Availability of accurate tests to diagnose schistosomiasis, a neglected tropical disease caused by parasitic worms, is crucial for successful reduction of the burden of disease and eventually... Show moreAvailability of accurate tests to diagnose schistosomiasis, a neglected tropical disease caused by parasitic worms, is crucial for successful reduction of the burden of disease and eventually moving towards elimination. This thesis provides further evidence on the suitability of CAA detection for diagnosing Schistosoma infections and monitoring treatment efficacy by evaluating the UCP-LF CAA test in the context of various endemic and non-endemic settings. The UCP-LF CAA test is a lateral flow (LF) test for sensitive quantitative detection – using luminescent up-converting reporter particles (UCP) – of circulating anodic antigen (CAA). This antigen is regurgitated by live schistosome worms into the human circulation. The presence of CAA in blood or urine thus reflects an active Schistosoma infection. CAA-levels decrease rapidly after treatment of infected patients with anti-schistosomal drugs. In non-endemic settings (i.e. the absence of reinfection), CAA-levels became undetectable after treatment, indicating clearance of infection. This is in contrast to endemic settings of continuous exposure and ongoing transmission. Here, CAA-levels significantly decreased post-treatment but often remained detectable. Although alternative procedures such as antibody and DNA detection methods remain crucial for certain context-specific purposes, this thesis shows that CAA is the most favorable diagnostic marker currently available for diagnosis of active Schistosoma infections. Show less
