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Trypanosomiasis, african
Diagnostic Methods
Diagnostic methodsPros and cons
Parasitological diagnosis 
Diagnosis may be achieved by microscopic detection of trypanosomes in blood, in chancre aspirates, in lymph or cerebrospinal fluids. However, sensitivity is limited even when parasite concentration techniques (micro-haematocrit or the mini-anion exchange centrifugation technique) are used. Sensitivity is less a problem in acute T.b. rhodesiense infections, where trypanosomes are numerous. Multiple specimens should be collected because parasite numbers fluctuate!
Caution when handling specimens of infected patients, which are highly infectious!
  • Sensitivity is a problem, especially in chronic T.b. gambiense infections
Molecular diagnosis 
Nested PCR tests have been developed to differentiate trypanosome species in domestic and wild animals for epidemiological studies. A recent paper describes a multiplex PCR that discriminates between T.b. brucei and zoonotic T.b. rhodesiense.
  • Genotyping is a powerful new tool for epidemiological studies
Antigen detection 
An ELISA method is available to detect antigen in serum and cerebrospinal fluid. A simple rapid test, the card indirect agglutination test (CIATT), is available for field surveys.
  • Sensitivity is higher than in microscopic methods
  • Card test is an excellent tool for epidemiological studies
Antibody detection 

Specific antibodies may be demonstrated by ELISA, IFAT and the card agglutination test (CATT). Serology is important in chronic sleeping sickness due to T.b. gambiense.
For serological screening of T. b. gambiense, the feasibility to detect antibodies in human saliva has been proven.

High levels of mainly non-specific IgM are common in African trypanosomiasis due to polyclonal activation of lymphocytes.

  • Antibody detection is a convenient tool for epidemiological screening of T.b. gambiense
  • No CATT available for T.b. rhodesiense