The current standard for diagnostics of S. stercoralis infection isthe detection of larvae in a stool sample. This study was designed tocompare the diagnostic efficacy of parasitological copro-diagnosticmethods (concentration-sedimentation, Harada-Mori and Baer-mann) with DNA-based detection of the parasite-derived repeatDNA in urine. Of the samples derived from 125 individuals 61 werenegative in both stool and urine based analyses (Table 2). For theurine samples, 56 had detectable levels of S. stercoralis repeat DNA.Interestingly only 27 of the 56 individuals who were positive for the S. stercoralis-repeat fragment were positive for matched stoolsamples. A further eight individuals had stool samples that werepositive for larvae but were negative for parasite repeat DNA in aurine sample taken at the same time.Thus, DNA-based detection in urine indicates prevalence infec-tion of 44.8% with a positive predictive value of 77.42% (95% CL58.90-90.41%). By contrast the standard parasitological method cal-culated by detection of larvae suggests a prevalence of only 28%with a positive predictive value of 36.92% (95% CL 25.26-49.80%).Only 21.6% of positive cases were congruent while 48.8% negativespecimens were in agreement. The disparity is most likely to beincreased sensitivity by detection of cell-free S. stercoralis DNA.Comparing urine positivity versus stool positivity the differenceis significant P = 0.0058.