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      A Research Agenda for Helminth Diseases of Humans: Diagnostics for Control and Elimination Programmes

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          Abstract

          Diagnostic tools appropriate for undertaking interventions to control helminth infections are key to their success. Many diagnostic tests for helminth infection have unsatisfactory performance characteristics and are not well suited for use in the parasite control programmes that are being increasingly implemented. Although the application of modern laboratory research techniques to improve diagnostics for helminth infection has resulted in some technical advances, uptake has not been uniform. Frequently, pilot or proof of concept studies of promising diagnostic technologies have not been followed by much needed product development, and in many settings diagnosis continues to rely on insensitive and unsatisfactory parasitological or serodiagnostic techniques. In contrast, PCR-based xenomonitoring of arthropod vectors, and use of parasite recombinant proteins as reagents for serodiagnostic tests, have resulted in critical advances in the control of specific helminth parasites. The Disease Reference Group on Helminths Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR) was given the mandate to review helminthiases research and identify research priorities and gaps. In this review, the diagnostic technologies relevant to control of helminth infections, either available or in development, are reviewed. Critical gaps are identified and opportunities to improve needed technologies are discussed.

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          Control of neglected tropical diseases.

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            Model-based geostatistics

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              Sex- and stage-related sensitivity of Schistosoma mansoni to in vivo and in vitro praziquantel treatment.

              The efficacy of praziquantel against a Puerto Rican strain of Schistosoma mansoni was assessed using both in vivo and in vitro approach. The drug effective dose (50%) in the infected mouse model was about 30 times higher when determined against 28-day-old infections than against 7-week-old parasites. Single-sex female infections were also largely refractory to treatment and single-sex male infections moderately refractory, in comparison with bisexual infections. The in vitro approach consisted of overnight exposure of parasite cultures to various drug concentrations, followed by several days of culture in drug-free medium. In vitro results confirmed in vivo data and allowed for the observation of schistosome morphological phenomena after praziquantel exposure. Early worm contraction was observed in all cases, even after exposure to sub-lethal concentrations of praziquantel or upon exposure of the largely refractory 28-day-old schistosomes. In these instances, however, worms resumed movements and normal shape upon drug removal and were able to survive. The inference of these observations on the clinical use of praziquantel and on its mechanism of action is discussed.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, USA )
                1935-2727
                1935-2735
                April 2012
                24 April 2012
                : 6
                : 4
                : e1601
                Affiliations
                [1 ]Queensland Institute of Medical Research, University of Queensland, Herston, Australia
                [2 ]Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
                [3 ]Department of Schistosomiasis Control, Jiangsu Institute of Parasitic Diseases, Jiangsu, People's Republic of China
                [4 ]High Institute of Public Health, Alexandria University, Alexandria, Egypt
                [5 ]Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
                [6 ]Tropical Disease Research Laboratory, Division of Experimental Pathology, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
                [7 ]Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
                [8 ]Institute of Parasitology, McGill University, Montreal, Canada
                [9 ]Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
                London School of Hygiene & Tropical Medicine, United Kingdom
                Author notes
                Article
                PNTD-D-11-01002
                10.1371/journal.pntd.0001601
                3335877
                22545166
                67cdd226-7094-4685-b4fa-715582aa628e
                McCarthy et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Page count
                Pages: 13
                Categories
                Review
                Medicine
                Infectious Diseases
                Neglected Tropical Diseases
                Clonorchiasis
                Echinococcosis
                Food-Borne Trematodes
                Hookworm
                Loiasis
                Lymphatic Filariasis
                Neurocysticercosis
                Onchocerciasis
                Opisthorchiasis
                Schistosomiasis
                Soil-Transmitted Helminths
                Parasitic Diseases
                Filariasis
                Helminth Infection
                Taeniasis
                Trichuriasis

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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