Development of a Sensitive and Specific Antigen-Detection System for Strongyloides Stercoralis and Hookworm Infections

Infections with Strongyloides stercoralis and Hookworms are endemic in tropic and subtropical areas of the world. These infections are a risk factor for U.S. troop operations. Often infections are asymptomatic and can be devastating to immunocompromised individuals. Detection has followed traditional routes of fecal and duodenal exams. These techniques lack sensitivity and specificity in that experts are necessary to make the definitive diagnosis. This proposal will develop a dipstick antigen capture or inhibition assay for detection and identification and will refine the current Elisa assay for antibody measurements. The immune response to Strongyloides is not well defined and completely unknown in hookworm infections. Phase I comprises of: (1) Purification of antigen to be used in the production of antibodies and for use in antigen assays. (2) Attempts to make a semi-quantitative antibody assay for antibodies to Strongyloides and to hookworm antigens. (3) Performs preliminary evaluations of these assays in panels of known positive individuals and (4) defines antigen detection limits. Phase II will validate these assays in clinical and field conditions for extensive testing of their sensitivity and specificity. Refinement of the dipsticks will be made accordingly, initiation of large clinical trials, and production of commercial materials will follow. Strongyloides and Hookworm antigen and antibody detection DS will address the needs of domestic and foreign health agencies for a simple, economical detection and definitive confirmation of infection with these organisms. They will supplement our line of rickettsia, leptospira and dengue DS already being sold world-wide.