The detailed identification of glycans on the surface of all schistosome life stages has announced that some glycans are preserved on the tegument during all the parasite life, and most importantly some of the most immunogenic glycans are exclusively found in Schistosoma sp. [42]. The during application of these glycans to innovative immunodiagnostic methods has now been strongly recommended.3. Immunodiagnostic Methods for Circulating Antigens Detection Besides indirect immunoassays, the diagnosis of schistosomiasis was increasingly improved by the development of new methods aiming at the detection of circulating anodic and cathodic antigens (CAA and CCA) in blood or urine [43]. CCA is regurgitated from worms into the circulatory system and later is eliminated in urine.

Since CCAs are only released from living worms, the rapid tests can be used to monitor the dynamics of existing worm burdens, as well as clearance following treatment [43, 44]. However, these assays were initially presented as cumbersome and with a low rate of sensitivity even for the diagnosis of patients with high parasite load. Current studies has confirmed that improvements in the initial methodology allowed the validation of a new method for the diagnosis of active infection presenting very high sensitivity and specificity for the detection of hard-to-detect patients. Additionally, rapid diagnostic tests detecting CCA of S. mansoni are also readily available in dipstick or cassette format. Recent studies carried out in different epidemiological settings of C?te d’Ivoire and Kenya revealed that a single CCA performed on urine samples shows equal or even higher sensitivity for S.

mansoni diagnosis than multiple Kato-Katz thick smears obtained from stool samples [45, 46].For utilization under field conditions, an assay should be rapid, specific and, most importantly, sensitive enough to discriminate between active infections. That is why fluorescence imaging has also become a valuable approach for antigen detection [47]. This method may be more cost-effective as well as more accurate, rapid and easy-to-do than quantitative ones. On the other hand, it depends on the technicians’ observation, and differences on the final data could be seen for different technicians.4. ConclusionWe are currently in a diagnostic dilemma for S. mansoni��the direct parasitological major technique (Kato-Katz) have become relatively insensitive due to widespread chemotherapy that results in generally low worm burdens, which leads to less efficiency in low transmission settings and in post-treatment situations [2, 8, 10, 14, GSK-3 25, 27, 30, 37].