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Diagnostic Methods
Diagnostic methodsPros and cons
Parasitological diagnosis 
Clinically suspected diagnosis can only be confirmed by identification of larvae in autopsy or biopsy specimens. Larvae are detected only very rarely (but occasionally in ocular larva migrans). Biopsies not recommended as a routine diagnostic approach
Most infections are without symptoms!
  • Parasitological diagnosis very difficult
Molecular diagnosis 
No test developed so far 
Antigen detection 
No test developed so far 
Antibody detection 
Antibody detection by ELISA using excretory/secretory antigens from larval cultures is the standard diagnostic test. Detecting IgG4 antibodies leads to better specificity but with a considerable loss in sensitivity. Serological results cannot differentiate past from active infections. In treated patients, one might observe a decline in antibody titres within 6–12 month post-therapy which might indicate successful treatment.
  • High sensitivity (75–90%) and good specificity (but not in poly-parasitised patients)
  • No differentiation of past and active infection
  • Commercially available ELISA test kits