Integration of diagnostics for Strongyloides stercoralis into the soil-transmitted helminths control programme in Rwanda.

Abstract

The WHO recently issued guidelines for public health control of Strongyloides stercoralis in endemic areas. We aimed to evaluate the feasibility of implementing the WHO recommendations in Rwanda, and our secondary objective was to estimate S. stercoralis prevalence. We conducted a community-based cross-sectional study in two Rwandan districts (Gisagara and Rubavu) including a training session focused on diagnostics for S. stercoralis: parasitological assays (Baermann and agar plate culture, APC) and a novel rapid diagnostic test (RDT). Technicians' perceptions of each assay were evaluated via a questionnaire; 1,415 individuals were screened. A critical aspect of the parasitological assays was the length of training, but there was no issues with RDT implementation. Based on the combination of Baermann and APC diagnostics, prevalence was 1.1% (95% CI 0.5-2.3) in Gisagara, and 3.9% (95% CI 2.6-5.7) in Rubavu, which was similar for the RDT. Overall, we found the implementation of S. stercoralis-specific tests was feasible, though intense training was crucial.