Roadmap for development of diagnostic tests for helminths

What are we trying to achieve and why? What is the problem we are trying to solve?

• Determine how pooling of samples and variation in collection, storage, preservation, preparation (e.g. homogenization) affect diagnostic test outcomes?
• Improve speed, reduce labour and improve sensitivity of sample collection.
• Ensure negative effect of storage and transport on diagnostic outcome is avoided or at least known.

What are the scientific and technological challenges (knowledge gaps needing to be addressed)?

• FEC and FECRT results are prone to issues such as operator dependency, method variability, and influence of sample collection, preservation, transport, preparation including all the steps of the pre-analytic phases.
• Different parasite species have different optimal storage conditions which can be a problem samples with multiple parasite species. (eg. Lungworm larvae more vulnerable to cooling than GI nematode larvae.
• More understanding required about the diurnal variation in egg output, influence of time of sampling and repeatability of counts.

What approaches could/should be taken to address the research question?

• Develop open-access material, including visual tutorials demonstrating different operational procedures for sample collection, preservation, transport and preparation of samples including technical advices (collection of the samples, preservation of the samples, reagent setup, flotation solutions), critical steps, troubleshooting advices, and interpretation of results).
• Develop eco-friendly devices with vacuum-system to preserve and transport faecal samples
• Develop an app for geographic coding for sample identification and tracing.
• Develop innovative tracking systems that provides a traceability of biological samples.
• Develop a parasite group-specific set of recommendations for sample collection and storage (eg WAAVP guidelines)

What else needs to be done before we can solve this need?

Promote the best practice of collection, preservation and analysis of faecal samples for the diagnosis of helminths and assessment of AR through the use of standardized procedure

Existing knowledge including successes and failures

A key issue that is often ignored is the accurate collection, identification and appropriate preservation of faecal samples at the point-of-collection, which impedes their transport under varying field conditions to centralized diagnostic laboratories.