Acta Parasitologica

, Volume 64, Issue 2, pp 394–405 | Cite as

Strongyloides stercoralis in Patients on Corticosteroids Therapy Using Enzyme-Linked Immunosorbent Assay and Gelatin Particles Indirect Agglutination Tests: A Diagnostic Approach

  • Shahira A. AhmedEmail author
  • Amany El-Moselhy
  • Amal El-Moammaly
  • Khalid El-Shewy
Original Paper



Patients on corticosteroids therapy (POCT) are more likely to flare up concealed Strongyloides infection and develop Strongyloides hyperinfection syndrome and/or dissemination. Such critical complications can lead to high mortality rates. Rapid detection methods are, therefore, necessary to detect Strongyloides infection in POCT with the advantage of being applicable in a developing country.


Two hundred POCT have been enrolled in this study to determine the rate of infection with Strongyloides. Three different groups of POCT (Strongyloides infected, non-infected, infected with other parasites) were used to evaluate the antibodies detection capability of two serological techniques (enzyme-linked immunosorbent assay (ELISA) and gelatin particles indirect agglutination (GPIAT) against the results of the gold standard agar plate culture (APC).


With APC, the infection rate of Strongyloides stercoralis in POCT was 9.5% (19/200). POCT with Strongyloides infection displayed related risk factors (job, rural settlements, and soil contact) for infection combined with the subtropical nature of Ismailia Governorate. With regard to serology, ELISA detection results were poor compared to APC with sensitivity and specificity of 42.1% and 82.6%, respectively, and positive and negative predictive values of 72% and 30%. GPIAT appeared to be closely related to APC with sensitivity and specificity of 89.4% and 81.8%, respectively, and positive and negative predictive values of 80.9% and 96.7%. Statistical moderate correlation was detected between GPIAT and ELISA.


The GPIAT technique is more convenient, easier, cheaper and faster to rule out the infection of Strongyloides in POCT. It might be the test of choice for routine immunodiagnosis of human strongyloidiasis.


Strongyloides Corticosteroid therapy Diagnosis APC ELISA GPIAT 



We would like to introduce our great thanks to Professor Dr. Panagiotis Karanis, Medical School, University of Cologne, Cologne, Germany for his critical review of this study.


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Copyright information

© Witold Stefański Institute of Parasitology, Polish Academy of Sciences 2019

Authors and Affiliations

  • Shahira A. Ahmed
    • 1
    Email author
  • Amany El-Moselhy
    • 1
  • Amal El-Moammaly
    • 1
  • Khalid El-Shewy
    • 1
  1. 1.Department of Parasitology, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt

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