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

Published online by Cambridge University Press:  27 August 2014

J. RUSSELL STOTHARD
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
MICHELLE C. STANTON
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
AMAYA L. BUSTINDUY
Affiliation:
Evelina London Children's Hospital, St Thomas's Hospital, London, UK
JOSÉ C. SOUSA-FIGUEIREDO
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
GOVERT J. VAN DAM
Affiliation:
Leiden Parasitology Diagnostics Group, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
MARTHA BETSON
Affiliation:
Department of Production and Population Health, Royal Veterinary College, Hatfield, Hertfordshire, UK
DAVID WATERHOUSE
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
STEVE WARD
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
FIONA ALLAN
Affiliation:
Parasites and Vectors Division, Life Sciences Department, Natural History Museum, London, UK
AMIR A. HASSAN
Affiliation:
Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
MOHAMMAD A. AL-HELAL
Affiliation:
Ministry of Health, Riyadh, Kingdom of Saudi Arabia
ZIAD A. MEMISH
Affiliation:
Ministry of Health, Riyadh, Kingdom of Saudi Arabia
DAVID ROLLINSON
Affiliation:
Parasites and Vectors Division, Life Sciences Department, Natural History Museum, London, UK
Corresponding
E-mail address:

Summary

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.

Type
Special Issue Article
Copyright
Copyright © Cambridge University Press 2014 

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