Sensitivities in HAT patients were respectively 99.6% (CI 97.6C100) for the combination SD Bioline HAT and trypanolysis, 99.1% (CI 96.9C99.9) for HAT Sero- em K /em -Set combined with trypanolysis, and 98.7% (CI 96.3C99.7) for the combination of the 2 2 RDTs with trypanolysis. but negative by parasitological tests. Immune trypanolysis was performed as a reference test for trypanosome specific antibody presence. Sensitivities in HAT patients were respectively 99.6% for SD Bioline HAT, and 99.1% for HAT Sero-K-Set, specificities in healthy controls were respectively 87.9% and 88.3%. Considering combined positivity in both RDTs, increased the specificity significantly (p0.0003) to 93.4%, while 98.7% sensitivity was maintained. Specificities in controls Gypenoside XVII were 98.7C99.6% for the combination of one or two RDTs with trypanolysis, maintaining a sensitivity of at least 98.1%. Conclusions/Significance The observed specificity of the single RDTs was relatively low. Serial application of SD Bioline HAT and HAT Sero-K-Set might offer superior specificity compared to a single RDT, maintaining high sensitivity. The combination of one or two RDTs with trypanolysis seems promising for HAT surveillance. Author Summary Screening for human African trypanosomiasis (HAT) or sleeping sickness is traditionally based on detection of trypanosome specific antibodies in blood. Whereas the card agglutination test is particularly suited for mass screening, individual rapid serodiagnostic tests (RDTs) are rather adapted for use in peripheral health-care centres. Two RDTs have been commercialized recently, and we assessed their diagnostic accuracy on stored plasma samples from West Africa. Immune trypanolysis was performed as a laboratory reference test for antibody presence. Although sensitivity for serodiagnosis of HAT in West Africa was high for both RDTs, their specificity was only 88%. Taking into account the high number of false positive test results, combined seropositivity in both RDTs was considered, raising Rabbit Polyclonal to KITH_HHV1C specificity to 93%. Serial application of two RDTs should therefore be considered as an option for passive case finding, especially in settings with low HAT prevalence. A combination of one or two RDTs with immune trypanolysis further improved specificity for HAT to 99%, while maintaining sensitivity at 99% and seems promising for HAT surveillance. Introduction Human African trypanosomiasis (HAT) or sleeping sickness is a fatal parasitic infection affecting rural populations in sub-Saharan Africa. During the last decade, active case finding by specialized mobile teams has considerably contributed to the reduction of the prevalence of HAT caused by (HAT in West Africa, while geographic variation in the accuracy of HAT serodiagnostic tests may occur [8]. The objective of this study was therefore to assess the diagnostic accuracy of 2 RDTs on stored plasma samples collected from HAT cases, negative controls, and serological suspects originating from Guinea and C?te dIvoire, two countries where HAT transmission is still active [9, 10]. Materials and Methods Ethical statement Samples were collected during medical surveys conducted by the national HAT control programs. All participants were informed about the study objectives in their own language and gave written informed consent. Children less than 12 years old were excluded. For participants between 12 and 18 years old, informed consent was obtained from the parents. Approval for this study was obtained from the consultative committee for deontology and Gypenoside XVII ethics (Comit Consultatif de Dontologie et dEthique) of the Institut de Recherche pour le Dveloppement. In C?te dIvoire, the protocol was approved by the national ethical committee (N0308/MSLS/CNER-P). Origin of test samples Plasma samples originated from subjects identified during active screening campaigns in the Dubreka, Boffa and Forecariah coastal mangrove HAT foci, situated north of Conakry in the Republic of Guinea and in the HAT foci of Oum, Bouafl, Sinfra, and Bonon in western central C?te dIvoire. All subjects underwent CATT/performed on whole blood (CATT-WB). Blood was collected in heparinised tubes and for CATT WB-positive persons, the plasma end titre was determined. All CATT-pl 1/4 positive persons underwent parasitological examination by direct microscopic examination of the lymph node aspirate if swollen lymph nodes were present and/or mini-anion exchange centrifugation technique on buffy coat (mAECT-BC) [11]. Based on the CATT and parasitological result, four categories of study participants (n = 722) were defined: 1 HAT: Parasitologically confirmed HAT patients with positive CATT-WB and CATT-pl end titer 1/4 (n = 229 from Guinea, n = 2 from C?te dIvoire); 2Control: CATT-WB negative individuals for whom Gypenoside XVII there was no suspicion for sleeping.
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