The ideal diagnostic method for schistosomiasis detection seems to be still
far from available. Paucity of egg output in low prevalence situations, low
levels of circulating antigens in individuals with low intensity of
infection and inadequate specificity of antibody detection systems outline
pieces of a puzzle that challenges scientific efforts. Estimated
prevalence, financial resources and operational reality must be taken into
account when deciding the diagnostic method to be used. A combination of a
screening step, using a fast strip test for antibody detection with a
parasitological ratification step such as Kato-Katz repeated stool
examination may serve as a diagnostic approach for a previously untreated
low level endemic area. However, when eradication is the aim, and high
financial investment is available, re-treatment may be based on the
association between multiple stool examination and circulating antigen
detection. Ethical aspects as well as cost-benefit rates between treatment
and diagnosis approaches lead to the conclusion that in spite of the recent
advances in simple administered and relatively safe drugs, treatment should
only be performed when supported by appropriated diagnosis.
