Diagnostics for human schistosomiasis: the way forward

Schistosomiasis is one of the major neglected tropical diseases,  affecting over 250 million people, including many children and young adults across the globe [1]. This involves significant chronic morbidity, posing a considerable public health threat, with substantial socioeconomic impact particularly on impoverished communities of the lowest socioeconomic status [2,3]. It is imperative to develop more effective approaches for the prevention, control and elimination of schistosomiasis.

Initial morbidity reduction and eventual disease elimination through integrated control strategies underpin current schistosomiasis control programs [3]. The accurate diagnosis of schistosomiasis, in both the mammalian and snail intermediate hosts as well as the environment, is extremely important in proper control and elimination of schistosomiasis. Mass drug administration of praziquantel has decreased the prevalence in some areas, rendering the usual diagnostics ineffective as the prevalence and intensity of infection drops. For elimination of schistosomiasis sensitive diagnostics will be required to assess if elimination has occurred, which will also prevent rebounding of infection if treatment is stopped prematurely [4]. Despite multiple efforts over last few decades, the search for cheap, sensitive diagnostics for schistosomiasis is ongoing.

Value of accurate diagnostics

Laboratory testing for any disease generally comprises two main approaches; screening and diagnostic assays. Screening tests allow for detection in a wide number of apparently healthy individuals. Diagnostic assays are helpful following a positive screening test to establish a definitive diagnosis, and in clinical settings where patients present directly with clinical manifestations.

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