Continued treatment, blood and stool monitoring thus may be necessary even if symptoms temporarily resolve. As cited earlier, due to the fact that some infections are insidiously asymptomatic, and relatively expensive bloodwork is often inconclusive via false-positives or false-negatives, just as stool samples can be unreliable in diagnoses, there is yet unfortunately no real gold standard for proof of cure, mirroring the lack of an efficient and reliable methodology of diagnosis. An objective eradication standard for strongyloidiasis is elusive given the high degree of suspicion needed to even begin treatment, the sometimes difficulty of the only definitive diagnostic criteria of detecting and isolating larvae or adult Strongyloides, the importance of early diagnosis, particularly before steroid treatments, and the very wide variability and exclusion/inclusion of differing collections of diffuse symptoms. Disregarding mis-ascribing bonafide delusional parasitosis disorders, strongyloidiasis should be more well known among medical professionals and have serious consideration for broad educational campaigns in effected geographic locales both within the semi-tropical developed world and otherwise, as well as in the tropical developing world where, among many other neglected tropical diseases, it is endemic.Government programs are needed to help decontaminate endemic areas and to help effected populations from infection. Furthermore, progress is required in establishing financial support to facilitate and cover affordable medications for individuals in effected at-risk regions and communities to help continuing treatments.There are conflicting reports on effective drug treatments. Ivermectin ineffectiveness and rising drug resistance has been documented. Albendazole is noted by the WHO as being the least effective.
Other conditions
A different serovar of Chlamydia trachomatis is also the cause of lymphogranuloma venereum, an infection of the lymph nodes and lymphatics. It usually presents with genital ulceration and swollen lymph nodes in the groin, but it may also manifest as rectal inflammation, fever or swollen lymph nodes in other regions of the body. Transmission
Chlamydia can be transmitted during vaginal, anal, or oral sex, or direct contact with infected tissue such as conjunctiva. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth. It is assumed that the probability of becoming infected is proportionate to the number of bacteria one is exposed to. Pathophysiology
Chlamydiae have the ability to establish long-term associations with host cells. When an infected host cell is starved for various nutrients such as amino acids (for example, tryptophan), iron, or vitamins, this has a negative consequence for Chlamydiae since the organism is dependent on the host cell for these nutrients. Long-term cohort studies indicate that approximately 50% of those infected clear within a year, 80% within two years, and 90% within three years.The starved chlamydiae enter a persistent growth state wherein they stop cell division and become morphologically aberrant by increasing in size. Persistent organisms remain viable as they are capable of returning to a normal growth state once conditions in the host cell improve.There is debate as to whether persistence has relevance. Some believe that persistent chlamydiae are the cause of chronic chlamydial diseases.