Toward 2030 road map: accelerating filariasis elimination through next-generation point-of-care diagnostics

Résumé

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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