New Technologies for Detection of Enteric Parasites

Abstract

Enteric parasites are major contributors to the global diarrhoeal disease load, infecting >67.2 million people. Their prevalence and clinical impact, however, are underestimated due to lack of adequate detection, which is largely still based on microscopy, particularly in developing countries. New commercially available enteric panel assays, which detect parasites (as well as bacteria and/or viruses) using multiplex PCR, offer enhanced sensitivity and specificity as well as the ability to detect mixed infections, and will play an important role in epidemiological surveillance and outbreak investigations. A major limitation of these technologies, however, particularly for developing countries, is the costs involved. Emerging technologies for low-resource, point-of-care (POC) settings have the potential to dramatically improve the cost and accuracy of enteric parasite detection in the future. Accurate diagnosis of diarrhoea caused by enteric parasites requires rapid, cost-effective, scalable, high-throughput, reproducible, and sensitive detection methods. Mixed infections are common, requiring clinicians and the detection methods they employ to screen for multiple pathogens. Current detection methods are labour-intensive, time-consuming, lack sensitivity and specificity, and fail to detect mixed infections. Gastrointestinal panel (GIP) assays based on multiplex PCR afford the opportunity to detect mixed infections and adhere to the requirements for diarrhoeal disease diagnosis. Costs associated with GIP assays are still unaffordable for laboratories, particularly in developing countries. More cost-effective, field-deployable technologies are required.