Tools for Detection of Schistosomiasis in Resource Limited Settings

Abstract

Schistosomiasis is a debilitating disease affecting over 200 million people, with the highest burden of morbidity and mortality in African countries. Despite its huge impact on the health and socio-economic burden of the society, it remains a neglected tropical disease, with limited attention from governments and stakeholders in healthcare. One of the critical areas that is hugely under-developed is the development of accurate diagnostics for both intestinal and urogenital schistosomiasis. Diagnosis of schistosomiasis is important for the detection and treatment of disease in endemic and non-endemic settings. A conclusive detection method is also an indispensable part of treatment, both in the clinic and during mass drug administration (MDA), for the monitoring efficacy of treatment. Here, we review the available diagnostic methods and discuss the challenges encountered in diagnosis in resource limited settings. We also present the available diagnostics and cost implications for deployment in resource limited settings. Lastly, we emphasize the need for more funding directed towards the development of affordable diagnostic tools that is affordable for endemic countries as we work towards the elimination of the disease.

Evaluation of serum-based real-time PCR to detect Schistosoma mansoni infection before and after treatment

“…In sub-Saharan Africa, Schistosoma mansoni is one of the major species causing hepatic and intestinal schistosomiasis [2,3]. The Kato-Katz method (KK) for microscopic detection of S. mansoni eggs in stool and the urine rapid diagnostic test for detection of circulating cathodic antigens (CCA) are extensively used for screening of schistosomiasis [4]. The KK method is cheap, easy to use and offers high diagnostic specificity in endemic areas with high parasite burden.…”

Serum low replacement medium versus serum rich replacement medium for production of Anti-Schistosoma Monoclonal antibody: A comparative study

“…It is possible that there are residual hormones and growth factors from the serum which helped to support the integrity of cells. 21 In the present study, MAb (6D/6F) was employed in sandwich ELISA for CSA detection in a number of subjects. This MAb/ELISA system reached a lower detection limit of 1.1 ng/ml of S. mansoni SEA in both standard curves for MAb (6D/6F) cultured in conventional medium or SLRM.…”

“…The use of MAbs in CSA assays has greatly improved their specificity and sensitivity. 18,19,20,21 The need of serum-free media for the production of MAbs by hybridoma cells has been clearly established by many authors. 2,7,8 There are many important problems associated with serum-containing media, the most important being the high protein load, which makes product purification more difficult, the high cost serum and the risk of contamination.…”

“…Hybridoma cell lines cultured in serum low or free media continued to secret MAbs at level achieved in the presence of serum. 21 Nu serum TM replacement-used in our work-has been used successfully on a large variety of human and animal cell types. Examples of cell types growing in Nu replacement medium include HepG2 human hepatocellular carcinoma, human bladder cancer cells and hybridoma cell lines.…”

Schistosomiasis: from established diagnostic assays to emerging micro/nanotechnology-based rapid field testing for clinical management and epidemiology

“…With the goal of the development of an automated and/or integrated device, microfluidic platforms procure hope. Miniaturization could enable affordable POC diagnostic tests for end-users in low resource settings [147,148] Table 3: Criteria/wish list for future diagnostic tests [116,148,149] ASSURED criteria: Affordable by those at risk of infection (less expensive for patients and for health services); Sensitive (few false negatives): able to diagnose light infections (1 egg per gram for intestinal and 1 egg/10 mL for urinary schistosomiasis);…”