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Lymphatic filariasis
Diagnostic Methods
Diagnostic methodsPros and cons
Parasitological diagnosis 
Microfilariae may be found in the peripheral blood between 10 p.m. and 2 a.m. for most species and subspecies. Microfilariae can be differentiated after staining of thick haemolysed blood films or after concentration of citrated blood (e.g. on polycarbonate membranes). Membrane filtration of 1 or 2 ml blood is the standard diagnostic procedure!
  • Sensitivity of parasitological method is limited since in pre-patent, in light and post-patent infections, no microfilariae are detectable
Molecular diagnosis 
PCR followed by RFLP analysis may be used to differentiate filariae of different species in co-endemic areas (e.g. infective larvae in the vector). A recent multiplex PCR method allowed the simultaneous detection of Brugia and Wuchereria in blood and mosquito samples.
  • Molecular diagnosis is valuable for epidemiological studies
Antigen detection 
For Wuchereria bancrofti infections, several immunochromatographic rapid diagnostic tests detecting circulating filarial antigens in whole blood are commercially available. However, they do not detect infections with Brugia spp.
  • High sensitivity (>95%); however restricted to Wuchereria bancrofti infections
  • Excellent specificity
  • Easy test procedure
  • No need to take night blood!
Antibody detection 
Many home-made serological tests have been developed for which specificity is the main problem. Extensive cross-reactivity with other filarial infections and strongyloidiasis.
High antibody levels in tropical pulmonary eosinophilia.
  • Serological tests have high sensitivities but poor specificities
  • No correlation with worm load
  • No need to take night blood