The TREMKIT consortium comprises Natural Resources Institute (UK), Mangalore College of Fisheries (India), University of Khon Kaen (Thailand), Institute for Parasitic Diseases, Shanghai (China) and University of Duesseldorf (Germany). Additional support is provided by FAO. The project Virtual Office is based on the FAO oneFish internet portal and can be found at http://www.onefish.org . Details of the project and progress will be posted on the public pages of the Virtual Office.

The TREMKIT project will develop diagnostic tools for the detection of opisthorchid fish-borne trematodes. Two approaches are being taken. One is to develop a monoclonal antibody (MAB) based detection for detection primarily of infection in humans. It is anticipated that the sensitivity of this method will be high, but cross-reaction between trematodes species may not enable differentiation. The second approach will be based on the polymerase chain reaction (PCR) which is capable of detecting very small amounts of trematodes DNA in all of the parasite's life stages. It is envisaged that this will be capable of detecting very low levels of infection which tend to be overlooked by current methods. The PCR kit should be capable of detection of trematode eggs in faeces, metacercariae in fish and possibly cercariae in snails. The PCR test is likely to be too expensive for use as a mass screening tool, but does offer a means of precise diagnosis and will be especially important in epidemiological studies.

TREMKIT will contribute to the better understanding of the biology of pathogens (specifically trematodes), the design of more effective control strategies and more accurate diagnosis. The primary objective of this project is the development of rapid, accurate and reliable tools for the detection of key life stages of fish-borne trematodes. The development of the tools will enable epidemiological studies to be conducted to determine the extent and severity of infestation in the peoples of the target Asia. In addition, by allowing easier and more accurate detection of trematodes before they infect humans, the tools will assist in the identification of key points in the chain of infection, and thus in the identification of possible control measures.

It is believed that 9 million people are infected with fish-borne trematodes in SE Asia, with a further 20 million are thought to be infected with C.sinensis in China. Health problems related to fish-borne trematodes are frequently misdiagnosed and the true burden on the population is under-reported. Studies indicate that morbidity rates from fish-borne trematode infection are high and that the impact on human health, the ability to work and thus on the local economies of Asia are significant. The death rate attributable directly to fish-borne trematode infections is not known, but it is known to be linked to the fatal cancer, cholangiocarcinoma, which is prevalent in Asia. NE Thailand has the highest death rate from this cancer in the World with annual age standardised rates of 135.4 and 43.0 per 100,000 for males and females respectively. This is far higher than for other parts of Thailand where Opisthorchis infection is rare. In addition to the developing country impact, rising levels of infection have been noted in ethnic communities in developed countries, including within the EU, due to increasing trade in fresh fish and improved access of communities to ethnic foods.

The development of reliable and accurate tools for the diagnosis of fish-borne trematode infections in humans and for the detection of early life stages in fish will both serve as a means for better health care through targeting individuals for treatment. It will also function as a research tool for the identification of key vectors for the parasites and critical control points for reducing infection. The tool will be an important aid in assessing the efficacy of current and future strategies for the prevention of fish-borne trematode infections and in the design of treatment programmes for affected areas.