Materiały źródłowe

• #1 Diagnosis and management of schistosomiasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3230106/

  Schistosomiasis, or bilharzia, is a common intravascular infection caused by parasitic Schistosoma trematode worms. […] Microscopic examination of excreta (stool, urine) is the gold standard diagnostic test but requires the adult worms to be producing eggs; serological tests can diagnose less advanced infections. […] Box 2 outlines the approach to making a positive diagnosis of schistosomiasis including important questions to ask on medical history, specific signs to look for on physical examination, and relevant supportive laboratory and radiological investigations that should be undertaken. […] Microscopic examination of excreta (stool, urine) remains the gold standard test for diagnosis of schistosomiasis albeit with some limitations. […] Schistosome eggs are easy to detect and identify on microscopy owing to their characteristic size and shape with a lateral or terminal spine.

• #1 Clinical Testing and Diagnosis for Schistosomiasis | Schistosomiasis | CDC

  https://www.cdc.gov/schistosomiasis/hcp/diagnosis-testing/index.html

  Examination of stool and/or urine for ova is the primary method of diagnosis for suspected schistosome infections. […] Testing of stool or urine can be of limited sensitivity, particularly for travelers who may have lighter burden infections. […] Serologic testing for antischistosomal antibody is recommended for diagnosis of travelers or immigrants from endemic areas who have not been treated appropriately for schistosomiasis in the past. […] Serologic testing may not be appropriate for determining active infection in patients who have been repeatedly infected and treated in the past. […] An antigen test has been developed that can detect active infection based on the presence of schistosomal antigen. […] Examination of stool and/or urine for ova is the primary method of diagnosis for suspected schistosome infections. […] Careful review of travel and residence history is critical for determining whether infection is likely and which species may be causing infection. […] Patients with freshwater exposures in those areas should have both stool and urine samples examined for eggs.

• #1 Bilharzia: Pathology, Diagnosis, Management and Control

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4208666/

  Detection of parasite eggs in the stool and urine is the gold standard for diagnosis of schistosomiasis. […] For rapid diagnosis of S. mansoni, S. japonicum, S. mekongi and S. intercalatum infection, stool samples are examined for the presence of parasite eggs using a Kato-Katz thick smear or rapid Kato techniques. […] Kato-Katz has low sensitivity if only one stool sample from each subject is examined. […] For urogenital schistosomiasis, examination of urine using a filtration technique and microscopy to detect S. haematobium eggs was the basis of early studies on this species of schistosome. […] Diagnosis of Schistosoma infection by the Miracidia Hatching Technique (MHT) was also introduced in China. […] In an attempt to improve diagnosis of schistosome infection, serologic tests (e.g. Circumoval Precipitin test [COPT] and Indirect Hemaglutination Assay [IHA]) were developed to detect the presence of antibody against different schistosome stages.

• #1 Diagnosis and management of schistosomiasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3230106/

  Wait at least two months after the last known freshwater contact before looking for eggs, as a patent infection takes this long to start producing eggs. […] A urine sample is ideally collected between 10 am and 2 pm to coincide with the maximum excretion of eggs. […] Specific and highly sensitive PCR based assays have been developed for the detection of schistosome DNA in faeces or sera and plasma. […] A biopsy of bladder or rectal mucosa may be considered for diagnosis in patients with a typical clinical presentation of schistosomiasis but with no eggs detectable in urine or faeces. […] Antibody detection can be useful in a few specific circumstances, but its application is limited. […] A positive serological test may be diagnostic in patients who are not excreting eggs, such as those with Katayama syndrome. […] Detection of circulating adult worm or egg antigens with labelled monoclonal or polyclonal antibodies in serum, urine, or sputum in infected individuals is another promising technique that may eventually supersede traditional diagnostic methods.

• #1

  https://www.who.int/news-room/fact-sheets/detail/schistosomiasis

  Schistosomiasis is diagnosed through the detection of parasite eggs in stool or urine specimens. Antibodies and/or antigens detected in blood or urine samples are also indications of infection. […] For urogenital schistosomiasis, a filtration technique using nylon, paper or polycarbonate filters is the standard diagnostic technique. Children with S. haematobium almost always have microscopic blood in their urine which can be detected by chemical reagent strips. […] The eggs of intestinal schistosomiasis can be detected in faecal specimens through a technique using methylene blue-stained cellophane soaked in glycerin or glass slides, known as the Kato-Katz technique. In S. mansoni transmission areas, the circulating cathodic antigen (CCA) test can also be used. […] For people living in non-endemic or low-transmission areas, serological and immunological tests may be useful in showing exposure to infection and the need for thorough examination, treatment and follow-up.

• #1 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  The conventional parasitological methods are the classical diagnostic approaches to be discovered. […] It is evident that microscopic examination of stool and urine remains the gold standard test for diagnosis of schistosomiasis with some limitations. […] The Kato-Katz technique has been reported to show a high level of specificity, is simple to use, inexpensive, less laborious and suitable under field conditions as compared to other similar procedures. […] On the other hand, sensitivity of the technique for detection of schistosomiasis varies by the species, intensity of infection and number of stool samples examined. […] For instance, when the magnitude of infection is considerable, with a huge worm burden in the host, KK exhibits high sensitivity owing to considerable egg output.

• #1 Schistosomiasis (Bilharzia) Workup: Approach Considerations, Stool or Urinary Analysis, Egg Viability Test

  https://emedicine.medscape.com/article/228392-workup

  Direct stool examination is not a sensitive test for intestinal and liver schistosomiasis (both of which occur in chronic disease). […] Antibody testing is epidemiologically useful but cannot be used to differentiate active and past illness. […] Because these tests measure parasite antigen as opposed to host antibody response, they reflect active infection. […] Ultrasonography (US) is a sensitive means of assessing hepatosplenic disease with periportal fibrosis or urinary obstruction. […] Biopsy is helpful when stool sample findings are negative or in light infection.

• #1 Bilharzia: Pathology, Diagnosis, Management and Control

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4208666/

  The most promising and extensively studied are tests that can detect major circulating antigens such as the Circulating Anodic Antigen (CAA) and Circulating Cathodic Antigen (CCA). […] Recently, a point-of-care (POC) urine assay test using CCA has been evaluated in five countries in order to determine its use as a future diagnostic screening tool. […] Infection with human schistosome species including S. haematobium can also be diagnosed through microscopic examination of tissues obtained by biopsies of the rectal mucosa. […] For organ pathology detection, sophisticated imaging methods, such as ultrasound, computed tomography scan (CT scan), and Magnetic Resonance Imaging (MRI), can demonstrate evidence of liver fibrosis and portal hypertension, and can visualize urinary tract fibrosis, polyps, and ulcers.

• #1 SCHIISTOSOMA

  https://www.ictdiagnostics.co.za/schistosomanew.html

  The sensitivity of the test varies with the intensity of the infection. […] In suspected clinical cases of Bilharzia, it should be kept in mind that the test may be false negative during the parasitic developing phase (first 6-7 weeks). […] The final diagnosis should be based on the test result in conjunction with other clinical and or laboratory findings. […] CCA in urine decreases usually already the next day, and should become undetectable 2-3 weeks after successful treatment.

• #1 Schistosomiasis (Bilharzia) Workup: Approach Considerations, Stool or Urinary Analysis, Egg Viability Test

  https://emedicine.medscape.com/article/228392-workup

  Blood tests are occasionally useful in supporting the diagnosis or assessing the severity of schistosomal infection. Serologies and polymerase chain reaction (PCR) assaybased testing can confirm a diagnosis. […] Using patient urine samples, polymerase chain reaction (PCR) assay was 94.4% sensitive and 99.9% specific for the diagnosis of schistosomiasis. […] Identify and speciate the eggs in the stool or urine. Quantification of the egg excretion is calculated by collecting 24-hour urine or stool, homogenizing the sample, and counting the eggs in a measured sample. […] This test is important for assessing the effectiveness of treatment. […] The following tests are performed in the diagnosis of urinary schistosomiasis: Urinary analysis and culture for hematuria, proteinuria, leukocyturia, and associated urinary infections.

• #1 Diagnosis of urinary Schistosomiasis

  https://www.xpedite-dx.com/application/schistosomiasis-1/

  Schistosomiasis is traditionally diagnosed through microscopic techniques mostly enhanced through Kato-Katz enrichment. […] Immunological detection is possible through ELISA and lateral-flow tests. Yet, the probably most sensitive approaches to detect Schistosoma infections are molecular. […] The respective sample type is dependent on the type of schistosomiasis: fecal samples are used to detect intestinal schistosomiasis and urine or vaginal lavage is used to detect urogenital schistosomiasis. […] In case of negative but suspected positive patient, tissue biopsies may be examined in both types to find schistosoma eggs. […] Molecular diagnosis of Schistosomiasis requires a sensitive extraction of DNA from urine and feces. […] Amplification and detection of Schistosoma DNA itself is usually performed using real-time PCR, RPA, RAA or LAMP.

• #1 Schistosomiasis — Drugs & Diagnostics for Tropical Diseases

  https://www.ddtd.org/schistosomiasis

  Schistosomiasis, also known as Bilharziasis, is a parasitic disease that affects 240 million people globally, with an estimated further 780 million people living at risk of contracting the disease. […] Schistosomiasis control programs critically depend on field-deployable diagnostic tools to guide decisions on MDA initiation and cessation. […] Traditionally, schistosomiasis has been diagnosed by detecting parasite eggs in host stool (Kato Katz method). […] Methods based on detecting parasite DNA in stool or urine by polymerase chain reaction (PCR) are anticipated to be more sensitive than egg detection methods but, similarly to the latter, also require laboratory equipment, trained personnel, and relatively expensive reagents. […] A portable, commercial RDT exists that detects Schistosoma circulating cathodic antigen (CCA) in urine.

• #1 Neuroschistosomiasis

  https://practicalneurology.com/diseases-diagnoses/ms-immune-disorders/neuroschistosomiasis/31662/

  Serologic tests for schistosomiasis include the Falcon assay screening test (FAST) ELISA, fluorescent microscopy immunoassay (FMI), and immunoblot (IB) testing. […] To definitively make a diagnosis of CNS schistosomiasis, a brain or spinal cord biopsy is required and hematoxylin and eosin staining will show a Schistosoma granuloma with ova and a refractile shell surrounded by fibroblasts, eosinophils, and macrophages. […] Although established treatment regimens exist for more common manifestations of systemic schistosomal infection (eg, swimmers itch and Katayama fever), there are no consensus guidelines or randomized controlled trials for the treatment of neuroschistosomiasis. […] Praziquantel is the antiparasitic of choice for schistosomiasis because of a reported cure rate of 70% to 90% for parasitic infections. […] In addition to praziquantel, steroids are typically administered. The role of steroids in CNS schistosomiasis is multifactorial.

• #1 Schistosomiasis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/809

  Schistosomiasis is a neglected tropical disease that mainly affects poor and rural communities, especially agricultural and fishing populations. […] Diagnosis is made by microscopic visualisation of eggs in stools or urine; supplemental approaches include serological testing or biopsy of affected tissues (rectum or bladder) for detection of parasite eggs. […] Key diagnostic factors include geographical exposure, abdominal pain, haematuria, and haematemesis. […] 1st investigations to order include stool or urine microscopy, urinalysis, full blood count, blood culture, and thick and thin blood smears. […] Investigations to consider include serology, liver function tests (LFTs), renal function tests, abdominal ultrasound, tissue biopsy, computed tomography (CT) or magnetic resonance imaging (MRI) abdomen, MRI brain and spinal cord, chest x-ray, CT chest, urinary circulating anodic antigen (CAA), and schistosome DNA/RNA.

• #1 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  Schistosomiasis is the second most devastating parasite prevalent in the tropical region of the world, posing significant public health impacts in endemic areas. […] Perhaps the current challenges of control of the disease appear to be strongly associated with a lack of appropriate diagnostic tools. Its well known that the current diagnosis of schistosomiasis greatly relies on conventional methods. […] Numerous scholars have reviewed various diagnostic methods of schistosomiasis and attempted to identify their strengths and weaknesses, currently on function. As a result of the known limitations of the existing diagnostic tools, the need to develop new and feasible diagnostic methods and diagnostic markers is unquestionable for more precise detection of the infection. […] As of today, the diagnostic standard for active schistosomiasis is detection of viable ova in urine (S. haematobium) or faeces (S. japonicum, S. mansoni).

• #1 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  In several antibody detection assays, the antigen prepared is a crude parasite extract of varied components which may result in high rates of cross-reactivity where related trematodes and soil-transmitted helminths (STH) occur, leading to lower test reliability and reduced specificity. […] Current diagnostic tools for schistosomiasis have realistic shortcomings regardless of their technical advancement. […] Surveillance and diagnosis play key roles in schistosomiasis control; however, current direct parasitological techniques for surveillance and diagnosis of the disease have limitations. […] The sensitivity of the parasitological diagnostic techniques depends on the rate of egg excretion and a major disadvantage is that the techniques have low sensitivity in low-prevalence endemic areas, resulting in high false-negative rates.

• #1 CRISPR-assisted test for Schistosoma haematobium | Scientific Reports

  https://www.nature.com/articles/s41598-023-31238-y

  Schistosomiasis is a major neglected tropical disease targeted for elimination as a public health issue by 2030, however there is an urgent need for more sensitive and specific diagnostic tests suitable to resource-limited settings. […] The current reference method for schistosomiasis diagnosis is microscopic examination of urine or stool samples by a trained technician, with visual egg count to assess the intensity of infection. However, microscopy lacks sensitivity for low intensity infections, which can be as low as 1 egg per 10 mL of urine sample. […] Antigen tests for the detection of active S. haematobium infections, targeting the circulating anodic antigen (CAA), reported high sensitivity and specificity compared to the traditional microscope method, but it is not yet a rapid diagnostic test amenable to rapid POC.

• #1 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  Nevertheless, the presence of a schistosomes infection cannot be ruled out definitively owing to the low sensitivity of standard urine and faecal tests. […] Despite the drawbacks, the WHO recommends microscopic examination of polycarbonate filters for ova in the urine, urine dipstick assays for heme, or the Kato-Katz faecal examination for schistosome mapping and field-based control of schistosomiasis. […] Given that schistosomiasis has significant public health importance, new intervention tools are necessary for the precise diagnosis of the infected cases to prevent morbidity. […] The achievement of new diagnostic tests may be possible by the consistent and continuous trial on identification of specific biomarkers. […] In this paper the existing diagnostic methods and the recent diagnostic developments in schistosomiasis are reviewed.

• #2 Schistosoma Species – Schistosomiasis | Choose the Right Test

  https://arupconsult.com/content/schistosoma-species

  Schistosomiasis is generally diagnosed by detection of ova in stool and/or urine samples. […] Laboratory testing for schistosomiasis can be considered in patients with a history of travel to or residence in an endemic or high-risk area, such as southern and sub-Saharan Africa. […] Laboratory testing for schistosomiasis is appropriate in travelers returning from or previous residents of endemic areas, especially those exposed to contaminated fresh water. […] Ova and parasite examination of stool or urine is the recommended laboratory test to diagnose schistosomiasis in most cases. […] Serology is useful for infections with a low parasite count, given that ova and parasite examination has particularly low sensitivity in such cases. […] Serology can also be used to provide a retrospective diagnosis of past schistosomiasis or to identify asymptomatic people who may have been exposed during travel and could benefit from treatment.

• #2 Schistosomiasis – Wikipedia

  https://en.wikipedia.org/wiki/Schistosomiasis

  Diagnosis is made by finding the parasites eggs in a person’s urine or stool. […] It can also be confirmed by finding antibodies against the disease in the blood. […] Diagnosis of infection is confirmed by the identification of eggs in stools. […] The diagnosis is improved through the use of the Kato-Katz technique, a semiquantitative stool examination technique. […] Microscopic identification of eggs in stool or urine is the most practical method for diagnosis. […] A stool examination should be performed when infection with S. mansoni or S. japonicum is suspected, and a urine examination should be performed if S. haematobium is suspected. […] Confirming microhematuria in urine using urine reagent strips is more accurate than circulating antigen tests to identify active schistosomiasis in endemic areas.

• #2 Schistosomiasis | Health Services Laboratories

  https://www.hslpathology.com/services/hsl-parasitology/tests-for-parasitic-diseases-and-specimen-requirements/schistosomiasis/

  Schistosomiasis is a helminth infection contracted when infective cercariae penetrate the skin of the human host during exposure to infected water (e.g. swimming and bathing). Fertilised females lay eggs which are shed via the lumen of the intestine (S. mansoni and S. japonicum) and of the bladder and ureters (S. haematobium), to spread via faeces or urine. […] Diagnosis of Schistosomiasis by microscopy […] Definitive diagnosis is by demonstration of the characteristic ova in clinical material. Deposition of ova commences at about six weeks after exposure to the infection but their first appearance (e.g. in urine) may be delayed for several (typically three) months. Confirmation of Schistosomiasis by finding ova should be sought where possible. […] For S. haematobium, a terminal urine sample (the last 10 to 20ml of urine passed) is required.

• #2 Bilharzia: Pathology, Diagnosis, Management and Control

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4208666/

  Detection of parasite eggs in the stool and urine is the gold standard for diagnosis of schistosomiasis. […] For rapid diagnosis of S. mansoni, S. japonicum, S. mekongi and S. intercalatum infection, stool samples are examined for the presence of parasite eggs using a Kato-Katz thick smear or rapid Kato techniques. […] Kato-Katz has low sensitivity if only one stool sample from each subject is examined. […] For urogenital schistosomiasis, examination of urine using a filtration technique and microscopy to detect S. haematobium eggs was the basis of early studies on this species of schistosome. […] Diagnosis of Schistosoma infection by the Miracidia Hatching Technique (MHT) was also introduced in China. […] In an attempt to improve diagnosis of schistosome infection, serologic tests (e.g. Circumoval Precipitin test [COPT] and Indirect Hemaglutination Assay [IHA]) were developed to detect the presence of antibody against different schistosome stages.

• #2 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  Similar reports have shown that the daily difference in schistosome ova release and the over dispersal of egg output can result in significant variability in KK test outcomes from day to day, particularly under light infection scenarios or after PZQ medication. […] It is also suggested that clumping together of ova in stool specimens can result in considerable variation in egg counts which may affect precise reporting of infection rate and/or intensity on the ground. […] In general, conventional parasitological diagnostic techniques using microscopy are inexpensive and do not need wide-ranging training and sophisticated facilities. […] Nevertheless, in addition to their low sensitivity for detection of light infections, conventional parasitological methods are labor-intensive and time-consuming.

• #2 Schistosomiasis (Bilharzia) Workup: Approach Considerations, Stool or Urinary Analysis, Egg Viability Test

  https://emedicine.medscape.com/article/228392-workup

  Blood tests are occasionally useful in supporting the diagnosis or assessing the severity of schistosomal infection. Serologies and polymerase chain reaction (PCR) assaybased testing can confirm a diagnosis. […] Using patient urine samples, polymerase chain reaction (PCR) assay was 94.4% sensitive and 99.9% specific for the diagnosis of schistosomiasis. […] Identify and speciate the eggs in the stool or urine. Quantification of the egg excretion is calculated by collecting 24-hour urine or stool, homogenizing the sample, and counting the eggs in a measured sample. […] This test is important for assessing the effectiveness of treatment. […] The following tests are performed in the diagnosis of urinary schistosomiasis: Urinary analysis and culture for hematuria, proteinuria, leukocyturia, and associated urinary infections.

• #2 Schistosomiasis (Bilharzia) Workup: Approach Considerations, Stool or Urinary Analysis, Egg Viability Test

  https://emedicine.medscape.com/article/228392-workup

  Direct stool examination is not a sensitive test for intestinal and liver schistosomiasis (both of which occur in chronic disease). […] Antibody testing is epidemiologically useful but cannot be used to differentiate active and past illness. […] Because these tests measure parasite antigen as opposed to host antibody response, they reflect active infection. […] Ultrasonography (US) is a sensitive means of assessing hepatosplenic disease with periportal fibrosis or urinary obstruction. […] Biopsy is helpful when stool sample findings are negative or in light infection.

• #2 Diagnosis and management of schistosomiasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3230106/

  Wait at least two months after the last known freshwater contact before looking for eggs, as a patent infection takes this long to start producing eggs. […] A urine sample is ideally collected between 10 am and 2 pm to coincide with the maximum excretion of eggs. […] Specific and highly sensitive PCR based assays have been developed for the detection of schistosome DNA in faeces or sera and plasma. […] A biopsy of bladder or rectal mucosa may be considered for diagnosis in patients with a typical clinical presentation of schistosomiasis but with no eggs detectable in urine or faeces. […] Antibody detection can be useful in a few specific circumstances, but its application is limited. […] A positive serological test may be diagnostic in patients who are not excreting eggs, such as those with Katayama syndrome. […] Detection of circulating adult worm or egg antigens with labelled monoclonal or polyclonal antibodies in serum, urine, or sputum in infected individuals is another promising technique that may eventually supersede traditional diagnostic methods.

• #2 Schistosomiasis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/schistosomiasis-pro

  Schistosomiasis is diagnosed through the detection of parasite eggs in stool or urine specimens. Antibodies and/or antigens detected in blood or urine samples are also indications of infection. […] Microscopic examination of stool or urine is the gold standard for diagnosis but requires the adult worms to be producing eggs. […] Serology can diagnose less advanced infections: Antigen detection is used in endemic areas and antibody tests elsewhere. It usually takes 4-8 weeks for seroconversion to occur, although it can be up to 22 weeks and serology remains positive for two years after eradication. […] The antibody test cannot be used to differentiate active and past illness (therefore, it is not useful in endemic areas) and does not allow quantification of the egg burden. […] Eggs in the urine or stool support a definite diagnosis and may be present as soon as 6-8 weeks after infection. The best time to collect urine is between noon and 3 pm or after physical exercise. […] Tissue biopsy of suspected tissues (eg, colonic biopsy or cystoscopy) may be used for diagnosis.

• #2 Neuroschistosomiasis

  https://practicalneurology.com/diseases-diagnoses/ms-immune-disorders/neuroschistosomiasis/31662/

  Serologic tests for schistosomiasis include the Falcon assay screening test (FAST) ELISA, fluorescent microscopy immunoassay (FMI), and immunoblot (IB) testing. […] To definitively make a diagnosis of CNS schistosomiasis, a brain or spinal cord biopsy is required and hematoxylin and eosin staining will show a Schistosoma granuloma with ova and a refractile shell surrounded by fibroblasts, eosinophils, and macrophages. […] Although established treatment regimens exist for more common manifestations of systemic schistosomal infection (eg, swimmers itch and Katayama fever), there are no consensus guidelines or randomized controlled trials for the treatment of neuroschistosomiasis. […] Praziquantel is the antiparasitic of choice for schistosomiasis because of a reported cure rate of 70% to 90% for parasitic infections. […] In addition to praziquantel, steroids are typically administered. The role of steroids in CNS schistosomiasis is multifactorial.

• #2

  https://journals.lww.com/aptm/fulltext/2019/12060/laboratory_diagnosis_of_schistosomiasis_mansoni_.1.aspx

  Circulating anodic antigen (CAA) and CCA originating from the worm gut, are indicators of active infection since they are detected in blood three weeks post-infection, also they are useful for follow up. When used in ELISA, detection of circulating anodic antigen in serum and CCA in urine gives similar sensitivities, and both can be used in low endemic areas. […] Nucleic acid detection using several techniques is an accurate method for diagnosis, particularly in field settings where collection and storage conditions are difficult to control. In conventional polymerase chain reaction (PCR), DNA extracted from blood or stool samples of schistosomiasis patient is the template for amplification using a probe targeting specific fragments of Schistosoma genome. […] Despite control programs, schistosomiasis is still a public health problem. Early and accurate diagnosis of schistosomiasis lead to early treatment, cessation of transmission cycle and prevention of chronic complications. Many diagnostic tests for schistosomiasis are available but have unsatisfactory performance. Although the application of molecular techniques to improve diagnostics for Schistosoma infection has resulted in some technical advances, but still with the lack of reliable diagnostic tools, underestimation of disease prevalence will lead to the misuse of protective chemotherapy and ultimately to an increase in costs and efforts. It is important to work on improving the current diagnostic methods for better results, and simultaneously look for new diagnostic markers.

• #2 Schistosoma

  http://www.ictdiagnostics.co.za/schistosoma1.html

  The urine-CCA (Circulating Cathodic Antigen) cassette test is for the qualitative presumptive detection of an active Schistosoma infection, more specific S. mansoni, but also other species e.g. S. haematobium and S. japonicum. […] The urine-CCA cassette test is fast and easy to perform methodology in the presumptive detection of Bilharzia in persons with clinical signs and symptoms consistent with an active bilharzia infection. A positive test result indicates an active infection. […] Laboratory diagnosis of Bilharzia is usually performed by microscopical detection of eggs in urine or stool or by immunological methods (antibody or antigen detection). Microscopic diagnosis is currently the most generally used method for detecting and confirmation of active Bilharzia. […] The urine CCA cassette test detects the parasite antigen CCA which is present in all Schistosoma species, including animal species. The major portion of CCA released by the adult live parasite is secreted in the urine. A positive CCA test result on randomly collected midstream urine indicates an active Bilharzia infection. […] The sensitivity of the test varies with the intensity of the infection. […] The highest concentrations of CCA are detected in S. mansoni infections, and therefore the test is particularly useful to diagnose intestinal schistosomiasis.

• #2 Diagnosis of urinary Schistosomiasis

  https://www.xpedite-dx.com/application/schistosomiasis-1/

  Validated for urine samples and cervicovaginal lavage. […] Development of rapid, field-friendly method for isolation of cfDNA from plasma and serum for diagnosis of Schistosoma infections. […] Validation of the isothermal Schistosoma haematobium Recombinase Polymerase Amplification (RPA) assay, coupled with simplified sample preparation, for diagnosing female genital schistosomiasis using cervicovaginal lavage and vaginal self-swab samples.

• #2 Bilharzia: Pathology, Diagnosis, Management and Control

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4208666/

  The most promising and extensively studied are tests that can detect major circulating antigens such as the Circulating Anodic Antigen (CAA) and Circulating Cathodic Antigen (CCA). […] Recently, a point-of-care (POC) urine assay test using CCA has been evaluated in five countries in order to determine its use as a future diagnostic screening tool. […] Infection with human schistosome species including S. haematobium can also be diagnosed through microscopic examination of tissues obtained by biopsies of the rectal mucosa. […] For organ pathology detection, sophisticated imaging methods, such as ultrasound, computed tomography scan (CT scan), and Magnetic Resonance Imaging (MRI), can demonstrate evidence of liver fibrosis and portal hypertension, and can visualize urinary tract fibrosis, polyps, and ulcers.

• #2 Medical Imaging in the Diagnosis of Schistosomiasis: A Review

  https://www.mdpi.com/2076-0817/10/8/1058

  The diagnosis is based on epidemiologic data, clinical presentation, eosinophilia, and direct/indirect laboratory methods. […] As regards laboratory evaluation, an important technique is represented by the microscopic examination of stools (for S. japonicum and S. mansoni) and filtered urines (for S. haematobium) to find the eggs with the Kato-Katz technique, since egg excretion is considered a marker of active infection. […] Laboratory evaluation also comprises serology (to find serum antibodies), which is non-specific because it cannot differentiate between active infection and former one, molecular assays such as polymerase chain reaction (PCR) for circulating DNA of the parasite in blood, stool, urine, saliva, tissues, which is proved to be a sensitive and specific method even in the non-endemic countries or immunodiagnostic assays such as enzyme-linked immunosorbent assay (ELISA) for the detection of schistosomulae antigens and of eggs antigens in blood. […] Moreover, another important tool for the diagnosis is represented by tissue biopsy, especially for intestinal (S. japonicum and S. mansoni) and urinary schistosomiasis.

• #2 Bilharzia (schistosomiasis): Transmission, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/173081

  If a person has symptoms, or they think they may have had contact with contaminated water, they should see a doctor. The doctor may refer them to an infectious disease or tropical medicine specialist. […] A stool or urine sample will indicate whether any eggs are present. The doctor may request a blood test. […] The worm takes about 40 days to mature. A blood sample may not show reliable results until at least 6 to 8 weeks after exposure. […] If there are intestinal symptoms, the person may need a biopsy of the rectum, even if urine and blood tests are negative. They may also have a bladder biopsy. […] It may be a good idea for a person to have a checkup 3 months after returning home, even if they have no symptoms, because the symptoms may not show up until later.

• #2 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  Nevertheless, the presence of a schistosomes infection cannot be ruled out definitively owing to the low sensitivity of standard urine and faecal tests. […] Despite the drawbacks, the WHO recommends microscopic examination of polycarbonate filters for ova in the urine, urine dipstick assays for heme, or the Kato-Katz faecal examination for schistosome mapping and field-based control of schistosomiasis. […] Given that schistosomiasis has significant public health importance, new intervention tools are necessary for the precise diagnosis of the infected cases to prevent morbidity. […] The achievement of new diagnostic tests may be possible by the consistent and continuous trial on identification of specific biomarkers. […] In this paper the existing diagnostic methods and the recent diagnostic developments in schistosomiasis are reviewed.

• #2 Advances in Diagnosis of Schistosomiasis | IJGM

  https://www.dovepress.com/advances-in-diagnosis-of-schistosomiasis-focus-on-challenges-and-futur-peer-reviewed-fulltext-article-IJGM

  The Kato-Katz technique is still the gold standard in schistosomiasis diagnosis. […] Although immunological methods have comparable sensitivity and specificity as that of the PCR technique, the former cannot distinguish between current infections and past infections which may lead to inappropriate treatment intervention. […] Despite the fact that the drive towards schistosomiasis elimination calls for developing novel diagnostic tools with a high sensitivity and high specificity, the validity of the tests is posing another problem for the diagnostic methods. […] False positive and false negative issues have been among the major challenges facing the diagnosis of pathogens in general and schistosomiasis in particular.

• #2 CRISPR-assisted test for Schistosoma haematobium | Scientific Reports

  https://www.nature.com/articles/s41598-023-31238-y

  The assay rapidly and consistently detected a single S. haematobium egg, added directly to the reaction, in an average time of 12 min. […] The cross-reactivity experiments showed that CATSH was able to detect S. haematobium, S. bovis and S. curassoni. […] We report the development of CATSH, an optimised one-tube CRISPR-based diagnostic tool for urogenital schistosomiasis, marking an important milestone for CRISPR-diagnostics for NTDs. […] The analytical performance of CATSH showed that its limit of detection was a single unprocessed egg or 2 eggs that had been spiked in donor urine, which was then subsequently prepared using an adequate methodology. […] The diagnostic developed herein meets the WHO target product profile. […] The CATSH freeze-dried reactions could be used quickly with minimal labour by resuspension of the pellet with nuclease-free water, addition of MgOAc and sample.

• #3

  https://journals.lww.com/aptm/fulltext/2019/12060/laboratory_diagnosis_of_schistosomiasis_mansoni_.1.aspx

  Immunological methods are relatively simple, more sensitive and essential during early stages of infection, in cases with fibrosis, or decreased infection prevalence and intensity as after praziquantel administration, and for initial screening at point-of-care facilities. […] Detection of antibodies against different Schistosoma stages in different human samples is important for diagnosis of infection in low endemic areas, in children with initial active infection, and in travellers returning from endemic areas. Antibody detection tests remain positive for years after successful treatment, so combination of serological tests and/or using different antigens enable differentiation between active and chronic disease. […] The indirect hemagglutination test is commonly used for routine diagnosis of schistosomiasis. It detects reactivity between antibodies and red blood cells (human O-type) coated with schistosomal antigen. The test is simple, highly sensitive, used in large-scale surveys, and as a monitoring method in schistosomes-endemic areas, but it has the same disadvantages of antibody detection tests.

• #3 CRISPR-assisted test for Schistosoma haematobium | Scientific Reports

  https://www.nature.com/articles/s41598-023-31238-y

  The assay rapidly and consistently detected a single S. haematobium egg, added directly to the reaction, in an average time of 12 min. […] The cross-reactivity experiments showed that CATSH was able to detect S. haematobium, S. bovis and S. curassoni. […] We report the development of CATSH, an optimised one-tube CRISPR-based diagnostic tool for urogenital schistosomiasis, marking an important milestone for CRISPR-diagnostics for NTDs. […] The analytical performance of CATSH showed that its limit of detection was a single unprocessed egg or 2 eggs that had been spiked in donor urine, which was then subsequently prepared using an adequate methodology. […] The diagnostic developed herein meets the WHO target product profile. […] The CATSH freeze-dried reactions could be used quickly with minimal labour by resuspension of the pellet with nuclease-free water, addition of MgOAc and sample.

• #3 CRISPR-assisted test for Schistosoma haematobium | Scientific Reports

  https://www.nature.com/articles/s41598-023-31238-y

  CATSH is one of the rare applications of CRISPR-based diagnostics for parasitic diseases, especially for NTDs. […] We showed that CRISPR-based diagnostics are amenable to detect parasitic infections, of which many are NTDs, and unlike PCR, the assay can be developed into a format suitable for POC testing in endemic countries.

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