Stothard J Russell, Adams Emily
Department of Parasitology,Liverpool School of Tropical Medicine,Liverpool L3 5QA,UK.
Parasitology. 2014 Dec;141(14):1781-8. doi: 10.1017/S0031182014001309.
There are many reasons why detection of parasites of medical and veterinary importance is vital and where novel diagnostic and surveillance tools are required. From a medical perspective alone, these originate from a desire for better clinical management and rational use of medications. Diagnosis can be at the individual-level, at close to patient settings in testing a clinical suspicion or at the community-level, perhaps in front of a computer screen, in classification of endemic areas and devising appropriate control interventions. Thus diagnostics for parasitic diseases has a broad remit as parasites are not only tied with their definitive hosts but also in some cases with their vectors/intermediate hosts. Application of current diagnostic tools and decision algorithms in sustaining control programmes, or in elimination settings, can be problematic and even ill-fitting. For example in resource-limited settings, are current diagnostic tools sufficiently robust for operational use at scale or are they confounded by on-the-ground realities; are the diagnostic algorithms underlying public health interventions always understood and well-received within communities which are targeted for control? Within this Special Issue (SI) covering a variety of diseases and diagnostic settings some answers are forthcoming. An important theme, however, throughout the SI is to acknowledge that cross-talk and continuous feedback between development and application of diagnostic tests is crucial if they are to be used effectively and appropriately.
检测具有医学和兽医重要性的寄生虫至关重要且需要新型诊断和监测工具,原因有很多。仅从医学角度来看,这些源于对更好的临床管理和合理用药的需求。诊断可以在个体层面,即在接近患者的环境中检验临床怀疑,也可以在社区层面,比如在电脑屏幕前,用于划分流行区域并制定适当的控制干预措施。因此,寄生虫病的诊断范围很广,因为寄生虫不仅与它们的终宿主有关,在某些情况下还与它们的传播媒介/中间宿主有关。在维持控制项目或消除疾病的环境中应用当前的诊断工具和决策算法可能会有问题,甚至不合适。例如,在资源有限的环境中,当前的诊断工具在大规模实际应用中是否足够强大,或者它们是否会被实际情况所混淆;针对控制目标的社区是否始终理解并接受公共卫生干预措施背后的诊断算法?在这个涵盖各种疾病和诊断环境的特刊中,会给出一些答案。然而,贯穿整个特刊的一个重要主题是承认,如果要有效且适当地使用诊断测试,那么在诊断测试的开发和应用之间进行相互交流和持续反馈至关重要。