Abstract
Schistosomiasis is a parasitic disease caused by trematode blood flukes of the genusSchistosoma, affecting over 250 million people mainly in the tropics. Clinically, the disease can present itself with acute symptoms, a stage which is relatively more common in naive travellers originating from non-endemic regions. It can also develop into chronic disease, with the outcome depending on theSchistosomaspecies involved, the duration and intensity of infection and several host-related factors. A range of diagnostic tests is available to determineSchistosomainfection, including microscopy, antibody detection, antigen detection using the Point-Of-Care Circulating Cathodic Antigen (POC-CCA) test and the Up-Converting Particle Lateral Flow Circulating Anodic Antigen (UCP-LF CAA) test, as well as Nucleic Acid Amplification Tests (NAATs) such as real-time PCR. In this mini review, we discuss these different diagnostic procedures and explore their most appropriate use in context-specific settings. With regard to endemic settings, diagnostic approaches are described based on their suitability for individual diagnosis, monitoring control programs, determining elimination as a public health problem and eventual interruption of transmission. For non-endemic settings, we summarize the most suitable diagnostic approaches for imported cases, either acute or chronic. Additionally, diagnostic options for disease-specific clinical presentations such as genital schistosomiasis and neuro-schistosomiasis are included. Finally, the specific role of diagnostic tests within research settings is described, including a controlled human schistosomiasis infection model and several clinical studies. In conclusion, context-specific settings have different requirements for a diagnostic test, stressing the importance of a well-considered decision of the most suitable diagnostic procedure.
Highlights
Schistosomiasis is a neglected tropical disease (NTD) caused by parasitic blood flukes of the Schistosoma genus, affecting over 250 million people of which the majority reside in sub-Saharan Africa [1, 2]
The most effective and widely used drug is praziquantel (PZQ), which is safe and efficacious against the adult worm stages of all Schistosoma spp [4]. It is commonly used for individual treatment as well as for mass drug administration (MDA), known as preventive chemotherapy, to at-risk populations for control of schistosomiasis in endemic areas
For the detection and quantification of Schistosoma-specific DNA, several Nucleic Acid Amplification Tests (NAATs) have been described for different types of clinical samples, including serum, stool and urine [54,55,56,57,58,59,60,61]
Summary
Schistosomiasis is a neglected tropical disease (NTD) caused by parasitic blood flukes of the Schistosoma genus, affecting over 250 million people of which the majority reside in sub-Saharan Africa [1, 2]. The most effective and widely used drug is praziquantel (PZQ), which is safe and efficacious against the adult worm stages of all Schistosoma spp [4]. It is commonly used for individual treatment as well as for mass drug administration (MDA), known as preventive chemotherapy, to at-risk populations for control of schistosomiasis in endemic areas. The diagnostic need is strongly related to its context-specific setting, each requiring its own distinctive approach In this mini review, we will provide a summary of the current diagnostic procedures for human schistosomiasis (part 1) and discuss their appropriate use in context-specific settings (part 2)
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