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Parasitology. 2014 Dec;141(14):1947-61. doi: 10.1017/S0031182014001152. Epub 2014 Aug 27.

Diagnostics for schistosomiasis in Africa and Arabia: a review of present options in control and future needs for elimination.

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Department of Parasitology,Liverpool School of Tropical Medicine,Liverpool,UK.
Evelina London Children's Hospital, St Thomas's Hospital,London,UK.
Department of Infectious and Tropical Diseases,London School of Hygiene and Tropical Medicine,London,UK.
Leiden Parasitology Diagnostics Group,Leiden University Medical Center,2333 ZA Leiden,The Netherlands.
Department of Production and Population Health,Royal Veterinary College,Hatfield, Hertfordshire,UK.
Parasites and Vectors Division, Life Sciences Department,Natural History Museum,London,UK.
Department of International Public Health,Liverpool School of Tropical Medicine,Liverpool,UK.
Ministry of Health,Riyadh,Kingdom of Saudi Arabia.


Within the World Health Organization 2012-2020 roadmap for control and elimination of schistosomiasis, the scale-up of mass drug administration with praziquantel is set to change the epidemiological landscape across Africa and Arabia. Central in measuring progress is renewed emphasis upon diagnostics which operate at individual, community and environmental levels by assessing reductions in disease, infections and parasite transmission. However, a fundamental tension is revealed between levels for present diagnostic tools, and methods applied in control settings are not necessarily adequate for application in elimination scenarios. Indeed navigating the transition from control to elimination needs careful consideration and planning. In the present context of control, we review current options for diagnosis of schistosomiasis at different levels, highlighting several strengths and weaknesses therein. Future challenges in elimination are raised and we propose that more cost-effective diagnostics and clinical staging algorithms are needed. Using the Kingdom of Saudi Arabia as a contemporary example, embedding new diagnostic methods within the primary care health system is discussed with reference to both urogenital and intestinal schistosomiasis.

[Indexed for MEDLINE]

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