{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:25:26Z","timestamp":1767176726068,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013136","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000}}],"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Strongyloidiasis is endemic in many remote Indigenous communities in Australia. Early diagnosis, treatment, and follow-up of chronic strongyloidiasis can prevent life-threatening clinical complications and decrease transmission in these endemic communities. The aim of this paper is to evaluate the effectiveness and sustainability of a primary healthcare strategy designed to measure and reduce the prevalence of strongyloidiasis in four remote communities in northeast Arnhem Land.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      The primary healthcare strategy was a prospective, longitudinal, health-systems intervention designed to integrate serological testing for chronic strongyloidiasis into the Indigenous preventive adult health assessment utilising the electronic health-record systems in four Aboriginal health services. Positive cases were recalled for treatment, and opportunistic follow-up serology after six months. Results were tracked using\n                      <jats:italic>Strongyloides<\/jats:italic>\n                      reports generated by the electronic health-record system. This paper describes the changes in prevalence, effectiveness of treatment, and reinfection during the implementation phase, 2012\u20132016. An improved\n                      <jats:italic>Strongyloides<\/jats:italic>\n                      electronic report was developed to evaluate the effectiveness and sustainability of the intervention to the end of 2020.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>During the entire period 2012\u20132020, 84% (2390\/2843) of the resident adults in the four communities were tested for strongyloidiasis at least once. Prevalence was reduced from 44% (1056\/2390) ever-positive to 10% (232\/2390) positive on their last test. Of positive, treated cases with a follow-up serology test, the last test was negative in 85% (824\/967) of individuals. Point prevalence continued to decrease in each community four years after the end of the implementation phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results provided practice-based evidence of a significant decrease in the prevalence of strongyloidiasis attributable to the strategy which could be replicated in other health services utilising electronic health-record systems. The final evaluation demonstrated the sustainability and ongoing benefits for endemically infected communities, and the key role that health services can play in strongyloidiasis prevention and control programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013136","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T13:55:02Z","timestamp":1748613302000},"page":"e0013136","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the effectiveness and sustainability of a primary healthcare strategy to reduce the prevalence of strongyloidiasis in endemically infected Indigenous communities in Northern Australia"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5669-529X","authenticated-orcid":true,"given":"Wendy A.","family":"Page","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Blair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Dempsey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverley-Ann","family":"Biggs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenni A.","family":"Judd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"5","key":"pntd.0013136.ref001","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002165","article-title":"A public health response against Strongyloides stercoralis: time to look at soil-transmitted helminthiasis in full","volume":"7","author":"AJ Krolewiecki","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013136.ref002","first-page":"40","article-title":"Chronic strongyloidiasis - don\u2019t look and you won\u2019t find","volume":"45","author":"W Page","year":"2016","journal-title":"Aust Fam Physician"},{"issue":"6","key":"pntd.0013136.ref003","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens9060468","article-title":"The Global Prevalence of Strongyloides stercoralis Infection","volume":"9","author":"D Buonfrate","year":"2020","journal-title":"Pathogens"},{"issue":"10","key":"pntd.0013136.ref004","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-006968","article-title":"How can we better integrate the prevention, treatment, control and elimination of neglected tropical diseases with other health interventions? 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