Comparison of ELISA, indirect immunofluorescence and mycological method for detection of Strongyloides Stercoralis infection among hemodialysis and renal transplantation patients

History and Objectives: Strongyloides stercoralis infection has adverse effect on hemodialysis and renal transplanted patients. Since Strongyloides stercoralis infection does not have apparent clinical signs, the present study was carried out to address the diagnostic power of ELISA and indirect immunofluorescence on patients referred to the hospitals for renal transplantation and hemodialysis in 1996. Materials and Methods: A diagnostic clinical trial was performed on 110 renal transplant and hemodialysis patients. ELISA, indirect immunofluorescence, direct microscopic fecal examination and formalin-ether examination of fecal samples were compared. Sensitivity, specificity and predictive value of each method was determined. Results: From 110 samples, 14 showed infection whereas 96 samples did not show any infection. Diagnostic value was 100% for ELISA and indirect immunofluorescent methods. There were close correlations between the two methods. Both method of direct fecal examination formalin ether method was unable to detect all the positive samples and all negative samples were reported as such by two fecal examination methods. There were no significant differences on the detection of positive samples of hemodialysis patients of Guilan and Tehran province and between hemodialysis and renal transplant patients of Guilan province. No significant difference between positive sample and sex was recorded. Conclusion: Immunosuppressant chemotherapy of renal transplant patients causes reduction of immune response and low antibody titer and poor diagnostic value of immunologic tests. ELISA and indirect immunofluorescent detection of strongyloides stercoralis infection is very simple and rapid test to perform and has an high degree of sensitivity and specificity.