article · Frontiers in Tropical Diseases
Neglected vector-borne parasitic filarial diseases affect hundreds of millions of people across tropical regions. Meeting the World Health Organization 2030 elimination targets requires field-deployable point-of-care diagnostics to guide mapping, mass drug administration, and surveillance. Current diagnostic tools for lymphatic filariasis and onchocerciasis show declining sensitivity in low-prevalence post-treatment settings, suffer cross-reactivity, and fail to satisfy international target product profiles. Furthermore, loiasis lacks any commercial point-of-care test, which creates dangerous barriers to safe ivermectin administration, whilst mansonellosis entirely lacks validated point-of-care tools. Emerging diagnostic innovations show promise, including multiplex rapid diagnostic tests, colorimetric loop-mediated isothermal amplification assays, and artificial intelligence-assisted microscopy. Closing these diagnostic gaps requires targeted investment in multiplex platforms, tests for neglected species, and sustainable procurement frameworks.
Filarial diseases affect hundreds of millions of people in tropical areas across Africa, the Americas, Asia, and the Pacific. Without reliable, easy-to-use diagnostic tests, health programmes cannot safely distribute treatments such as ivermectin, accurately track infections, or verify eradication. Overcoming diagnostic limitations is critical to preventing severe illness and meeting international targets for the global elimination of these neglected parasitic infections by 2030.
This review identifies market needs for diagnostic developers and healthcare suppliers targeting tropical diseases. Innovations like multiplex rapid diagnostic tests, colorimetric loop-mediated isothermal amplification assays, and artificial intelligence-assisted microscopy represent emerging technologies seeking development and deployment. These tools are intended for public health programmes and field clinicians. However, the abstract indicates that development remains early, requiring prioritised research investment, commercialisation for neglected targets like loiasis, and structured procurement frameworks before widespread market adoption can occur.
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Filariasis comprises neglected vector-borne parasitic diseases, including lymphatic filariasis (LF), onchocerciasis, loiasis, and mansonellosis, that affect hundreds of millions across tropical regions. Achieving the World Health Organization’s (WHO) 2030 elimination targets depends on accurate, field-deployable point-of-care (POC) diagnostics for endemicity mapping, mass drug administration, treatment-stopping decisions, and post-validation surveillance. Multiplex diagnostics are relevant not only in sub-Saharan Africa but also in the Americas, Asia, and the Pacific, where distinct filarial species and co-endemic infections create additional diagnostic challenges. This mini-review synthesizes the current POC diagnostic landscape. LF and onchocerciasis programmes rely on antigen and antibody tools, but these suffer declining sensitivity in low-prevalence post-mass drug administration settings, antigenic cross-reactivity, and failure to meet WHO target product profiles. Loiasis lacks a commercial POC test, creating life-threatening barriers to safe ivermectin delivery. Mansonellosis remains the most neglected, with no validated POC tool and poorly characterized cross-reactivity. Emerging innovations, such as multiplex rapid diagnostic tests, colorimetric loop-mediated isothermal amplification assays, and artificial intelligent-assisted microscopy, offer credible pathways forward. We recommend prioritized investment in loiasis and mansonellosis diagnostics, multiplex platforms, and sustainable procurement frameworks to support elimination by 2030.
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DOI: 10.3389/fitd.2026.1897015
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