Strongyloidiasis Treatment Outcomes: A Prospective Study Using Serological and Molecular Methods

Strongyloidiasis, caused by the soil-transmitted helminth <i>Strongyloides stercoralis</i>, is estimated to infect around 600 million people worldwide. Ivermectin is the current first-line treatment. This prospective study evaluated long-term treatment response in patients with chronic strongyloidiasis. Conducted from 2019 to 2022 at Vega Baja Hospital in Alicante, Spain, this study enrolled 28 patients diagnosed with <i>S. stercoralis</i> infection. Patients received ivermectin at a dosage of 200 mcg/kg for one or two days and were followed for at least 12 months, with evaluations at 3, 6, 12, and 18 months post-treatment. Assessments included hemogram, IgE, <i>Strongyloides</i> serology, larvae culture and direct visualization and <i>Strongyloides</i> PCR in stool. Twenty-three patients completed at least 12 months of follow-up. Twenty-one patients (91.3%) achieved treatment response. Two patients (8.6%) experienced parasitological treatment failure, with detectable <i>Strongyloides stercoralis</i> DNA during follow-up. Ivermectin is highly effective in treating strongyloidiasis, with serology aiding in monitoring treatment efficacy. However, PCR detected an additional case of persistent infection, underscoring its complementary role.