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Diagnostic Methods
Diagnostic methodsPros and cons 
Parasitological diagnosis 
Diagnosis is proven by finding the characteristic eggs in faeces or in duodenal fluid (by duodenal aspiration or with the “string test”).
Multiple samples and concentration methods improve sensitivity in light infections!
  • It is difficult to detect light infections
  • Eggs of Asian liver flukes are difficult to differentiate by egg morphology
Molecular diagnosis 
First attempts to detect and differentiate DNA from Asian liver flukes (C. sinensis, O. viverrini and O. felineus) in faecal samples using specific primers
  • Method has still to be validated
Antigen detection 
 No tests developed so far 
 Antibody detection 
 Serological tests using crude worm antigens have low specificities (cross-reactivity with other trematode infections).
A better specificity can be reached using recombinant or purified antigens (e.g. cysteine proteinase or excretory/secretory antigens). However, there is a loss in sensitivity.
  • High sensitivity
  • Limited specificity