Introduction: Human onchocerciasis affects an estimated 21 million people, with 99% of cases reported in 31 sub-Saharan countries (WHO, 2020a). The Expanded Special Program for Elimination of Neglected Tropical Diseases (ESPEN) has as objective to eliminate onchocerciasis with other Neglected Tropical Diseases (NTDs) by 2030. But one problem faced by the control programs is the absence of an antigen based diagnostic test to determine an active infection with Onchocerca volvulus. Onchocerciasis diagnosis is hampered by the lack of early, sensitive and objective laboratory tests.

Methods: We mined for O. volvulus proteins in patient urine and assessed the suitability of one of the proteins as antigenic diagnostic marker for human onchocerciasis. We describe a facile method for the diagnosis of the filarial Onchocerca volvulus based on specific detection of the antigen which has been shown to be components of extracellular secretory proteins in human urine. Dot blot filtration assays allow for the filtration and concentration of proteins from human urine.

Results: Standard antibody techniques using an antibody raised against this antigen allowed for the detection of as little as fmol of the protein in urine. Most importantly, using urine samples from endemic areas, we were able to distinguish filariasis patients from control individuals not affected with any form of filariasis. Using urine samples from other endemic parasitic diseases, our test showed an overall sensitivity of 80% and specificity of 90%. These findings provide the proof of principle for developing a cheap highly sensitive and specific tests for filarial diseases

Conclusion: Development of a more efficient diagnostic test for human onchocerciasis will serve control programs to map for the disease and follow up treatment, especially as onchocerciasis and other NTDs are programed for elimination by 2030 by WHO.