Diagnosis of African trypanosomiasis

In African trypanosomiasis, diagnosis is complex since several diseases are caused by different parasites and occur in different host species giving rise to a variety of parasite-host relationships. At one end of the spectrum we find acute or chronic but fatal diseases while at the other end long lasting subclinical and almost commensal infections are observed. The result is that all diagnostic methods, whether clinical or molecular, have their limitations that will define how, where and for what particular trypanosomiasis they will eventually be applied, alone or in combination. Research on diagnosis of African trypanosomiasis perfectly reflects the technological and socio-economical environment wherein it is conducted. After the discovery of African trypanosomes causing sleeping sickness and nagana in the early 20th century, refinement of clinical diagnosis was soon followed by the development of improved parasitological methods. Later, serological and molecular diagnostics appeared but hardly found their way to the non-academic end-user with one exception, a direct agglutination test for gambiense sleeping sickness. Only in the last decade, African trypanosomiases were freed from their status of neglected tropical diseases and received much more attention from public and private financial donors and from researchers. This evolution has lead to major breakthroughs in diagnostics development that may have a huge impact on control of human and animal African trypanosomiases.
Keywords:
African trypanosomiasis, diagnosis, surra, nagana, dourine, sleeping sick-ness, Trypanosoma brucei, Trypanosoma brucei gambiense, Trypanosoma brucei rhodesiense, Trypanosoma congolense, Trypanosoma vivax, Trypanosoma evansi, Trypanosoma equiperdum