Challenges in the diagnosis of Chagas disease – an example of difficulties in strategies against neglected tropical parasitic diseases

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Background
The worldwide impact of neglected tropical diseases, specifically neglected tropical parasites, remains a major issue. These parasites, such as Leishmania spp., Echinococcus spp., Schistosoma spp., Trypansoma cruzi and T. brucei affect and kill hundreds of thousands of people annually, primarily in socially and geographically neglected areas. Control strategies include surveillance, vector control and reliable diagnostics [1].

Specific and sensitive diagnosis of parasitic infections is essential for patient management as well as for epidemiological analysis; however, reliable diagnosis of parasitic disease is extremely challenging. Current diagnostic methods for the detection of parasites come with well-defined challenges, for example, deficiencies in specificity and/or sensitivity – due to close relationships among certain parasites and low parasitemia, respectively. This combination of challenging diagnostic assay development and presumed irrelevancy for the northern hemisphere leads to a disinterest in the development of reliable detection methods by the diagnostics industry.

A typical example of the complexity and the challenges of neglected tropical parasitic diseases – regarding the parasite´s lifecycle, courses of the disease and diagnosis – is Chagas disease.

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