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Performance of parasitological and molecular techniques for the diagnosis and surveillance of gambiense sleeping sickness

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dc.contributor.author Mumba Ngoyi, D. en_US
dc.contributor.author Ali Ekangu, R. en_US
dc.contributor.author Mumvemba Kodi, M. F. en_US
dc.contributor.author Pyana, P. P. en_US
dc.contributor.author Balharbi, F. en_US
dc.contributor.author Decq, M. en_US
dc.contributor.author Kande Betu, V. en_US
dc.contributor.author Van der Veken, W. en_US
dc.contributor.author Sese, C. en_US
dc.contributor.author Menten, J. en_US
dc.contributor.author Büscher, P. en_US
dc.contributor.author Lejon, V. en_US
dc.date.accessioned 2014-09-25T13:39:54Z
dc.date.available 2014-09-25T13:39:54Z
dc.date.issued 2014 en_US
dc.identifier.issn 1935-2727 en_US
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0002954 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.identifier.uri http://hdl.handle.net/10390/7960
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 http://www.ncbi.nlm.nih.gov/pubmed/24921941 en_US
dc.citation.jabbreviation PLos Negl Trop Dis en_US


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