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Strongyloidiasis Diagnostic Methods
Diagnostic methods | Pros and cons | Parasitological diagnosis | | In fresh stool preparations, motile rhabditiform larvae (with a short buccal cavity) can be seen. However, the sensitivity is rather limited even when concentration methods are used, because numbers of larvae vary from day to day. Several faecal samples have therefore to be processed to get a good predictive value for a negative result. It is debated whether duodenal samples (aspirates or Entero-test) may be more effective. There are special parasitological methods, e.g. Baerman or faecal culture on Petri dishes (on charcoal or on gels), but they face the same limitations as other coprologic methods. Infected patients often remain without symptoms for many years. | - Sensitivity of parasitological methods is low
| Molecular diagnosis | | No tests developed so far | | Antigen detection | | No tests available | | Antibody detection | | Serology is of great interest as a screening test. There are a few ELISA and dipstick tests available to detect circulating antibodies. However, there is still room for improvement in sensitivity and even more in specificity. | - Sensitivity is fairly high (80–90%) but problems arise from false positives, especially cross-reactive antibodies elicited by filarial and other tissue-dwelling helminth infections
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