@article{fdi:010062365,
  title = {{P}erformance of parasitological and molecular techniques for the diagnosis and surveillance of gambiense sleeping sickness},
  author = {{N}goyi, {D}. {M}. and {E}kangu, {R}. {A}. and {K}odi, {M}. {F}. {M}. and {P}yana, {P}. {P}. and {B}alharbi, {F}. and {D}ecq, {M}. and {B}etu, {V}. {K}. and {V}an der {V}eken, {W}. and {S}ese, {C}. and {M}enten, {J}. and {B}uscher, {P}. and {L}ejon, {V}eerle},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives: {R}ecently, improvements have been made to diagnostics for gambiense sleeping sickness control but their performance remains poorly documented and may depend on specimen processing prior to examination. {I}n a prospective study in the {D}emocratic {R}epublic of the {C}ongo, we compared the diagnostic performance of several parasite detection techniques, immune trypanolysis and of m18{S} {PCR} on whole blood stored in a stabilisation buffer or dried on filter paper. {M}ethods: {I}ndividuals with {CATT} whole blood ({WB}) titer >= 1:4 or with clinical signs indicative for sleeping sickness were examined for presence of trypanosomes in lymph node aspirate ({LNA}) and/or in blood. {B}lood was examined with {C}apillary {C}entrifugation {T}echnique ({CTC}), mini-{A}nion {E}xchange {C}entrifugation {T}echnique (m{AECT}) and m{AECT} on buffy coat ({BC}). {PCR} was performed on whole blood (i) stored in guanidine hydrochloride {EDTA} ({GE}) stabilisation buffer and (ii) dried on filter paper, and repeatability and reproducibility were assessed. {I}mmune trypanolysis ({TL}) was performed on plasma. {R}esults: {A} total of 237 persons were included. {A}mong 143 parasitologically confirmed cases, 85.3% had a {CATT}-{WB} titre of >= 1/8, 39.2% were positive in {LNA}, 47.5% in {CTC}, 80.4% in m{AECT}-{WB}, 90.9% in m{AECT}-{BC}, 95.1% in {TL} and up to 89.5% in {PCR} on {GE}-stabilised blood. {PCR} on {GE}-stabilised blood showed highest repeatability (87.8%) and inter-laboratory reproducibility (86.9%). {O}f the 94 non-confirmed suspects, respectively 39.4% and 23.4% were {TL} or {PCR} positive. {S}uboptimal specificity of {PCR} and {TL} was also suggested by latent class analysis. {C}onclusion: {T}he combination of {LNA} examination with m{AECT}-{BC} offered excellent diagnostic sensitivity. {F}or {PCR}, storage of blood in stabilisation buffer is to be preferred over filter paper. {TL} as well as {PCR} are useful for remote diagnosis but are not more sensitive than m{AECT}-{BC}. {F}or {TL} and {PCR}, the specificity, and thus usefulness for management of non-confirmed suspects remain to be determined.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {N}eglected {T}ropical {D}iseases},
  volume = {8},
  numero = {6},
  pages = {e2954},
  ISSN = {1935-2735},
  year = {2014},
  DOI = {10.1371/journal.pntd.0002954},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062365},
}