Strongyloides-infecties bij voormalige krijgsgevangenen in Zuidoost-Azië in de Tweede Wereldoorlog; extra informatie door serologische diagnostiek

To analyse the efficacy of ELISA serology in patients with Strongyloides infection acquired during World War II and maintained through repeated autoinfection.

Design

Descriptive.

Setting

Laboratory of Parasitology, Faculty of Medicine, Leiden, the Netherlands.

Methods

Parasitological and clinical data on 193 ex-prisoners of war (South-east Asia) were presented previously (1990) by Verburg and De Geus. ELISA using L-3 S. ratti antigen was carried out with sera of these patients and the results were compared with those of repeated stool examinations using Baermann's method.

Results

All subjects harbouring larvae in repeated stool examinations (26) were positive in serology. In 21 out of 167 patients in whom no larvae could be demonstrated, specific antibodies were detected. Anamnestic information together with data on eosinophilia and IgE levels suggested that the majority of these subjects were actually infected. The serological prevalence of infection with Strongyloides stercoralis was 33 for those imprisoned in Burma and 4 for those who were prisoners of war in the former Netherlands East Indies.

Conclusion

In the group of subjects studied, in whom Strongyloides infection was apparently maintained through a process of autoinfection for a period of over 40 years, serology appears a sensitive and specific diagnostic tool. Larvae could be detected in no more than 26 out of 47 serologically positive subjects.