Strongyloidiasis in personnel of the Regional Assistance Mission to Solomon Islands (RAMSI)

Objective: to investigate the first reported cases of strongyloidiasis in the Solomon Islands, and to establish whether this disease poses a risk to personnel of the Regional Assistance Mission to Solomon Islands (RAMSI). Design, setting and participants: Retrospective review of the pathology database of the RAMSI Medical Facility in Honiara, Solomon Islands, for the period 1 July 2006 – 30 September 2007. Main outcome measures: number and clinical features of confirmed cases of Strongyloides stercoralis infestation, as diagnosed by serological tests or faecal microscopy. Results: fourteen confirmed cases of strongyloidiasis in previously healthy RAMSI participants were identified. Of 13 patients with notes available, symptoms documented at presentation included epigastric pain (10 patients), diarrhoea (7) and urticaria (4). Clinical disease in all patients responded to oral antihelminthic therapy (albendazole or ivermectin). Conclusions: Strongyloidiasis is endemic in the Solomon Islands and a risk for RAMSI personnel. Australian medical professionals should be aware of this potentially fatal and lifelong infestation, particularly the importance of an occupation history, appropriate diagnostic tests, effective treatment and adequate follow-up to document cure. We recommend implementation of a postdeployment screening program for strongyloidiasis.