@article{fdi:010089712,
  title = {{C}onducting active screening for human {A}frican trypanosomiasis with rapid diagnostic tests : the {G}uinean experience (2016-2021)},
  author = {{C}amara, {O}. and {K}abor{\'e}, {J}. {W}. and {S}oumah, {A}. and {L}eno, {M}. and {B}angoura, {M}. {S}. and {N}'{D}iaye, {D}. and {B}elem, {A}. {M}. {G}. and {B}i{\'e}ler, {S}. and {C}amara, {M}. and {B}art, {J}ean-{M}athieu and {R}otureau, {B}. and {B}ucheton, {B}runo},
  editor = {},
  language = {{ENG}},
  abstract = {{S}trategies to detect {H}uman {A}frican {T}rypanosomiasis ({HAT}) cases rely on serological screening of populations exposed to trypanosomes. {I}n {G}uinea, mass medical screening surveys performed with the {C}ard {A}gglutination {T}est for {T}rypanosomiasis have been progressively replaced by door-to-door approaches using {R}apid {D}iagnostic {T}ests ({RDT}s) since 2016. {H}owever, {RDT}s availability represents a major concern and medical teams must often adapt, even in the absence of prior {RDT} performance evaluation. {F}or the last 5 years, the {G}uinean {HAT} {N}ational {C}ontrol {P}rogram had to combine three different {RDT}s according to their availability and price: the {SD} {B}ioline {HAT} (not available anymore), the {HAT} {S}ero-{K}-{S}e{T} (most expensive), and recently the {A}bbott {B}ioline {HAT} 2.0 (limited field evaluation). {H}ere, we assess the performance of these {RDT}s, alone or in different combinations, through the analysis of both prospective and retrospective data. {A} parallel assessment showed a higher positivity rate of {A}bbott {B}ioline {HAT} 2.0 (6.0%, n = 2,250) as compared to {HAT} {S}ero-{K}-{S}e{T} (1.9%), with a combined positive predictive value ({PPV}) of 20.0%. {H}owever, an evaluation of {A}bbott {B}ioline {HAT} 2.0 alone revealed a low {PPV} of 3.9% (n = 6,930) which was surpassed when using {A}bbott {B}ioline {HAT} 2.0 in first line and {HAT} {S}ero-{K}-{S}e{T} as a secondary test before confirmation, with a combined {PPV} reaching 44.4%. {A} retrospective evaluation of all 3 {RDT}s was then conducted on 189 plasma samples from the {HAT}-{NCP} biobank, confirming the higher sensitivity (94.0% [85.6-97.7%]) and lower specificity (83.6% [76.0-89.1%]) of {A}bbott {B}ioline {HAT} 2.0 as compared to {SD} {B}ioline {HAT} ({S}e 64.2% [52.2-74.6%]-{S}p 98.4% [94.2-99.5%]) and {HAT} {S}ero-{K}-{S}e{T} ({S}e 88.1% [78.2-93.8%]-{S}p 98.4% [94.2-99.5%]). {A} comparison of {A}bbott {B}ioline {HAT} 2.0 and malaria-{RDT} positivity rates on 479 subjects living in {HAT}-free malaria-endemic areas further revealed that a significantly higher proportion of subjects positive in {A}bbott {B}ioline {HAT} 2.0 were also positive in malaria-{RDT}, suggesting a possible cross-reaction of {A}bbott {B}ioline {HAT} 2.0 with malaria-related biological factors in about 10% of malaria cases. {T}his would explain, at least in part, the limited specificity of {A}bbott {B}ioline {HAT} 2.0. {O}verall, {A}bbott {B}ioline {HAT} 2.0 seems suitable as first line {RDT} in combination with a second {HAT} {RDT} to prevent confirmatory lab overload and loss of suspects during referral for confirmation. {A} state-of-the-art prospective comparative study is further required for comparing all current and future {HAT} {RDT}s to propose an optimal combination of {RDT}s for door-to-door active screening. {S}trategies to detect {H}uman {A}frican {T}rypanosomiasis ({HAT}) cases rely on serological screening of populations exposed to trypanosomes. {I}n {G}uinea, mass medical screening surveys performed with the {C}ard {A}gglutination {T}est for {T}rypanosomiasis have been progressively replaced by door-to-door approaches using {R}apid {D}iagnostic {T}ests ({RDT}s) since 2016. {H}owever, {RDT}s availability represents a major concern and medical teams must often adapt, even in the absence of prior {RDT} performance evaluation. {F}or the last 5 years, the {G}uinean {HAT} {N}ational {C}ontrol {P}rogram had to combine three different {RDT}s according to their availability and price: the {SD} {B}ioline {HAT} (not available anymore), the {HAT} {S}ero-{K}-{S}e{T} (most expensive), and recently the {A}bbott {B}ioline {HAT} 2.0 (limited field evaluation). {H}ere, we assess the performance of these {RDT}s, alone or in different combinations, through the analysis of both prospective and retrospective data. {O}verall, {A}bbott {B}ioline {HAT} 2.0 seems suitable as first line {RDT} in combination with a second {HAT} {RDT} to prevent confirmatory lab overload and loss of suspects during referral for confirmation. {A} state-of-the-art prospective comparative study is further required for comparing all current and future {HAT} {RDT}s to propose an optimal combination of {RDT}s for door-to-door active screening.},
  keywords = {{GUINEE}},
  booktitle = {},
  journal = {{PL}o{S} {N}eglected {T}ropical {D}iseases},
  volume = {18},
  numero = {2},
  pages = {e0011985 [14 p.]},
  ISSN = {1935-2735},
  year = {2024},
  DOI = {10.1371/journal.pntd.0011985},
  URL = {https://www.documentation.ird.fr/hor/fdi:010089712},
}