Revisiting Koch's postulates: A tailored approach for clinical parasitology

Abstract

Koch's postulates have long served as a foundational framework in microbiology for establishing causal relationships between microorganisms and diseases. However, when applied to parasitic infections, these postulates often reveal limitations due to the unique complexities associated with parasites. The intricate life cycles, diverse clinical presentations, and interactions between hosts and parasites necessitate a reformed approach. This paper proposes a set of postulates specifically designed for parasitic diseases. The revised criteria underscore the consistent identification of the parasite, its correlation with clinical manifestations, the specificity and sensitivity of diagnostic methods, experimental infections in appropriate animal models, therapeutic responses, host-parasite dynamics, and molecular epidemiology. By integrating these elements, the postulates provide a more comprehensive framework for establishing causality in parasitic diseases. As our understanding of these infections evolves, so must our approaches to defining causation, especially with technological advancements and research on host-parasite interactions. This adaptability will help maintain an accurate and current understanding of parasitic diseases.

Keywords: Blastocystis spp.; Dientamoeba fragilis; Plasmodium falciparum.