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Diagnostic value of urinary and serum IgG antibodies in evaluating drug treatment response in strongyloidiasis assessed by fecal examination and digital droplet PCR

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  • Phattharaphon Wongphutorn
  • Kulthida Y Kopolrat
  • Chanika Worasith
  • Chatanun Eamudomkarn
  • Nuttanan Hongsrichan
  • Opal Pitaksakulrat
  • Jiraporn Sithithaworn
  • Patcharaporn Tippayawat
  • Anchalee Techasen
  • Rahmah Noordin
  • Thomas Crellen
  • Paiboon Sithithaworn

Abstract

Detection of Strogyloides-specific IgG antibodies in urine and serum has been used in diagnostic and epidemiological studies on strongyloidiasis. However, the usefulness of these assays in assessing responses to anthelmintic treatment is unclear. Thus, we evaluated the diagnostic performance and temporal profiles of Strongyloides-specific IgG antibodies in a cohort of participants at baseline and post-treatment. The participants were prospectively screened for baseline parasitic infections by fecal examination [agar plate culture technique (APCT) and formalin-ethyl acetate concentration technique (FECT)] and digital droplet polymerase reaction (ddPCR) for Strongyloides stercoralis. At each sampling point, Strongyloides-specific IgG in urine and serum were measured by an in-house S. ratti-based enzyme-linked immunosorbent assay (ELISA). At baseline, 169 of 351 participants (48.1%) had S. stercoralis infection by the combined fecal examination and ddPCR. The diagnostic sensitivities of IgG in urine and serum were 91.1% and 88.2%, respectively. The participants were given treatment with a single oral dose of ivermectin (IVM, 200 μg/kg) and were followed up by fecal and immunological diagnosis at 3 to 18 months post-treatment. The cure rate of IVM treatment evaluated by APCT and ddPCR was 88.3% at three months post-treatment. The profiles of IgG in urine in the curative treatment group showed a significant trend of decline with time post-treatment (Kruskal-Wallis test = 113.4–212.6, p value 50% reduction in urinary IgG antibody units) was 100%, and conversion from positive to negative results was 65.4%. The treatment response and conversion to negative assessed by serum IgG-ELISA were similar to those by urine IgG-ELISA. The results from this long-term diagnostic study highlight the utility of urinary IgG and serum IgG for screening and monitoring treatment outcomes in strongyloidiasis.

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  • Phattharaphon Wongphutorn & Kulthida Y Kopolrat & Chanika Worasith & Chatanun Eamudomkarn & Nuttanan Hongsrichan & Opal Pitaksakulrat & Jiraporn Sithithaworn & Patcharaporn Tippayawat & Anchalee Techa, 2024. "Diagnostic value of urinary and serum IgG antibodies in evaluating drug treatment response in strongyloidiasis assessed by fecal examination and digital droplet PCR," PLOS ONE, Public Library of Science, vol. 19(12), pages 1-18, December.
    • Handle: RePEc:plo:pone00:0306732
    DOI: 10.1371/journal.pone.0306732
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    1. Armelle Forrer & Virak Khieu & Penelope Vounatsou & Paiboon Sithithaworn & Sirowan Ruantip & Rekol Huy & Sinuon Muth & Peter Odermatt, 2019. "Strongyloides stercoralis : Spatial distribution of a highly prevalent and ubiquitous soil-transmitted helminth in Cambodia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(6), pages 1-21, June.
    2. Saravanan Munisankar & Anuradha Rajamanickam & Suganthi Balasubramanian & Satishwaran Muthusamy & Chandra Kumar Dolla & Pradeep Aravindan Menon & Ponnuraja Chinnayan & Christopher Whalen & Paschaline , 2022. "Seroprevalence of Strongyloides stercoralis infection in a South Indian adult population," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 16(7), pages 1-13, July.
    3. repec:plo:pntd00:0003491 is not listed on IDEAS
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