Serologic and Molecular Tests for Parasitic Infections
Infection | Antibody | Antigen or DNA/RNA |
|---|---|---|
Protozoans | ||
African trypanosomiasis (T. b. gambiense only) | Card agglutination trypanosomiasis test for Trypanosoma brucei gambiense (CATT), other rapid lateral flow tests | — |
Amebiasis | EIA, IHA | Stool: Antigen (EIA), PCR |
Babesiosis | IFA | Blood: PCR |
Chagas disease | EIA, IFA, IB | Blood, tissue, or CSF: PCR |
Cryptosporidiosis | — | Stool: Antigen (EIA), PCR |
Cyclosporiasis | — | Stool: PCR |
Free-living amebic infection (Acanthamoeba, Naegleria fowleri, and Balamuthia mandrillaris) | IFA of brain tissue, skin, or cornea for Acanthamoeba (rarely found in CSF) IFA of tissue samples (Balamuthia) | CSF, brain, or other tissue: PCR CSF or tissue: IFA (Naegleria fowleri) |
Giardiasis | — | Stool: Antigen (EIA), DFA, PCR |
Leishmaniasis | EIA or IFA (for visceral, but not cutaneous leishmaniasis) | Blood or tissue: PCR |
Malaria | IFA (not for acute malaria) | Blood: ICG for antigen (rapid diagnostic test), PCR |
Microsporidiosis | — | Stool or tissue: IFA for antigen, PCR |
Toxoplasmosis | IFA, EIA (IgG and IgM) | Tissue or blood: PCR |
Trichomoniasis | DFA (urogenital secretion) | Urogenital secretion: PCR |
Roundworms | ||
Lymphatic filariasis (Wuchereria bancrofti) | EIA | Blood: Antigen (ICG; not available in the United States) |
Strongyloidiasis | EIA, IFA, IHA | Stool, duodenal aspirate, and/or biopsy specimens (possibly sputum in disseminated infections): PCR/LAMP |
Trichinellosis | EIA, IFA | — |
Toxocariasis | EIA (higher sensitivity for visceral disease than ocular disease), IB | — |
Flukes | ||
Paragonimiasis | CF, IB, EIA | — |
Schistosomiasis | FAST-ELISA, IB, IHA, EIA | Blood, urine, and/or stool: Antigen detection; PCR is available in some reference labs |
Fascioliasis | EIA, IB | –- |
Tapeworms | ||
Echinococcosis | EIA (IgG), IHA, IFA, IB | — |
Neurocysticercosis (Taenia solium) | IB (serum or CSF), EIA | Serum or CSF: Antigen (used to assess responses to therapy; not sensitive enough for diagnosis) CSF: PCR (limited availability) |
CDC = Centers for Disease Control and Prevention; CF = complement fixation; CSF = cerebrospinal fluid; DFA = direct fluorescent antibody; EIA = enzyme immunoassay; FAST-ELISA = Falcon assay screening test–enzyme-linked immunosorbent assay; IB = immunoblot; ICG = immunochromatographic assay; IFA = indirect immunofluorescence assay; IHA = indirect hemagglutination assay; LAMP = loop-mediated isothermal amplification; PCR = polymerase chain reaction; TEM = transmission electronic microscopy. | ||
NOTE: Some antigen and parasite detection kits are available commercially. Others are available at the CDC or other reference laboratories. Molecular tests (eg, PCR) for DNA are available to detect enteric protozoa in stool samples, but they are expensive. Molecular tests for a number of other parasites are available in reference or research laboratories. | ||
Based on CDC’s Laboratory Identification of Parasites of Public Health Concern. | ||