Human African trypanosomiasis diagnosis in first-line health services of endemic countries, a systematic review

Patrick Mitashi, Epco Hasker, Veerle Lejon, Victor Kande, Jean-Jacques Muyembe, Pascal Lutumba, Marleen Boelaert

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Abstract

While the incidence of Human African Trypanosomiasis (HAT) is decreasing, the control approach is shifting from active population screening by mobile teams to passive case detection in primary care centers. We conducted a systematic review of the literature between 1970 and 2011 to assess which diagnostic tools are most suitable for use in first-line health facilities in endemic countries. Our search retrieved 16 different screening and confirmation tests for HAT. The thermostable format of the Card Agglutination Test for Trypanosomiasis (CATT test) was the most appropriate screening test. Lateral flow antibody detection tests could become alternative screening tests in the near future. Confirmation of HAT diagnosis still depends on visualizing the parasite in direct microscopy. All other currently available confirmation tests are either technically too demanding and/or lack sensitivity and thus rather inappropriate for use at health center level. Novel applications of molecular tests may have potential for use at district hospital level.

Original languageEnglish
JournalPLoS Neglected Tropical Diseases
Volume6
Issue number11
Pages (from-to)e1919
ISSN1935-2727
DOIs
Publication statusPublished - 2012

Keywords

  • Protozoal diseases
  • Trypanosomiasis-African
  • Trypanosoma brucei gambiense
  • Vectors
  • Tsetse flies
  • Glossina
  • Control strategies
  • Diagnostics
  • Tools
  • Primary health services
  • Screening
  • Confirmation
  • Test kits
  • Evaluation
  • Feasibility
  • Sensitivity
  • Card agglutination test
  • CATT
  • Review of the literature
  • Units

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