{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T22:33:10Z","timestamp":1786660390581,"version":"build-2736575974"},"reference-count":50,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The infection burden of\n                    <jats:italic>Strongyloides stercoralis<\/jats:italic>\n                    in India remains poorly defined. We aimed to estimate the burden of\n                    <jats:italic>S. stercoralis<\/jats:italic>\n                    infection among immunocompromised patients at our tertiary care hospital in north India and evaluated the performance of multiple diagnostic tests. Paired stool and blood samples were collected from 498 immunosuppressed individuals. Screening included stool microscopy without concentration, Baermann\u2019s funnel method, Agar plate and Harada Mori cultures,\n                    <jats:italic>18S ribosomal RNA<\/jats:italic>\n                    gene real-time polymerase chain reaction (RT-PCR), and anti-\n                    <jats:italic>Strongyloides<\/jats:italic>\n                    IgG antibody ELISA. Bayesian latent class analysis (BLCA) was performed to estimate diagnostic accuracy without assuming a gold standard. Overall, 16.9% (\n                    <jats:italic>n<\/jats:italic>\n                    = 84\/498) of immunosuppressed individuals were positive by a composite reference standard, most commonly detected by a combination of ELISA and RT-PCR. Among single tests, BLCA estimated ELISA sensitivity of 74.5% (95% credible interval [CrI]: 62.7\u201384.5) and specificity of 88.3% (95% CrI: 85.4\u201390.9). Culture and RT-PCR showed sensitivities of 62.9% (95% CrI: 50.0\u201375.1) and 62.6% (95% CrI: 50.2\u201374.6) and specificities of 99.8% (95% CrI: 99.4\u2013100.0) and 95.5% (95% CrI: 93.6\u201397.2), respectively. ELISA plus RT-PCR demonstrated the best performance with 87.5% (95% CrI: 76.9\u201395.0) sensitivity and 89.0% (95% CrI: 83.4\u201394.7) specificity.\n                    <jats:italic>Strongyloides stercoralis<\/jats:italic>\n                    infection was most frequent among patients with hypereosinophilia syndromes (33.3%), and increasing absolute eosinophilia count independently predicted infection. This study highlights a high burden of\n                    <jats:italic>S. stercoralis<\/jats:italic>\n                    infection in immunocompromised patients in north India and underscores the utility of combining serological and molecular assays for optimal detection in high-risk populations.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0566","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:32:25Z","timestamp":1764689545000},"page":"269-274","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Diagnostic Performance of Molecular and Serological Tests for Strongyloides stercoralis Infection in Immunosuppressed Patients from North India"],"prefix":"10.4269","volume":"114","author":[{"given":"Abhishek","family":"Mewara","sequence":"first","affiliation":[{"name":"Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Dhir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahajal","family":"Dhooria","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vignesh","family":"Pandiarajan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surinder Singh","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surjit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritesh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Pathogens","first-page":"468","article-title":"The global prevalence of Strongyloides stercoralis infection","volume":"9","author":"Buonfrate","year":"2020"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"208","article-title":"Strongyloides stercoralis in the immunocompromised population","volume":"17","author":"Keiser","year":"2004"},{"key":"b3","article-title":"Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030.","year":"2020"},{"key":"b4","series-title":"Am J Trop Med Hyg","first-page":"645","article-title":"Evidence-based guidelines for screening and management of strongyloidiasis in non-endemic countries","volume":"97","author":"Requena-M\u00e9ndez","year":"2017"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e2214","article-title":"Strongyloides stercoralis: A plea for action","volume":"7","author":"Bisoffi","year":"2013"},{"key":"b6","series-title":"Pathog Glob Health","first-page":"7","article-title":"Prevalence of strongyloidiasis in the general population of the world: A systematic review and meta-analysis","volume":"115","author":"Eslahi","year":"2021"},{"key":"b7","series-title":"Infez Med","first-page":"593","article-title":"Seroprevalence of Strongyloides infection among steroid recipients in a tertiary care centre in North India","volume":"30","author":"Ramprasad","year":"2022"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0010561","article-title":"Seroprevalence of Strongyloides stercoralis infection in a South Indian adult population","volume":"16","author":"Munisankar","year":"2022"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"1285","article-title":"Comparison of nested polymerase chain reaction and real-time polymerase chain reaction with parasitological methods for detection of Strongyloides stercoralis in human fecal samples","volume":"93","author":"Sharifdini","year":"2015"},{"key":"b10","series-title":"Front Immunol","first-page":"620417","article-title":"A real-time PCR assay for the diagnosis of intestinal schistosomiasis and cure assessment after the treatment of individuals with low parasite burden","volume":"11","author":"Siqueira","year":"2021"},{"key":"b11","series-title":"Adv Parasitol","first-page":"1","article-title":"The diagnosis of human and companion animal Strongyloides stercoralis infection: Challenges and solutions. A scoping review","volume":"118","author":"Buonfrate","year":"2022"},{"key":"b12","series-title":"Lancet Glob Health","first-page":"e740","article-title":"Accuracy, acceptability, and feasibility of diagnostic tests for the screening of Strongyloides stercoralis in the field (ESTRELLA): A cross-sectional study in Ecuador","volume":"11","author":"Tamarozzi","year":"2023"},{"key":"b13","series-title":"Parasitology","first-page":"812","article-title":"A retrospective study comparing agar plate culture, indirect immunofluorescence and real-time PCR for the diagnosis of Strongyloides stercoralis infection","volume":"144","author":"Buonfrate","year":"2017"},{"key":"b14","series-title":"Trans R Soc Trop Med Hyg","first-page":"459","article-title":"Serological assays for the diagnosis of Strongyloides stercoralis infection: A systematic review and meta-analysis of diagnostic test accuracy","volume":"114","author":"Kalantari","year":"2020"},{"key":"b15","series-title":"BMC Infect Dis","first-page":"297","article-title":"Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia","volume":"22","author":"Hailu","year":"2022"},{"key":"b16","series-title":"PLoS Negl Trop Dis","first-page":"e2002","article-title":"The laboratory diagnosis and follow up of strongyloidiasis: A systematic review","volume":"7","author":"Requena-M\u00e9ndez","year":"2013"},{"key":"b17","series-title":"Rev Esp Salud Publica","first-page":"581","article-title":"Diagnosis of Strongyloides stercoralis infection: Meta-analysis on evaluation of conventional parasitological methods (1980\u20132013)","volume":"88","author":"Campo Polanco","year":"2014"},{"key":"b18","series-title":"Parasit Vectors","first-page":"427","article-title":"Detection of human strongyloidiasis among patients with a high risk of complications attending selected tertiary care hospitals in Colombo, Sri Lanka using molecular and serological diagnostic tools","volume":"17","author":"Weerasekera","year":"2024"},{"key":"b19","series-title":"PLoS Negl Trop Dis","first-page":"e75","article-title":"Occurrence of Strongyloides stercoralis in Yunnan Province, China, and comparison of diagnostic methods","volume":"1","author":"Steinmann","year":"2007"},{"key":"b20","series-title":"Parasit Vectors","first-page":"221","article-title":"Prevalence and risk factors of Strongyloides stercoralis in Takeo Province, Cambodia","volume":"7","author":"Khieu","year":"2014"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e2288","article-title":"Strongyloides stercoralis: Global distribution and risk factors","volume":"7","author":"Sch\u00e4r","year":"2013"},{"key":"b22","series-title":"Clin Microbiol Infect","first-page":"1621","article-title":"Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: A systematic review and meta-analysis","volume":"27","author":"Buonfrate","year":"2021"},{"key":"b23","series-title":"PLoS Negl Trop Dis","first-page":"e2165","article-title":"A public health response against Strongyloides stercoralis: Time to look at soil-transmitted helminthiasis in full","volume":"7","author":"Krolewiecki","year":"2013"},{"key":"b24","series-title":"PLoS Negl Trop Dis","first-page":"e1292","article-title":"Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting","volume":"5","author":"Becker","year":"2011"},{"key":"b25","series-title":"Lancet Infect Dis","first-page":"1181","article-title":"Multiple-dose versus single-dose ivermectin for Strongyloides stercoralis infection (Strong Treat 1 to 4): A multicentre, open-label, phase 3, randomised controlled superiority trial","volume":"19","author":"Buonfrate","year":"2019"},{"key":"b1","series-title":"Pathogens","first-page":"468","article-title":"The global prevalence of Strongyloides stercoralis infection","volume":"9","author":"Buonfrate","year":"2020"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"208","article-title":"Strongyloides stercoralis in the immunocompromised population","volume":"17","author":"Keiser","year":"2004"},{"key":"b3","article-title":"Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030.","year":"2020"},{"key":"b4","series-title":"Am J Trop Med Hyg","first-page":"645","article-title":"Evidence-based guidelines for screening and management of strongyloidiasis in non-endemic countries","volume":"97","author":"Requena-M\u00e9ndez","year":"2017"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e2214","article-title":"Strongyloides stercoralis: A plea for action","volume":"7","author":"Bisoffi","year":"2013"},{"key":"b6","series-title":"Pathog Glob Health","first-page":"7","article-title":"Prevalence of strongyloidiasis in the general population of the world: A systematic review and meta-analysis","volume":"115","author":"Eslahi","year":"2021"},{"key":"b7","series-title":"Infez Med","first-page":"593","article-title":"Seroprevalence of Strongyloides infection among steroid recipients in a tertiary care centre in North India","volume":"30","author":"Ramprasad","year":"2022"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0010561","article-title":"Seroprevalence of Strongyloides stercoralis infection in a South Indian adult population","volume":"16","author":"Munisankar","year":"2022"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"1285","article-title":"Comparison of nested polymerase chain reaction and real-time polymerase chain reaction with parasitological methods for detection of Strongyloides stercoralis in human fecal samples","volume":"93","author":"Sharifdini","year":"2015"},{"key":"b10","series-title":"Front Immunol","first-page":"620417","article-title":"A real-time PCR assay for the diagnosis of intestinal schistosomiasis and cure assessment after the treatment of individuals with low parasite burden","volume":"11","author":"Siqueira","year":"2021"},{"key":"b11","series-title":"Adv Parasitol","first-page":"1","article-title":"The diagnosis of human and companion animal Strongyloides stercoralis infection: Challenges and solutions. A scoping review","volume":"118","author":"Buonfrate","year":"2022"},{"key":"b12","series-title":"Lancet Glob Health","first-page":"e740","article-title":"Accuracy, acceptability, and feasibility of diagnostic tests for the screening of Strongyloides stercoralis in the field (ESTRELLA): A cross-sectional study in Ecuador","volume":"11","author":"Tamarozzi","year":"2023"},{"key":"b13","series-title":"Parasitology","first-page":"812","article-title":"A retrospective study comparing agar plate culture, indirect immunofluorescence and real-time PCR for the diagnosis of Strongyloides stercoralis infection","volume":"144","author":"Buonfrate","year":"2017"},{"key":"b14","series-title":"Trans R Soc Trop Med Hyg","first-page":"459","article-title":"Serological assays for the diagnosis of Strongyloides stercoralis infection: A systematic review and meta-analysis of diagnostic test accuracy","volume":"114","author":"Kalantari","year":"2020"},{"key":"b15","series-title":"BMC Infect Dis","first-page":"297","article-title":"Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia","volume":"22","author":"Hailu","year":"2022"},{"key":"b16","series-title":"PLoS Negl Trop Dis","first-page":"e2002","article-title":"The laboratory diagnosis and follow up of strongyloidiasis: A systematic review","volume":"7","author":"Requena-M\u00e9ndez","year":"2013"},{"key":"b17","series-title":"Rev Esp Salud Publica","first-page":"581","article-title":"Diagnosis of Strongyloides stercoralis infection: Meta-analysis on evaluation of conventional parasitological methods (1980\u20132013)","volume":"88","author":"Campo Polanco","year":"2014"},{"key":"b18","series-title":"Parasit Vectors","first-page":"427","article-title":"Detection of human strongyloidiasis among patients with a high risk of complications attending selected tertiary care hospitals in Colombo, Sri Lanka using molecular and serological diagnostic tools","volume":"17","author":"Weerasekera","year":"2024"},{"key":"b19","series-title":"PLoS Negl Trop Dis","first-page":"e75","article-title":"Occurrence of Strongyloides stercoralis in Yunnan Province, China, and comparison of diagnostic methods","volume":"1","author":"Steinmann","year":"2007"},{"key":"b20","series-title":"Parasit Vectors","first-page":"221","article-title":"Prevalence and risk factors of Strongyloides stercoralis in Takeo Province, Cambodia","volume":"7","author":"Khieu","year":"2014"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e2288","article-title":"Strongyloides stercoralis: Global distribution and risk factors","volume":"7","author":"Sch\u00e4r","year":"2013"},{"key":"b22","series-title":"Clin Microbiol Infect","first-page":"1621","article-title":"Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: A systematic review and meta-analysis","volume":"27","author":"Buonfrate","year":"2021"},{"key":"b23","series-title":"PLoS Negl Trop Dis","first-page":"e2165","article-title":"A public health response against Strongyloides stercoralis: Time to look at soil-transmitted helminthiasis in full","volume":"7","author":"Krolewiecki","year":"2013"},{"key":"b24","series-title":"PLoS Negl Trop Dis","first-page":"e1292","article-title":"Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting","volume":"5","author":"Becker","year":"2011"},{"key":"b25","series-title":"Lancet Infect Dis","first-page":"1181","article-title":"Multiple-dose versus single-dose ivermectin for Strongyloides stercoralis infection (Strong Treat 1 to 4): A multicentre, open-label, phase 3, randomised controlled superiority trial","volume":"19","author":"Buonfrate","year":"2019"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/2\/article-p269.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/2\/article-p269.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/2\/article-p269.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:19:45Z","timestamp":1775841585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/2\/article-p269.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":50,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0566","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}