WHO guideline on preventive chemotherapy for public health control of strongyloidiasis

Book excerpt: Human strongyloidiasis is a soil-transmitted helminth caused by infection with Strongyloides stercoralis, and it estimated to infect 300–600 million people worldwide. In recent years, the World Health Organization (WHO) has been contacted by the health ministries of several countries in which strongyloidiasis is endemic for advice on how to address the disease as a public health problem. While there are no public health programmes specifically for control of strongyloidiasis, in some settings, preventive chemotherapy (PC) with ivermectin are being conducted to control lymphatic filariasis and onchocerciasis. These programmes have demonstrated a reduction in prevalence of S. stercoralis infection, suggesting that PC may be a potential public health strategy in areas endemic for strongyloidiasis. WHO convened a guideline development group (GDG) to address the need to control strongyloidiasis and develop guidance. The objective of this WHO guideline is to provide an evidence-informed recommendation on whether PC with ivermectin as a public health intervention could reduce the disease burden. After considering all available evidence, The GDG made one recommendation which is annual mass drug administration with single-dose ivermectin in all age groups from 5 years and above in endemic settings with prevalence of Strongyloides stercoralis infection ≥ 5%.