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Performance of clinical signs and symptoms,rapid and reference laboratory diagnostic tests for diagnosis of human African trypanosomiasis by passive screening in Guinea:a prospective diagnostic accuracy study

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Infectious Diseases of Poverty 2023年第2期12卷 117-118页

作者： Oumou Camara Mamadou Camara Laura Cristina Falzon Hamidou Ilboudo Jacques Kaboré charlie franck alfred compaoré Eric Maurice Fèvre Philippe Büscher Bruno Bucheton Veerle Lejon Programme National de Lutte contre la Trypanosomiase Humaine Africaine Conakry Guinea International Livestock Research Institute Nairobi Kenya Institute of Infection Veterinary and Ecological Sciences University of Liverpool Liverpool UK Clinical Research Unit of Nanoro Institute for Health Science Research (IRSS) Ouagadougou Burkina Faso Vector-Borne Diseases and Biodiversity Unit International Research and Development Center on Livestock in Sub-Humid Areas (CIRDES) Bobo-Dioulasso Burkina Faso Unit of Research and Training in Life and Earth Sciences University of Nazi Boni Bobo-Dioulasso Burkina Faso Department of Biomedical Sciences Institute of Tropical Medicine Antwerp Belgium UMR Intertryp IRD-CIRAD French National Research Institute for Sustainable Development (IRD) University of Montpellier Montpellier France

Background Passive diagnosis of human African trypanosomiasis(HAT)at the health facility level is a major component of HAT control in *** examined which clinical signs and symptoms are associated with HAT,and assessed the performance of selected clinical presentations,of rapid diagnostic tests(RDT),and of reference laboratory tests on dried blood spots(DBS)for diagnosing HAT in *** The study took place in 14 health facilities in Guinea,where 2345 clinical suspects were tested with RDTs(HAT Sero-K-Set,rHAT Sero-Strip,and SD Bioline HAT).Seropositives underwent parasitological examination(reference test)to confirm HAT and their DBS were tested in indirect enzyme-linked immunoassay(ELISA)/Trypanosoma brucei gambiense,trypanolysis,Loopamp Trypanosoma brucei Detection kit(LAMP)and m18S quantitative PCR(qPCR).Multivariable regression analysis assessed association of clinical presentation with ***,specificity,positive and negative predictive values of key clinical presentations,of the RDTs and of the DBS tests for HAT diagnosis were *** The HAT prevalence,as confirmed parasitologically,was 2.0%(48/2345,95%CI:1.5–2.7%).Odds ratios(OR)for HAT were increased for participants with swollen lymph nodes(OR=96.7,95%CI:20.7–452.0),important weight loss(OR=20.4,95%CI:7.05–58.9),severe itching(OR=45.9,95%CI:7.3–288.7)or motor disorders(OR=4.5,95%CI:0.89–22.5).Presence of at least one of these clinical presentations was 75.6%(95%CI:73.8–77.4%)specific and 97.9%(95%CI:88.9–99.9%)sensitive for *** Sero-K-Set,rHAT Sero-Strip,and SD Bioline HAT were respectively 97.5%(95%CI:96.8–98.1%),99.4%(95%CI:99.0–99.7%)and 97.9%(95%CI:97.2–98.4%)specific,and 100%(95%CI:92.5–100.0%),59.6%(95%CI:44.3–73.3%)and 93.8%(95%CI:82.8–98.7%)sensitive for *** RDT’s positive and negative predictive values ranged from 45.2–66.7%and 99.2–100%*** DBS tests had specificities≥92.9%.While LAMP and m18S qPCR sensitivities were below 50%,trypanolysis and E

关键词： Human African trypanosomiasis Trypanosoma brucei gambiense Diagnosis Clinical Rapid diagnostic test Sensitivity Specificity Dried blood spot Trypanolysis

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Specificity of serological screening tests and reference laboratory tests to diagnose gambiense human African trypanosomiasis: a prospective clinical performance study

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Infectious Diseases of Poverty 2024年第4期13卷 48-63页

作者： Martial Kassi N'Djetchil Oumou Camara Mathurin Koffi Mamadou Camara Dramane Kaba Jacques Kabore Alkali Tall Brice Rotureau Lucy Glover Melika Barkissa Traorel Minayegninrin Kone Bamoro Coulibaly Guy Pacome Adingra Aissata Soumah Mohamed Gassama Abdoulaye Dansy Camara charlie franck alfred compaore Aissata Camara Salimatou Boiro Elena Perez Anton Paul Bessell Nick Van Reet Bruno Bucheton Vincent Jamonneau Jean-Mathieu Bart Philippe Solano Sylvain Bieler Veerle Lejon Laboratory of Biodiversity and Ecosystem Management Jean Lorougnon Guede UniversityDaloaCote d'ivoire National Program for Neglected Tropical Disease Control Patient ManagementMinistry of HealthConakryGuinea Trypanosomosis Research Unit Pierre Richet InstituteBouakeCote d'ivoire International Research and Development Centre on Livestock in Subhumid Zones Bobo-DioulassoBurkina Faso National Program for Malaria Control ConakryGuinea Parasitology Unit Institut Pasteur de GuineeConakryGuinea Trypanosome Molecular Biology Unit Department of Parasites and Insect VectorsPasteur InstituteParis Cite UniversityParisFrance Intertryp IRD-CIRAD-University of MontpellierMontpellierFrance Independent Consultant EdinburghUk Department of Biomedical Sciences Institute of Tropical MedicineAntwerpBelgium Foundation for Innovative New Diagnostics GenevaSwitzerland

Background Serological screening tests play a crucial role to diagnose gambiense human African trypanosomiasis(gHAT).Presently,they preselect individuals for microscopic confrmation,but in future"screen and treat"strategies they willidentify individuals for *** in reported specificities,the development of new rapid diagnos-tic tests(RDT)and the hypothesis that malaria infection may decrease RDT specificity led us to evaluate the specificity of 5 gHAT screening *** During active screening,venous blood samples from 1095 individuals from Cote d'ivoire and Guinea were tested consecutively with commercial(CATT,HAT Sero-K-SeT,Abbott Bioline HAT 2.0)and prototype(DCN HAT RDT,HAT Sero-K-SeT 2.0)gHAT screening tests and with a malaria *** with≥1 positive gHAT screening test underwent microscopy and further immunological(trypanolysis with *** LiTat 1.3,1.5 and 1.6;indirect ELISA/***;*** inhibition ELISA with *** LiTat 1.3 and 1.5 VSG)and molecular reference laboratory tests(PCR TBRN3,18S and TgsGP;SHERLOCK 18S Tids,7SL Zoon,and TgsGP;Trypanozoon S2-RT-qPCR 18S2,177T,GPl-PLC and TgsGP in multiplex;RT-qPCR DT8,DT9 and TgsGP in multiplex).Microscopic trypanosome detection confrmed gHAT,while other individuals were considered gHAT *** in fractions between groups were assessed by Chi square and differences in specificity between 2 tests on the same individuals by *** One gHAT case was *** test specificities(n=1094)were:CATT 98.9%(95%CI:98.1-99.4%);HAT Sero-K-SeT 86.7%(95%CI:84.5-88.5%);Bioline HAT 2.082.1%(95%CI:79.7-84.2%);DCN HAT RDT 78.2%(95%CI:75.7-80.6%);and HAT Sero-K-SeT 2.078.4%(95%CI:75.9-80.8%).In malaria positives,gHAT screening tests appeared less specific,but the difference Was significant only in Guinea for Abbott Bioline HAT 2.0(P=0.03)and HAT Sero-K-Set 2.0(P=0.0006).The specificities of immunological and molecular laboratory tests in gHAT seroposit

关键词： Human African trypanosomiasis Trypanosoma brucei gambiense Diagnosis Specificity Rapid diagnostic test Immunoloaical test Molecular test

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