Recent advances in Strongyloides screening, diagnostics, therapeutics, and management

Area of Science:

• Neglected tropical diseases
• Parasitology
• Infectious disease diagnostics

Background:

• Strongyloidiasis affects 30-100 million people worldwide, often underdiagnosed due to diagnostic limitations.
• Life-threatening hyperinfection can occur in immunocompromised individuals.
• Existing diagnostics and treatments face challenges in accessibility and efficacy.

Purpose of the Study:

• To review recent advances in diagnostics and therapeutics for strongyloidiasis.
• To highlight the impact of novel tools on screening, diagnosis, and treatment strategies.
• To identify future research priorities for managing strongyloidiasis, particularly in high-risk groups.

Main Methods:

• Review of recent scientific literature on strongyloidiasis diagnostics and treatments.
• Analysis of novel molecular and serologic diagnostic assays.
• Evaluation of emerging anthelmintic drugs, including moxidectin and emodepside.

Main Results:

• Molecular diagnostics and improved stool extraction methods are replacing traditional techniques.
• New rapid diagnostic tests (RDTs) using recombinant antigens (NIE, SsIR) facilitate point-of-care serologic screening.
• Moxidectin shows noninferior efficacy to ivermectin with a longer half-life; emodepside demonstrates promising early results.
• WHO conditionally recommends mass drug administration with ivermectin in endemic areas.
• Understanding of at-risk immunocompromised populations has improved, leading to updated screening recommendations.

Conclusions:

• Serologic and molecular tools are enhancing strongyloidiasis screening and diagnosis.
• Moxidectin and emodepside show potential to expand treatment options.
• Further research is needed for severe disease and special populations.
• Harmonized screening algorithms and prospective studies in high-risk groups are crucial priorities.