Molecular detection of Strongyloides stercoralis: Emerging factors and diagnostic utility

Abstract

Strongyloides stercoralis infection, a neglected tropical disease, poses a significant public health threat, especially in immunocompromised individuals. This parasitic nematode can establish chronic infections, potentially progressing to life-threatening conditions such as hyperinfection syndrome and disseminated disease. Timely and accurate diagnosis is critical for effective treatment and the prevention of severe complications. Traditional diagnostic methods, such as stool microscopy, are limited by low sensitivity, particularly for detecting low-intensity infections. Advances in molecular diagnostics, particularly Polymerase Chain Reaction (PCR), have significantly improved sensitivity and specificity, marking a pivotal shift in detection capabilities. However, critical barriers persist, including inconsistencies in sample collection and handling, geographic variations in parasite strains, and the impact of genetic diversity on assay performance. Emerging molecular technologies, such as real-time PCR, loop-mediated isothermal amplification (LAMP), and droplet digital PCR (ddPCR) hold significant promise for further enhancing diagnostic precision. These advanced methods provide opportunities for more robust and accessible diagnostics, particularly in resource-limited settings. To maximize their potential, it is imperative to address existing challenges through the standardization of protocols, optimization of sample handling procedures, and the development of high-quality, reliable reagents. By overcoming these obstacles, molecular diagnostics can be more effectively integrated into clinical and public health frameworks, facilitating improved management and control of S. stercoralis infection, ultimately reducing the morbidity and mitigating the global burden of this neglected tropical disease.