Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Institute of Medical Microbiology and Hygiene, Saarland University Medical Centre, Homburg/Saar, Germany.
Clin Microbiol Infect. 2015 Jun;21(6):529-42. doi: 10.1016/j.cmi.2015.03.014. Epub 2015 Apr 3.
Schistosomiasis is a water-based parasitic disease that affects over 250 million people. Control efforts have long been in vain, which is one reason why schistosomiasis is considered a neglected tropical disease. However, since the new millennium, interventions against schistosomiasis are escalating. The initial impetus stems from a 2001 World Health Assembly resolution, urging member states to scale-up deworming of school-aged children with the anthelminthic drug praziquantel. Because praziquantel is safe, efficacious and inexpensive when delivered through the school platform, diagnosis before drug intervention was deemed unnecessary and not cost-effective. Hence, there was little interest in research and development of novel diagnostic tools. With the recent publication of the World Health Organization (WHO) Roadmap to overcome the impact of neglected tropical diseases in 2020, we have entered a new era. Elimination of schistosomiasis has become the buzzword and this has important ramifications for diagnostic tools. Indeed, measuring progress towards the WHO Roadmap and whether local elimination has been achieved requires highly accurate diagnostic assays. Here, we introduce target product profiles for diagnostic tools that are required for different stages of a schistosomiasis control programme. We provide an update of the latest developments in schistosomiasis diagnosis, including microscopic techniques, rapid diagnostic tests for antigen detection, polymerase chain reaction (PCR) assays and proxy markers for morbidity assessments. Particular emphasis is placed on challenges and solutions for new technologies to enter clinical practice.
血吸虫病是一种水生寄生虫病，影响着超过 2.5 亿人。长期以来，控制工作都收效甚微，这也是血吸虫病被视为被忽视的热带病的原因之一。然而，自新千年以来，针对血吸虫病的干预措施正在不断升级。最初的动力源于 2001 年世界卫生大会的一项决议，敦促会员国扩大对学龄儿童进行驱虫治疗，使用驱虫药物吡喹酮。由于吡喹酮在通过学校平台提供时安全、有效且价格低廉，因此在药物干预之前进行诊断被认为是不必要的，也不具有成本效益。因此，人们对开发新的诊断工具几乎没有兴趣。随着 2020 年世界卫生组织（WHO）克服被忽视的热带病影响路线图的最近发布，我们已经进入了一个新时代。消除血吸虫病已成为热门话题，这对诊断工具产生了重要影响。事实上，衡量世卫组织路线图的进展情况以及是否已在当地实现消除，需要高度准确的诊断检测。在这里，我们介绍了针对血吸虫病控制规划不同阶段所需的诊断工具的目标产品概况。我们更新了血吸虫病诊断的最新进展，包括显微镜技术、抗原检测快速诊断测试、聚合酶链反应（PCR）检测以及发病率评估的替代标志物。特别强调了新技术进入临床实践所面临的挑战和解决方案。
