Abstract
Despite extensive efforts over the last few decades, the global disease burden of schistosomiasis still remains unacceptably high. This could partly be attributed to the lack of accurate diagnostic tools for detecting human and animal schistosome infections in endemic areas. In low transmission and low prevalence areas where schistosomiasis elimination is targeted, case detection requires a test that is highly sensitive. Diagnostic tests with low sensitivity will miss individuals with low infection intensity and these will continue to contribute to transmission, thereby interfering with the efficacy of the control measures operating. Of the many diagnostic approaches undertaken to date, the detection of schistosome DNA using DNA amplification techniques including polymerase chain reaction (PCR) provide valuable adjuncts to more conventional microscopic and serological methods, due their accuracy, high sensitivity, and the capacity to detect early pre-patent infections. Furthermore, DNA-based methods represent important screening tools, particularly in those endemic areas with ongoing control where infection prevalence and intensity have been reduced to very low levels. Here we review the role of DNA diagnostics in the path towards the control and elimination of schistosomiasis.
Highlights
The public health and socioeconomic impact of schistosomiasis is such that, to date, over 230 million people have acquired the disease, including many children, mainly in the tropics and subtropics
A recent World Health Organization (WHO) expert committee report [12] highlighted the significance of a One Health approach focusing on preventive chemotherapy, improvement of water, sanitation and hygiene (WASH), health promotion, snail control, and detection and treatment of animal reservoirs for the sustained control and elimination of Asian schistosomiasis [12]
DNA extraction is a key procedure but it can be a methodological bottleneck in polymerase chain reaction (PCR)-based diagnostic assays since the yield and quality of DNA directly affects the outcome of the amplification procedure; it is often the most expensive part of DNA-based diagnosis, when using commercially-available extraction kits [55,56]
Summary
The public health and socioeconomic impact of schistosomiasis is such that, to date, over 230 million people have acquired the disease, including many children, mainly in the tropics and subtropics. A recent World Health Organization (WHO) expert committee report [12] highlighted the significance of a One Health approach focusing on preventive chemotherapy, improvement of water, sanitation and hygiene (WASH), health promotion, snail control, and detection and treatment of animal reservoirs for the sustained control and elimination of Asian schistosomiasis [12]. This further emphasizes the importance and essential need for accurate diagnostics, if the target goals of transmission interruption by 2025 and elimination of transmission by 2030 are to be achieved
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