Point-of-care lateral flow assay (LFA) for schistosomaisis diagnosis for use in low intensity infections and drug-efficacy monitoring

Schistosomiasis affects >240 million people worldwide, with 90% living in Africa. Schistosomiasis is also the most frequently reported parasitic disease in Scottish travellers. Current egg diagnostic methods cannot detect low infection intensities, such as those seen in return travellers and in some endemic areas. Antibody tests cannot differentiate between someone who is currently infected or who has previously been infected. Egg microscopy and antibody tests are therefore not suitable for measuring treatment success. We need improved point-of-care diagnostics. Detection of egg-derived DNA is highly sensitive for low egg numbers, while our assays for determination of worm antigen can detect just single-worm infections. At present, however, these methods require expensive laboratory equipment or processes. Accurate, point-of-care diagnostics are needed for logistical, economical and ethical reasons, enabling rapid and appropriate treatment protocols. A polysaccharide-carrying protein released by feeding worms (circulating anodic antigen (CAA)) is the target for highly sensitive diagnosis of all active human schistosome infections. This PhD will develop, validate and apply a commercial point-of-care rapid diagnostic CAA test (like a pregnancy test), deployable in low-resource settings. Alongside novel paper-based DNA detection the student will assess accuracy, field applicability and acceptability as well as the product market of CAA tests.