title: Towards improved diagnosis of neglected zoonotic trematodes using a One Health approach.
abstract: Reaching the goal of control, elimination and eradication of the Neglected Tropical Disease in a foreseeable future provides significant challenges at the ground level especially regarding helminthiasis. Helminths are still mainly diagnoses by egg identification in stool, methods with low sensitivity and for most species low specificity. Cross-sectoral collaboration with regard to zoonoses is almost non-existing and cross-validation by inter-laboratory evaluation of diagnostic tests is not a common practice. The aim of this review was to elucidate the dilemma of helminth diagnosis using zoonotic trematodes as examples. Much progress has been made improving the diagnostic sensitivity of Opisthorchis and Clonorchis using DNA-based techniques but the specificity of these tests is still a challenge due to the many most common but neglected intestinal trematodes. The burden of these diseases and ways to control them remains to be elucidated. Although efficacious drugs are available, the effectiveness of mass drug administration remains to be assessed. The importance of animal reservoirs and ways to control the diseases in animals are yet unknown. Diagnostic challenges regarding Schistosoma japonicum and Schistosoma mekongi include the many light infections and the persisting influx from the animal reservoirs. The sensitivity of the faecal based techniques suited morbidity control but will be insufficient for elimination of the helminths. More accurate diagnostic tools are required and new algorithms for detection and progression of helminth elimination will be needed. Standardized inter-laboratory test validation, inter-sectoral collaboration and establishment of an international One Health diagnostic platform, sharing best practices on diagnosis of helminth zoonoses, could all significantly contribute to control and elimination of these diseases.
authors.affiliation: Section for Parasitology and Aquatic Diseases, Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address: mvj@sund.ku.dk.
authors.forename: Maria Vang
authors.initials: MV
authors.lastname: Johansen
authors.affiliation: Department of Microbiology and Infection Control, University Hospital of North Norway, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Lier
authors.affiliation: Department of Parasitology and Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Thailand.
authors.forename: Paiboon
authors.initials: P
authors.lastname: Sithithaworn
mesh_terms: D000818:Animals; D005243:Feces / Q000469:parasitology; D006801:Humans; D058069:Neglected Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014200:Trematoda / Q000302:isolation & purification*; D014201:Trematode Infections / Q000175:diagnosis*; D015047:Zoonoses / Q000175:diagnosis* / Q000469:parasitology
keywords: Diagnosis; Neglected Tropical Diseases; One Health; Trematode zoonoses