Diagnosing schistosomiasis: where are we?

In light of the World Health Organization's initiative to extend schistosomiasis morbidity and mortality control programs by including a disease elimination strategy in low endemic settings, this paper reviews diagnostic tools described during the last decades and provide an overview of ongoing efforts in making an efficient diagnostic tool available worldwide. A literature search on PubMed using the search criteria schistosomiasis and diagnosis within the period from 1978 to 2013 was carried out. Articles with abstract in English and that used laboratory techniques specifically developed for the detection of schistosomiasis in humans were included. Publications were categorized according to the methodology applied (parasitological, immunological, or molecular) and stage of development (in house development, limited field, or large scale field testing). The initial research generated 4,535 publications, of which only 643 met the inclusion criteria. The vast majority (537) of the publications focused on immunological techniques; 81 focused on parasitological diagnosis, and 25 focused on molecular diagnostic methods. Regarding the stage of development, 307 papers referred to in-house development, 202 referred to limited field tests, and 134 referred to large scale field testing. The data obtained show that promising new diagnostic tools, especially for Schistosoma antigen and deoxyribonucleic acid (DNA) detection, which are characterized by high sensitivity and specificity, are being developed. In combination with international funding initiatives these tools may result in a significant step forward in successful disease elimination and surveillance, which is to make efficient tests accessible and its large use self-sustainable for control programs in endemic countries.

鉴于世界卫生组织（World Health Organization）提出的拓展血吸虫病（schistosomiasis）发病与死亡控制项目的倡议，该倡议计划在低流行地区纳入疾病消除策略。本文回顾了近数十年间报道的血吸虫病诊断工具，并概述了当前为在全球范围内推广高效可及诊断工具所开展的工作。本研究以PubMed为数据库，以1978年至2013年为时间范围，以"血吸虫病"与"诊断"为检索策略开展文献检索。纳入具备英文摘要、且采用专为人体血吸虫病检测开发的实验室技术的文献。研究根据所采用的方法学（寄生虫学、免疫学或分子生物学方法）以及研发阶段（实验室内部研发、有限现场试验、大规模现场试验）对文献进行分类。本次检索初获4535篇文献，其中仅643篇符合纳入标准。其中绝大多数（537篇）聚焦免疫学技术，81篇聚焦寄生虫学诊断，25篇聚焦分子诊断方法。按研发阶段划分，307篇文献涉及实验室内部研发，202篇涉及有限现场试验，134篇涉及大规模现场试验。研究结果显示，当前正开发多款极具应用前景的新型诊断工具，尤其是针对血吸虫（Schistosoma）抗原与脱氧核糖核酸（DNA）检测的工具，这类工具具备高灵敏度与高特异性的优势。若结合国际资助项目，这些工具将为疾病消除与监测工作带来重大突破，其目标是让流行国家的疾病控制项目能够便捷获取高效检测工具，并实现检测工具的大规模自主可持续应用。