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16 Feb 2024

Towards eradication of strongyloidiasis in Australia

A multidisciplinary team of experts, including Doherty Institute researchers Professor Beverley-Ann Biggs (infectious diseases physician and public health researcher), Associate Professor (Hon.) Siddhartha Mahanty (infectious diseases physician and senior researcher) and Dr Stephen Muhi (infectious diseases physician and researcher), has secured a $5 million Synergy Grant from the National Health and Medical Research Council (NHMRC) to tackle one of the most neglected tropical diseases in the world – strongyloidiasis.

Strongyloidiasis is endemic in many remote Indigenous communities in Australia, with reported prevalence rates as high as 60 per cent in some communities. Yet, despite being preventable and treatable, there is currently no global or national strategy in place to control the disease.

The little-known, yet potentially deadly infection, Dr Muhi explained, is caused by the parasitic worm Strongyloides stercoralis.

Strongyloides stercoralis thrives in tropical and subtropical regions of the world where warmth, moisture and poor sanitation favour its spread,” he said.

“When the worm larvae enter the body through the skin upon exposure to soil, they travel via the circulatory system to the lungs, where they’re coughed up and swallowed, settling in the gut to mature and reproduce. Strongyloidiasis is a chronic infection that can persist throughout an individual's life, often unnoticed. Occasionally the parasite causes overwhelming, disseminated infection which can be fatal for immunocompromised people.”

Faecal microscopy and culture showing parasites consistent with filariform Strongyloides stercoralis
Faecal microscopy and culture showing parasites consistent with filariform Strongyloides stercoralis

Professor Biggs said that targeted control measures can help reduce prevalence and spread of the parasite.

“There is a crucial need to address issues such as poor sanitation, inadequate hygiene, the scarcity of clean water and the lack of culturally appropriate health education in local languages,” she said.

Thanks to the NHMRC grant, experts from various fields are coming together with a ‘One Health’ approach to tackle this issue. The multidisciplinary team, led by Professor Darren Gray at QIMR Berghofer, will investigate the role of animals in disease transmission, develop new diagnostics, including rapid tests that can be deployed in local communities to accelerate access to treatment, improve public health interventions and provide updated estimates of prevalence of the infection in north-east Arnhem Land. The comprehensive approach of the multidisciplinary team is a real strength of the project.

A pivotal aspect of the project is the roll out of a pilot elimination program, codesigned and delivered through active engagement with the community. The pilot program will combine treatment, improved sanitation and hygiene practices, improved infrastructure, educational initiatives, veterinary management and surveillance.

Associate Professor Mahanty said that the availability of point-of-care diagnostic tests, which will be evaluated in this project, could be a game-changer for future control efforts for strongyloidiasis.

“This work has the potential to take us a step closer to the elimination of this potentially fatal infection, which would make a significant positive impact on the health and wellbeing of the affected communities,” he said.

The research program brings together a multidisciplinary team of researchers, practitioners, policy makers and community, including critical partnerships with Strongyloides AustraliaMiwatj Health Aboriginal ServiceAnimal Management in Rural and Remote Indigenous CommunitiesEast Arnhem Regional CouncilNT HealthNT Power and Water and NSW Health Pathology.

The research collaborators are from QIMR BerghoferFlinders UniversityDoherty Institute and University of MelbourneAustralian National UniversityUNSWFederation University Australia and Central Queensland University.