Diagnosis of schistosomiasis pdf

To avoid this, Yang et al 23 suggested linalool Cinnamomum camphora L extracts to kill Oncomelania hupensis snails. Linalool could also be used to treat S. Snails treated with linalool showed gill destruction and cell degeneration. Additionally, the hepatopancreas of snails treated with linalool shrank and separated from the connective parenchyma.

These snails had much smaller tubular lumen and less oval dark granules compared with snails without linalool. Hepatopancreas is the combined hepatic and pancreatic tissue. The results showed that gill damage and hepatopancreas could be the main causes of death. Moreover, linalool extracts do not have environmental risks. SpAE also reduced granuloma volumes in the liver by The thickness of the small intestine's muscular layer was reduced by Thus, SpAE might be used for the development of medication against S.

Those authors used zingeber officinole rhizome berberine and selenium nanoparticles. Sundaraneedi et al 2 discovered polypyridylruthenium II complexes to treat schistosomiasis in mammals.

These complexes were effective against stages of schistosomes, schistosomula, and eggs. The authors concluded that Rubb 12 -tri and Rubb 7 -tnl were able to reduce worm burdens. Both had an effect on the viability of parasite eggs in vivo. Sundaraneedi et al 2 stated that ruthenium compounds were able to reduce parasite eggs in vitro.

They could also kill adult worms and praziquantel-refractory juvenile worms in vitro. A schistosomiasis vaccine could create a long-term decrease in illness spectrum and transmission. Tallima et al 26 found that a cysteine peptidase-based vaccination could shield against S.

You et al 28 discovered that the S. The authors used ribonucleic acid interference to kill parasites in vitro. In addition, You et al 29 suggested a vaccination with rSjLD1 and 2. The authors stated that rSjLD1 and 2 would be safe for immunizing bovines and humans. Moreover, to control S. Genetic manipulation techniques can be beneficial to control schistosomiasis.

For example, He et al 31 suggested that rAAV8-mediated miRp could become a drug for human diseases. The authors showed that rAAV8-mediated miRp protected mice from schistosome infection and alleviated hepatic pathology. He et al 31 showed that rAAV8-mediated miRp managed the enlargement of hepatic lymphoid cells.

It also reduced the production of hepatic lymphoid cells throughout infection. Thus, these techniques are potential tools for eliminating schistosomiasis. However, there are currently no studies analyzing the utility of these 2 tools for schistosomiasis treatment. Schistosomiasis is a blood-worm disease that exists in either the intestine or urethra in humans.

Three main species can infect humans. The schistosomiasis life cycle has 2 hosts: snails and mammals. Asexual reproduction occurs in snails and sexual reproduction occurs in mammals.

To control schistosomiasis, diagnosis has an important role. Currently, praziquantel is the only drug treatment available for schistosomiasis. No vaccines are available for this disease at present. Furthermore, genetic manipulation techniques are potential tools to control schistosomiasis in the future. Research and manuscript development were performed exclusively by M. The author has indicated that he has no conflicts of interest regarding the content of this article.

National Center for Biotechnology Information , U. Curr Ther Res Clin Exp. Published online Jun Martin L. Author information Article notes Copyright and License information Disclaimer. Nelwan: moc. Received Nov 7; Accepted Jun 6. This article has been cited by other articles in PMC. Abstract Background Human schistosomiasis is a parasitic disease caused by blood-worms that infect multiple organs, including the liver, intestine, bladder, and urethra. Aims In this review, the author describes the progress in a study of schistosomiasis that focused on the life cycle, diagnosis, and control.

Results The life cycle of this parasites involve two hosts: snails and mammals. Key words: Praziquantel, Schistosome, Schistosomula , Schistosomiasis. Background Schistosomiasis is caused by infection with blood flukes of the genus Schistosoma. Schistosome life cycle The schistosome life cycle occurs in 2 hosts: snails and mammals. Open in a separate window. Figure 1. Snail hosts Mammal hosts release worm eggs into the external environment through feces or urine. Mammalian hosts Cercariae enter human skin and shed their forked tail, forming schistosomula.

Schistosomiasis Transmission Dam and irrigation projects are potential sites for outbreaks of schistosomiasis. Diagnosis Examination of excrement is a key method used to diagnose suspected schistosomiasis infections Table 1.

Table 1 Scistosomiasis, habitat, and diagnosis. Control of Schistosomiasis S. Treatment Schistosomiasis eradication attempts commonly concentrate on controlling the infection through preventive chemotherapy. Vaccine Development A schistosomiasis vaccine could create a long-term decrease in illness spectrum and transmission. Table 2 Schistosomiais vaccine candidates. Table 3 Vaccine development for schistosomiasis.

Genetic Manipulation Genetic manipulation techniques can be beneficial to control schistosomiasis. Conclusions Schistosomiasis is a blood-worm disease that exists in either the intestine or urethra in humans. Acknowledgments Research and manuscript development were performed exclusively by M. Conflicts of Interest The author has indicated that he has no conflicts of interest regarding the content of this article. References 1. Viana M.

The effects of subcurative praziquantel treatment on life-history treats and trade-offs in drug-resistant Schistosoma mansoni. Evolutionary Applications. Sundaraneedi M. Polypyridylruthenium II complexes exert anti-schistosome activity and inhibit parasite acetylcholinesterases. PloS Negl Trop Dis. Alemu M.

Under diagnosis of intestinal schistosomiasis in a referral hospital, North Ethiopia. BMC Res Notes. Mohamed I. Diet and hygiene practices influence morbidity in schoolchildren living in Schistosomiasis endemic areas along Lake Victoria in Kenya and Tanzania—A cross-sectional study.

Wei Y. The diagnosis and treatment introspection of the first imported case of atypical cerebral schistosomiasis in Guangzhou city. Chala B. Serological testing can be useful in field studies for defining regions of low level endemicity, where individual patients have low egg burdens, and may also be beneficial for determining whether infection has re-emerged in a region after an apparently successful control programme.

It is important for diagnosis in travellers. Commercially available immunodiagnostic kits are less sensitive than multiple faecal examinations and less specific, owing to antibody cross-reactivity with antigens from other helminths.

Detection of circulating adult worm or egg antigens with labelled monoclonal or polyclonal antibodies in serum, urine, or sputum in infected individuals is another promising technique that may eventually supersede traditional diagnostic methods.

Randomised controlled trials have shown that praziquantel, a pyrazinoisoquinoline derivative, is a safe and effective oral drug that is active against all schistosome species. It is secreted in breast milk and is metabolised by the liver, and its metabolites which are inactive are excreted in the urine. The drug acts within one hour of ingestion although its precise action on adult worms is unknown. Laboratory studies have shown that it causes tetanic contractions and tegumental vacuoles, which cause worms to detach from the walls of veins and die.

Schistosome calcium ion channels have been indirectly identified as the molecular target of praziquantel. In animal models, the presence of host antibodies is critical for efficacy. Praziquantel has few side effects other than transient nausea, dizziness, rash, and pruritus, which are thought to be associated with the consequences of worm death rather than the drug itself. Treatment and prophylaxis for schistosomiasis. Adapted from Ross et al 8 with permission from Elsevier. Experimental laboratory studies in mice have indicated, somewhat controversially, that resistance to praziquantel may be emerging in Africa, where there has been heavy exposure to the drug, and where, worryingly, there are reports of S mansoni and S haematobium infections that are not responsive.

So far, however, patients in many communities have undergone multiple courses of treatment over a period of 10 or more years without demonstrable loss of efficacy. Because worm reproduction in the mammalian host is sexual and the generation time is relatively long, resistance is likely to take many years to become an important clinical and public health issue.

Nevertheless, resistance against praziquantel in the future cannot be ruled out and research should continue on developing alternative drugs—such as 4-phenyl-1,2,5-oxadiazolecarbonitrileoxide, a new compound that has been shown to inhibit a crucial parasite enzyme, thioredoxin glutathione reductase. Corticosteroids for example, prednisone 1. Anticonvulsants are used to treat seizures associated with cerebral schistosomiasis but lifelong use is rarely indicated table.

Surgery should be preserved for particular patients, such as those with evidence of medullary compression and for those who deteriorate, despite clinical treatment. Other drugs used to treat schistosomiasis are oxamniquine for S mansoni and metrifonate for S haematobium , but neither is effective against S japonicum.

Praziquantel cannot be used for chemoprophylaxis because of its short half-life Artemether is effective against juvenile schistosomes during the first 21 days of infection in animals and humans 28 and, if given every two weeks, should kill all immature schistosomula. It has been used as a chemoprophylactic in schistosomiasis endemic areas for those at high risk of infection, such as flood relief workers and fishermen in China table.

Randomised controlled trials have shown that combination therapy with praziquantel plus artemether is safe and results in higher rates of worm reduction than praziquantel alone. The challenge for researchers who aim to improve the diagnosis and management of schistosomiasis will be to find a way to respond to environmental changes w2 and to the threat of praziquantel resistance.

New diagnostic procedures that are simple, rapid, and able to diagnose light infections such as simple dipstick tests and PCR-based assays need further development, as do new drugs that act effectively on both adult and larval schistosomes, and vaccines that target either the human host or, in the case of S japonicum or S mekongi, the animal reservoir hosts.

An integrated approach to the management of schistosomiasis 32 w66 that offers treatment alongside measures to reduce transmission by snail control focal mollusciciding and environmental modification , health education and promotion, improved sanitation, and vaccination is the key to sustainable long term control of schistosomiasis.

Introduction to schistosomiasis www. Health topics: schistosomiasis www. Parasites—schistosomiasis www. Schistosomiasis www. I am a 26 year old driver from Yueyang, China. One Sunday last summer, I drove to the Dongting Lake and fished and swam for 30 minutes.

Twenty five days later, I developed a fever and cough and had a distended abdomen and diarrhoea. I was tired and had little appetite. On the third day of fever I attended a private hospital in Yueyang city. A chest x ray suggested a lung infection. I was treated for four days with antibiotics and intravenous drips, but my condition did not improve.

At another local hospital, I was diagnosed with acute schistosomiasis. I returned to Yueyang to attend a special schistosomiasis hospital. Schistosome eggs were found in my stool and my blood reacted to substances in schistosome eggs. X rays showed fluid in my left lung, and my liver and spleen were enlarged. Acute schistosomiasis was confirmed. I was told all my problems were caused by Schistosoma japonicum and its eggs. I was prescribed a drug called praziquantel and took the tablets three times a day after meals, three pills each time, for six days.

My fever was highest A special injection to lower my temperature was given to me and it worked well. I was discharged from hospital two days after I finished taking the drug.

My stool, re-checked 10 and 20 days later, showed no more eggs. After three months, I feel well now. We thank Mimi Kersting and Simon Forsyth for their graphical support. D Gray and D McManus finalised the article. Competing interests: All authors have completed the Unified Competing Interest form at www. Provenance and peer review: Not commissioned, externally peer reviewed. The management of tennis elbow ;d Advising on travel during pregnancy ;d Laser refractive eye surgery ;d Management of paracetamol poisoning ;d The challenge of managing coexistent type 2 diabetes and obesity ;d Post-acute care and secondary prevention after ischaemic stroke ;d National Center for Biotechnology Information , U.

Journal List BMJ v. Published online May Darren J Gray , research fellow , visiting scientist , 1 2 Allen G Ross , professor and chair of public health , director, population health research , 1 3 Yue-Sheng Li , senior research fellow , honorary director , 2 4 and Donald P McManus , laboratory head and National Health and Medical Research Council Australia senior principal research fellow 2.

Author information Article notes Copyright and License information Disclaimer. Correspondence to: D P McManus ua. Accepted Apr This article has been cited by other articles in PMC.

Associated Data Supplementary Materials Web reference list. Open in a separate window. Sources and selection criteria Information for this clinical review was obtained from personal reference archives, personal experience, and extensive literature searches of the PubMed and Cochrane databases. Where and how is schistosomiasis acquired? What are the clinical features of schistosomiasis? Early manifestations Rash A maculopapular eruption, comprising discrete erythematous raised lesions that vary in size from 1 cm to 3 cm, may arise at the site of percutaneous penetration by schistosome cercariae.

Acute schistosomiasis Katayama syndrome The symptoms of acute schistosomiasis are mediated by the immune complex w4-w7 and usually begin with the deposition of schistosome eggs into host tissues. Chronic and advanced disease Mature, patent, schistosome infections are associated with a chronic local inflammatory response to schistosome eggs trapped in host tissues, which may lead to inflammatory and obstructive disease in the urinary system S haematobium or intestinal disease, hepatosplenic inflammation, and liver fibrosis S mansoni , S intercalatum, S japonicum and S mekongi.

Gastrointestinal and liver disease Eggs retained in the gut wall induce inflammation, hyperplasia, ulceration, micro-abscess formation, and polyposis. Genitourinary disease Urinary tract disease develops after infection with S haematobium and granulomatous inflammation in response to deposition of eggs in tissues.

Box 1: Neuroschistosomiasis Diagnosis The finding of eggs in the stool or positive serology provides supportive but not direct evidence of schistosomal involvement in the central nervous system. Signs and symptoms Focal or generalised epilepsy S japonicum Transverse myelitis S mansoni and S haematobium Nystagmus Speech disturbances Motor weakness hemiplegia, paraplegia, or quadriplegia Papilloedema Lumbar pain and lower limb radicular pain S mansoni and S haematobium Sensory loss T12 to L1 Bladder dysfunction.

Neuro-imaging Computerised tomography Magnetic resonance imaging Myelography. Management Consult with a neurologist and an infectious disease physician Treatment with corticosteroids and anticonvulsants within two months of infection Praziquantel chemotherapy two months after known water contact.

How is schistosomiasis diagnosed? Box 2: Key indicators for positive diagnosis of schistosomiasis Medical history Have you travelled to or emigrated from an endemic country recently? Physical examination An urticarial rash maculopapular lesions may be present where the cercariae penetrated the skin discrete erythematous raised lesions that vary in size from cm On palpation of the abdomen, hepatomegaly tender left lobe and in about a third of patients splenomegaly may be detected Auscultation of the lungs frequently detects dry or moist rales during the acute phase Generalised lymphadenopathy may be present.

KK provides a high diagnostic specificity in endemic areas where parasite loads are high, but the detection limits falls to low levels when being applied in non-endemic areas or in the diagnosis of infections at an early stage.

KK is cheap, easy to use, and diagnostic sensitivity can be improved by the examination of two or more KK thick smears from the same stool sample, thus eliminating the need for re-sampling [ 19 ].

The Helmintex method for stool analysis of S. Another approach that is used in stool examination is the fecal concentration technique FECT. FECT suspends the fecal sample in formalin and ethyl acetate, centrifuge, the suspension sediments the parasite material in a pellet, which can subsequently be mixed with saline or stained with iodine for microscopy [ 21 ]. Urogenital schistosomiasis is usually assessed by the microscopic examination of parasite eggs in urine samples.

About 10 mL of urine is filtered, and the residue that is examined for parasite eggs following centrifugation. The number of eggs per 10 mL of urine is used to express infection intensity [ 22 ]. One of the pitfalls of microscopic examination of eggs in urine or stool is that this approach is not sensitive enough for monitoring the efficiency of praziquantel treatment during MDA campaigns.

Schistosome eggs might still be present in urine or stool weeks after the adult worms have died, conversely young worms schistosomula and worms that temporarily stopped shedding eggs will not be detected [ 23 ].

Microscopy is also limited in sensitivity, because it takes about two months from the time of infection for the eggs to appear in stool or urine [ 13 ]. Hence, this method of diagnosis may prevent the benefits of early detection and the treatment with praziquantel [ 24 ]. It is a general recommendation that testing for schistosomiasis be repeated by follow up with two consecutive visits for increased accuracy, since none of the current diagnostic tests is absolutely accurate [ 25 ].

This recommendation is really cumbersome with respect to sample collection, manpower, and materials that are required for processing specimens. Also, stool samples require immediate analysis as soon as possible because they cannot be stored, and this adds to the difficulties of diagnosis in resource-poor settings, especially where repeat testing is required. Urine samples, on the other hand, are easier to handle since they can be filtered in the field and stored for subsequent laboratory analysis.

Urine microscopy is also regarded as the gold standard for S. However, in areas of low transmission intensity, which were recently treated with praziquantel, young children with light infections or adults with chronic infections who usually excrete few eggs, urine microscopy is not sensitive.

Microscopy sensitivity can be improved by repeated screening of the children, but this brings up the total cost of diagnosis for each person, manpower needs and resources, which might be unaffordable. This inability to carry out repeated testing will result in an underestimation of the true burden of infection, necessitating a more sensitive diagnostic and cost effective tool in such settings [ 11 , 26 ].

In schistosomiasis screening campaigns, hematuria has been found to be significantly associated with S. Macro- or micro-hematuria can be assessed using dipstick [ 28 ]. However, a large percentage of micro-hematuria in low prevalence areas may be from other causes that are unrelated to S. The sensitivity of IFAT and IHA in detecting schistosome infection compares favorably with standardized western blot analysis, with specificity of IHA depending on the application of the right cut off values [ 29 ].

CDIFA therefore may have the potential to fill the demand for a POC diagnostic for use in the field without any instrumentation being required. Generally, serological assays have improved level of sensitivity when the right tools are employed, as compared to microscopy for schistosome diagnosis [ 32 ].

However, errors may arise from false positive results from non-infected subjects carrying antibodies from previous exposure to schistosomiasis [ 17 ], and cross reactions with antibodies from other helminth infections [ 16 ]. Antibody detection methods are limited by their inability to distinguish between Schistosoma species, are more sensitive at later stages of infection, and are unable to differentiate between recent or past infections.

Applicability of antibody based detection methods in SSA has been limited due to these factors, especially in areas where the disease is highly endemic and people living in the area are likely to be re-infected following treatment. Detection of adult worms and egg antigens in serum or urine holds a lot of diagnostic potential; it may ultimately replace the traditional methods, and the antigens that are detected in urine or serum are either anodic circulating anodic antigen or cathodic circulating cathodic antigen [ 17 ].

Circulating anodic antigen CAA assay uses luminescent quantitative up-converting phosphor UCP reporter particles and a rapid user-friendly lateral flow LF test format. Increasing the volume of urine sample that is needed for CAA test was found to increase the sensitivity and the accuracy of CAA assay for S. In addition, the ability of CAA test to detect a single pair of worms early stage infection , correlation of the test results CAA levels to egg production and worm burden makes this assay a true measure of schistosomiasis infection [ 23 ].

Applicability of this test is still limited in field settings, as it involved a centrifugation step, including other resources that are needed for carrying out analysis, which will bring up the cost and the required personnel. POC-CCA has the advantage of using urine samples instead of stool for analysis, thereby increasing the acceptability by patients and the applicability for epidemiological surveys in large populations [ 37 ].

When being used in combination with serology for S. CCA test sensitivity and versatility makes it useful for detecting schistosomiasis in non-endemic locations, and for use as a reference test for treatment evaluation.

Results from POC-CCA might give errors from trace values results that fall between positive and negative outcomes , but it has been suggested that treating trace values as positive values significantly increased the sensitivity of the assay with better reproducibility of disease prevalence [ 41 ].

A study by Sanneh et al. In a study that was carried out in Brazil, POC-CCA was shown to have limited sensitivity as a stand-alone diagnostic in areas with low infection intensities, suggesting its limitation in countries moving towards the elimination of the disease. Similar findings have been observed by Bezerra et al. POC-CCA also has the limitation of being a qualitative test; hence, its interpretation is based on individual analysis that could introduce some form of bias.

Together with hematuria test strips, CCA cassette testing could have limited application in the screening and mapping of S. DNA-based assays have recently gained popularity for the detection of infectious disease agents.

In the detection of schistosomes, PCR techniques have exhibited a promising degree of sensitivity and specificity. A glimpse of what the application of the new DNA technologies might ultimately achieve was first proposed and demonstrated with southern blotting and hybridization methods [ 47 , 48 , 49 ].

Recently, the use of molecular methods in the detection and characterisation of schistosomes have been perfected [ 50 , 51 ]. PCR has been used in detecting schistosomes in human serum, urine and faeces, water, snails, and many other sample types [ 47 , 52 , 53 , 54 , 55 ].

Parasite-specific target sequences can be amplified from cell-free DNA in urine or serum for S. PCR is also useful is analyzing vaginal lavages which may identify genital schistosomiasis. PCR can also be used to investigate the association between schistosomiasis in women and the increased susceptibility to human immunodeficiency virus HIV [ 57 ]. More recently, loop-mediated isothermal amplification LAMP was compared to PCR for the amplification of the bp fragment of a highly repeated bp region of S.

LAMP was found to be as specific as PCR in detecting both schistosome species, as well as being simpler, saves time and does not require the standard thermocycler [ 58 ].

It is therefore potentially adaptable to rural conditions as a point-of-care molecular diagnostics kit.

Another technique that is currently undergoing research and development is the Recombinase Polymerase Amplification RPA assay, which has been demonstrated in Plasmodium falciparum and pathogenic Leptospira as a reliable genomic DNA based diagnostic [ 59 , 60 ]. The RPA assay has been tested in detecting low levels of S. The RPA assay is rapid, requiring low temperatures, materials that are needed for the assay can be preserved at room temperature and positive reactions are interpreted using lateral flow strips.

RPA has good potential for field application, and further experiments validating their usefulness and bringing down the costs for use in resource limited settings are needed.

One of the limitations in the field application of DNA based diagnostics is total DNA sample preparation and the purification from urine [ 61 , 63 ]. This has been a bottleneck in the application of genomic DNA based diagnostics, because of the costs, and the technical and time consuming nature of the preparation.

RPA, however, offers hope that sample genomic DNA preparation and purification might not be required. Hence, this could potentially bring down the costs of the assay with increased feasibility in a POC setting [ 61 ]. In most low resource settings, the use of molecular screening methods have been explored; however, due to the limited resources and the requirement of expensive technology, cold chain logistics, uninterrupted power supply, highly skilled manpower, the application of PCR is rare [ 64 , 65 , 66 , 67 ].

Improved funding for research and health systems across developing countries would encourage the application of molecular diagnostic tests for screening schistosomiasis. In the developing countries, one of the major challenges facing the deployment of most diagnostic methods is the huge costs [ 68 , 69 ]. The drivers of cost of diagnosis include the supply of kits and reagents, labour, the nature of the test whether multi-step or not , and for field-based diagnosis, transportation is an important factor [ 70 ].

Table 1 summarises the diagnostic kits for schistosomiasis and market prices. Microscopy, as a method of schistosomiasis diagnosis, is inexpensive and it does not need extensive training and sophisticated facilities. However, in addition to its low sensitivity for detecting light infections, other limitations include its lack of rapidity, might need a centrifugation or filtration step to concentrate the eggs, as seen in FECT and FLOTAC, thereby increasing the cost for use in resource-poor countries [ 71 ].

Worrell et al. This price is very expensive, and it therefore leads to limited application of the test irrespective of its performance. In addition to the cost that is associated with carrying out triplicate KK to enhance sensitivity, the availability of the materials for the protocol can be difficult to obtain in endemic countries except when donated by stakeholders or WHO.

Interestingly, it is believed that if CCA dipstick test is internationally accepted as a viable alternative to single stool sample microscopy, the price may drop to a fairly affordable range due to an increase in demand. Moreover, since CCA dipstick is manufactured in Africa, it would be shipped across the continent at a reduced cost [ 85 ].

It is rapid, user-friendly, robust in performance, highly sensitive, and specific [ 69 , 86 ]. As it is, without support from governments and stakeholders, the deployment of more sensitive diagnostics at affordable prices, particularly in rural settings of low and middle income countries, remains far fetched [ 71 , 86 ]. Schistosomiasis diagnosis in most developing countries still relies heavily on microscopy, both for urogenital urine and intestinal schistosomiasis feces.

Although this is the approved approach by WHO for urogenital schistosomiasis, a lot of intestinal schistosomiasis cases go undetected in countries that have low transmission rates for intestinal schistosomes, likewise for urogenital schistosomiasis. Affordability of diagnostics that are identified to be very sensitive, such as POC-CCA, is a tough challenge for stakeholders and partners to overcome. This presents a challenge for monitoring the efficacy of control measures being put in place as we march towards the proposed eradication of the parasite by Efforts towards designing cheaper, more sensitive, and specific RDTs, especially for S.

Lastly, the cost of purchasing the current RDT kit for S. We thank the anonymous peer reviewers for their contribution towards improving the quality of this paper. All authors read, critically reviewed and approved the final version of the manuscript. National Center for Biotechnology Information , U. Journal List Med Sci Basel v. Med Sci Basel. Published online May Find articles by Olumide Ajibola. Find articles by Bashar Haruna Gulumbe. Author information Article notes Copyright and License information Disclaimer.

Received May 4; Accepted May This article has been cited by other articles in PMC. Abstract Schistosomiasis is a debilitating disease affecting over million people, with the highest burden of morbidity and mortality in African countries.

Keywords: diagnosis, schistosomiasis, neglected, Africa. Introduction Schistosomiasis is a common neglected tropical disease that is caused by parasitic trematodes of the genus Schistosoma. Clinical Presentations of Schistosomiasis People that have visited, or live in Africa or the Middle east, are likely to be infected by S. Schistosomiasis Detection Methods Currently available diagnostic methods for schistosomiasis include those that are relying on stool and urine microscopy for parasite detection Kato Katz and urine microscopy , serum antibodies, antigen detection, and the detection of DNA.

Antigen Based Detection Methods Detection of adult worms and egg antigens in serum or urine holds a lot of diagnostic potential; it may ultimately replace the traditional methods, and the antigens that are detected in urine or serum are either anodic circulating anodic antigen or cathodic circulating cathodic antigen [ 17 ]. Cost Analysis of Diagnostics In the developing countries, one of the major challenges facing the deployment of most diagnostic methods is the huge costs [ 68 , 69 ].

Open in a separate window. Future Directions Schistosomiasis diagnosis in most developing countries still relies heavily on microscopy, both for urogenital urine and intestinal schistosomiasis feces.