Towards improved diagnosis of zoonotic trematode infections in Southeast Asia

Johansen, M. V. and Sithithaworn, P. and Bergquist, R. and Utzinger, J.. (2010) Towards improved diagnosis of zoonotic trematode infections in Southeast Asia. Advances in parasitology, Vol. 73. pp. 171-195.

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Official URL: http://edoc.unibas.ch/dok/A5843056

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Humans in Southeast Asia are at risk for at least 70 species of food-borne and water-borne trematodes, including blood flukes, intestinal flukes, liver flukes and lung flukes, which are shared with a great variety of animals. Co-infection with several other zoonotic trematodes is pervasive, and hence differential diagnosis represents a major challenge. Many zoonotic trematodes are commonly overlooked, leading to unreliable prevalence data, underappreciation of their veterinary and public health burden and impact, and general neglect with respect to treatment and control. Additionally, many eggs are indistinguishable by microscopy. For example, failure to address this diagnostic dilemma has resulted in overestimation of Clonorchis sinensis prevalence and underestimation of minute intestinal flukes. Test insensitivity is becoming a problem of prime interest as surveillance is gaining in importance and various control programmes now regularly register progress. Hence, the likelihood of underestimating the true burden of disease is growing in well-controlled areas when the faecal egg excretion among infected individuals approaches zero. While antibody testing has ultimate sensitivity, its use as a test of cure remains contentious. On the other hand, employing faecal egg detection as the diagnostic 'gold' standard makes many positive antibody test results (incorrectly) appear false. Polymerase chain reaction (PCR)-based diagnostics could solve this dilemma, but more experience is needed and costs must be brought down to permit large-scale use of this approach. The future development of virtual microscopy to be used for diagnosis of parasitic infections in the field could make ordinary microscopy obsolete by electronically capturing specimens at point-of-contact in remote areas
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Health Impact Assessment (Utzinger)
UniBasel Contributors:Utzinger, Jürg
Item Type:Article, refereed
Article Subtype:Research Article
Note:Also published in: Important helminth infections in southeast Asia. - Amsterdam : Elsevier. - Part B, S. S. 171-195 -- Publication type according to Uni Basel Research Database: Journal article
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Last Modified:09 Jan 2015 09:25
Deposited On:14 Sep 2012 06:51

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