Abstract
Clinical cases of Moroccan residents have been recorded since 2004, indicating successful interruption of transmission of S. haematobium infection at national level. The first national survey initiated in 2009 for Schistosomiasis haematobium among children born after 2004, applied diagnostic test was the HAMA-EITB, based on the Western blot technology, and molecular malacological diagnostic tools clearly confirm transmission stop. In 2015, a recent, small survey utilizing an HAI, ELISA tests and an ultrasensitive antigen test, FTCUP CAA, in a group of individual with a past history of infection. However, obviously follow-up surveys to prevent reemergency and for certification of the schistosomiasis elimination require vigilant diagnosis strategies. Here we discuss diagnosis story line in the national laboratory and challenges based on the available tools in relation to their clinical parameters (sensitivity/specificity; Sn/Sp), practicability and associated costs. When transmission stop has been achieved, survey cost and speed are likely to benefit from cost effective pooling strategies and ultrasensitive assays indicating active infection in all potential risk groups. Similarly molecular pooling strategies to monitor infections in the snail vectors.
Highlights
Schistosomiasis haematobium is a worldwide public health problem affecting 150 million persons in third-world countries
It was estimated that annual mortality due to nonfunctioning kidneys caused by infections with S. haematobium could be as high as 150,000 [1, 2]
National programs applying repetitive mass drug administration (MDA) approaches have been implemented in several countries in Africa [4]. e immediate impact of chemot.herapy in case of S. haematobium infection is a decrease in the number of severe cases of urinary schistosomiasis and the concurrent reduction of the parasite load, in general this leads to overall lower endemicity
Summary
Schistosomiasis haematobium is a worldwide public health problem affecting 150 million persons in third-world countries. E status of schistosomiasis in areas that have reached low-transmission was reviewed not long ago [6] and recommendations offered regarding tools and strategies for monitoring, criteria to determine interruption of transmission and validation of elimination. These recommendations do not (yet) include the implementation of the newly developed ultrasensitive diagnostic tools [7, 8] that allow highly accurate determination of the infection status [9,10,11,12,13,14,15]. An unequivocal approach including the use of accepted diagnostic tools is crucial to demonstrate actual elimination status. e aim of our review is to present the line story of the disease in Morocco, the description of the diagnostic considerations for verification of elimination, and cost effective diagnosis strategy purposed to certify schistosmiasis elimination
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