TABLE 3.

Characteristics of strongyloidiasis and strategies to improve disease management

Characteristic	Strategy
Potential zoonotic transmission	Studies that characterize subpopulations of Strongyloides stercoralis in humans and animal hosts
Extent of disease distribution and population infected	Epidemiological studies and mapping that take into consideration the limitations of diagnostic tests—overestimates vs underestimates Development of disease registries
Limited awareness about chronic asymptomatic infections or nonspecific symptoms	Health care worker education regarding clinical features, risk factors for acquisition, and the autoinfective cycle
Lack of a single, high-sensitivity reference standard diagnostic test	Use of composite reference standards and/or latent class analysis for test validation and strategic use of the most effective diagnostics, with awareness of test limitations
Optimal diagnostics for use in mass drug administration programs versus individual diagnosis	Use of simple testing strategies (e.g., serology) for mass screening and more intensive strategies (serology and stool-based testing) for test-of-cure and individual diagnostics
Treatment of a spectrum of disease severity	Effective regimens for mass drug administration: chronic asymptomatic infection in immunocompetent persons versus individualized therapy based on disease burden and host immune status
Treatment of special groups	Further research into safe and effective regimens for pregnant/breastfeeding women and young children