edu.au.
authors: Deborah
authors: D
authors: Holt
authors: Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia. Electronic address: bart.currie@menzies.edu.au.
authors: Bart J
authors: BJ
authors: Currie
authors: Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia. Electronic address: ross.andrews@menzies.edu.au.
authors: Ross
authors: R
authors: Andrews
authors: National Institutes of Health, Bethesda, MD, United States. Electronic address: tnutman@niaid.nih.gov.
authors: Thomas
authors: T
authors: Nutman
authors: QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia; School of Medicine, University of Queensland, Herston, QLD, Australia. Electronic address: j.mccarthy@uq.edu.au.
authors: James
authors: J
authors: McCarthy
mesh_terms: D015766:Albendazole / Q000008:administration & dosage; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage; D000909:Antibodies, Helminth / Q000097:blood*; D000947:Antigens, Helminth; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003890:Desiccation; D016903:Drug Monitoring; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage; D008297:Male; D044382:Population Groups; D012372:ROC Curve; D011994:Recombinant Proteins; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D013048:Specimen Handling / Q000379:methods*; D017171:Strongyloides stercoralis / Q000276:immunology*; D013322:Strongyloidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D011994:Recombinant Proteins; D007559:Ivermectin; D015766:Albendazole
keywords: Helminth infection; Indigenous health; Serological diagnosis; Strongyloides stercoralis