Institute of Tropical Medicine Antwerp
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Performance of parasitological and molecular techniques for the diagnosis and surveillance of gambiense sleeping sickness

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Show simple item record Mumba Ngoyi, D. en_US Ali Ekangu, R. en_US Mumvemba Kodi, M. F. en_US Pyana, P. P. en_US Balharbi, F. en_US Decq, M. en_US Kande Betu, V. en_US Van der Veken, W. en_US Sese, C. en_US Menten, J. en_US Büscher, P. en_US Lejon, V. en_US 2014-09-25T13:39:54Z 2014-09-25T13:39:54Z 2014 en_US
dc.identifier.issn 1935-2727 en_US
dc.identifier.doi en_US
dc.identifier.other ITG-B5B; ITG-B6B; ITG-C10A; ITG-B11A; MULTI; DBM; U-PARDIA; DCS; U-CTU; ZRB; JIF; DOI; FTA; E-only; OAJ; Abstract; UPD56 en_US
dc.description.abstract OBJECTIVES: Recently, improvements have been made to diagnostics for gambiense sleeping sickness control but their performance remains poorly documented and may depend on specimen processing prior to examination. In a prospective study in the Democratic Republic of the Congo, we compared the diagnostic performance of several parasite detection techniques, immune trypanolysis and of m18S PCR on whole blood stored in a stabilisation buffer or dried on filter paper. METHODS: Individuals with CATT whole blood (WB) titer >/=1ratio4 or with clinical signs indicative for sleeping sickness were examined for presence of trypanosomes in lymph node aspirate (LNA) and/or in blood. Blood was examined with Capillary Centrifugation Technique (CTC), mini-Anion Exchange Centrifugation Technique (mAECT) and mAECT on buffy coat (BC). PCR was performed on whole blood (i) stored in guanidine hydrochloride EDTA (GE) stabilisation buffer and (ii) dried on filter paper, and repeatability and reproducibility were assessed. Immune trypanolysis (TL) was performed on plasma. RESULTS: A total of 237 persons were included. Among 143 parasitologically confirmed cases, 85.3% had a CATT-WB titre of >/=1/8, 39.2% were positive in LNA, 47.5% in CTC, 80.4% in mAECT-WB, 90.9% in mAECT-BC, 95.1% in TL and up to 89.5% in PCR on GE-stabilised blood. PCR on GE-stabilised blood showed highest repeatability (87.8%) and inter-laboratory reproducibility (86.9%). Of the 94 non-confirmed suspects, respectively 39.4% and 23.4% were TL or PCR positive. Suboptimal specificity of PCR and TL was also suggested by latent class analysis. CONCLUSION: The combination of LNA examination with mAECT-BC offered excellent diagnostic sensitivity. For PCR, storage of blood in stabilisation buffer is to be preferred over filter paper. TL as well as PCR are useful for remote diagnosis but are not more sensitive than mAECT-BC. For TL and PCR, the specificity, and thus usefulness for management of non-confirmed suspects remain to be determined. en_US
dc.language English en_US
dc.subject Protozoal diseases en_US
dc.subject Sleeping sickness en_US
dc.subject Trypanosomiasis, African en_US
dc.subject Trypanosoma brucei gambiense en_US
dc.subject Vectors en_US
dc.subject Tsetse flies en_US
dc.subject Glossina morsitans morsitans en_US
dc.subject Diagnosis en_US
dc.subject Surveillance en_US
dc.subject Rapid diagnostic tests en_US
dc.subject Parasitology en_US
dc.subject Molecular diagnostic techniques en_US
dc.subject Performance en_US
dc.subject Specificity en_US
dc.subject Sensitivity en_US
dc.subject Laboratory techniques and procedures en_US
dc.subject Congo-Kinshasa en_US
dc.subject Africa, Central en_US
dc.title Performance of parasitological and molecular techniques for the diagnosis and surveillance of gambiense sleeping sickness en_US
dc.type Article-E en_US
dc.citation.issue 6 en_US
dc.citation.jtitle PLoS Neglected Tropical Diseases en_US
dc.citation.volume 8 en_US
dc.citation.pages e2954 en_US
dc.identifier.pmid en_US
dc.citation.jabbreviation PLos Negl Trop Dis en_US

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