Evaluation of variant specific trypanolysis tests for serodiagnosis of human infections with Trypanosoma brucei gambiense

Twelve T.b. gambiense clone populations of distinct Variable Antigen Type (VAT) were combined in immune lysis tests with 340 sera of trypanosome infected patients from 8 different African countries and 267 non trypanosomiasis control sera. The diagnostic specificity of the test was 100%. At a serum dilution of 1:4 the overall test sensitivity with single VATs varied from 39.1 to 98.2% and from 12.1 to 86.8% at 1:32. At a serum dilution of 1:32 some combination tests with 2 VATs still scored above 96%. The VAT recognition patterns were clearly correlated with the geographical origin of the sera, reflecting a diversity in variable antigen repertoires.