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American Journal of Epidemiology Vol. 132, No. 2: 257-264
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health

research-article

SEROEPIDEMIOLOGY OF STRONGYLOIDES INFECTION IN THE SOUTHEAST ASIAN REFUGEE POPULATION IN CANADA

THERESA W. GYORKOS1,2, ROBERT M. GENTA3, PIERRE VIENS4 and J. DICK MACLEAN2

1Department of Epidemiology and Biostatistics, McGill University, and Division of Clinical Epidemiology, Montreal General Hospital Montreal, Quebec, Canada
2McGill University Centre for Tropical Diseases, Montreal General Hospital Montreal, Quebec, Canada
3Department of Pathology, School of Medicine, University of Washington Seattle, WA
4Le Centre de Coopération Internationale en Santé et Développement, Faculté de Medecine, Université Laval Ste-Foy, Quebec, Canada

Reprint requests to Dr. Theresa W. Gyorkos, Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, Canada H3G 1A4

As part of a screening and treatment program for intestinal parasite infections offered to newly arrived Southeast Asian refugees in Canada between July 1982 and February 1983, a total of 232 sera were tested for Strongylokies infection using an enzyme-linked immunosorbent assay (immunoglobulin G). These results were compared with coprologic results and eosinophil counts. The seropreval-ence was 76.6% (131 of 171) among Kampucheans, 55.6% (15 of 27) among Laotians, and 11.8% (4 of 34) among Vietnamese. A statistically significant relation (p<0.001) was found between Strongyloides aerology and Strongyloides infection on stool examination (prevalence, 24.7%) among Kampucheans. Eosin-ophilia (≥10%) was found to be significantly associated with both infection measures. Using coprologic results as the "gold standard," the properties of the serotogic test were estimated to be: sensitivity (95%), specificity (29%), positive predictive value (30%), and negative predictive value (95%). These estimates should be regarded as minimal values, as stool examination for Strongyloides infection can be an unreliable diagnostic reference. Further evaluation of the discrepancies observed between coprologic and serologic testing is required to determine the usefulness of these tests in epidemiologic studies.

mass screening; refugees; serology; Strongyloldes


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