Serological approaches for the diagnosis of schistosomiasis – A review

Abstract

Schistosomiasis is a common disease in endemic areas of Sub-Saharan Africa, South America and Asia. It is rare in Europe, mainly imported from endemic countries due to travelling or human migration. Available methods for the diagnosis of schistosomiasis comprise microscopic, molecular and serological approaches, with the latter detecting antigens or antibodies associated with Schistosoma spp. infection. The serological approach is a valuable screening tool in low-endemicity settings and for travel medicine, though the interpretation of any diagnostic results requires knowledge of test characteristics and a patient's history. Specific antibody detection by most currently used assays is only possible in a relatively late stage of infection and does not allow for the differentiation of acute from previous infections for therapeutic control or the discrimination between persisting infection and re-infection. Throughout the last decades, new target antigens have been identified, and assays with improved performance and suitability for use in the field have been developed. For numerous assays, large-scale studies are still required to reliably characterise assay characteristics alone and in association with other available methods for the diagnosis of schistosomiasis. Apart from S. mansoni, S. haematobium and S. japonicum, for which most available tests were developed, other species of Schistosoma that occur less frequently need to be taken into account. This narrative review describes and critically discusses the results of published studies on the evaluation of serological assays that detect antibodies against different Schistosoma species of humans. It provides insights into the diagnostic performance and an overview of available assays and their suitability for large-scale use or individual diagnosis, and thus sets the scene for serological diagnosis of schistosomiasis and the interpretation of results.

Percutaneous Emergence of Gnathostoma spinigerum Following Praziquantel Treatment

“…This raises the possibility that the G. spinigerum infection generated antibodies that reacted with the schistosomiasis antigen in the FAST-ELISA. Some schistosomiasis seroassays have known cross-reactivity with nematode infections, and anti-Gnathostoma antibodies were shown to cross-react in the Schistosoma mekongi-specific SmkAWA ELISA [15]. Similarly to our case, serologic testing for Schistosoma mansoni in one reported gnathostomiasis case from Brazil was weakly positive, which lead to an initial incorrect diagnosis of schistosomiasis [14].…”

“…Our patient presented with eosinophilia and was positive for Schistosoma antibody, prompting praziquantel treatment. She had recently returned from Saudi Arabia, but the testing was within the five-week minimum period required for seroconversion in schistosomiasis [15,16]. Exposures within a year or two prior were unlikely since Bangladesh is schistosomiasis nonendemic [17].…”

Parasitic Diseases Within the Spinal Cord and Nerve Roots

“…This disease is caused by the trematode Schistosoma [29]. It is often found in sub-Saharan Africa, South America, and Asia but it is also more recently moving to areas that it was not as common previously due to tourism [19,30]. It can occur at any time through parasitic infection [31].…”

“…Parasitic diseases, such as those outlined in Table 1, are found throughout the world. However, they are much more common in developing countries with poor sanitary conditions such as Africa, the Middle East, and the West Indies [1, [19][20][21][22][23]. Despite this, they are still common in North America, as they often transfer when people travel to less developed territories and carry the disease back to areas that did not have it beforehand [1].…”

A library of cell-surface and secreted proteins fromSchistosoma mansoniidentifies early serological markers of infection

“…Host antibody responses to S. mansoni parasites is often measured against whole parasite extracts such as soluble egg antigens (SEA) or soluble worm antigen preparation (SWAP), which are not molecularly defined and can lead to cross-reactivity with other helminths species. While a diagnostic test based on a recombinant protein could mitigate these problems, only very few have been used to test patient antibody responses to Schistosoma infections [11]. The development of new, more sensitive diagnostic tools would therefore help to improve the detection and early treatment of schistosomiasis.…”