title: Dot enzyme-linked immunosorbent assay for more reliable staging of patients with Human African trypanosomiasis.
abstract: Human African trypanosomiasis (HAT) or sleeping sickness is a disease characterized by a hemolymphatic stage 1 followed by a meningoencephalitic stage 2 which is fatal without specific treatment. Furthermore, due to the toxicity of drugs used to treat stage 2 (mainly melarsoprol) accurate staging is required. Actual criteria employed during field surveys are not sensitive enough for precise staging. Antineurofilament (anti-NF) and antigalactocerebrosides (anti-GalC) antibodies have been identified in cerebrospinal fluid (CSF) as potential markers of central nervous system (CNS) involvement. We describe a dot enzyme-linked immunosorbent assay (dot-ELISA) to detect anti-GalC and anti-NF antibodies and its value in staging. NF- and GalC-dotted nitrocellulose strips were first developed in our laboratory. They were then evaluated in Angola and Central African Republic on 140 CSF samples. Compared to our staging criteria (i.e., CSF cell count > or = 20 cells/microl, CSF immunoglobulin M concentration > or = 100 mg/liter, and/or the presence of trypanosomes in the CSF), combined detection of both CSF anti-NF and CSF anti-GalC by dot-ELISA showed 83.2% sensitivity and 100.0% specificity. Dot-ELISA could be a useful test to diagnose CNS involvement in HAT in the less-equipped laboratories or in the field situation and to improve patient treatment.
authors.affiliation: IENT EA 3174 Neuroparasitologie et Neuroépidémiologie Tropicale, Faculty of Medicine, Limoges, France. bertrand.courtioux@unilim.fr
authors.forename: Bertrand
authors.initials: B
authors.lastname: Courtioux
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bisser
authors.forename: Pascal
authors.initials: P
authors.lastname: M'belesso
authors.forename: Edgard
authors.initials: E
authors.lastname: Ngoungou
authors.forename: Murielle
authors.initials: M
authors.lastname: Girard
authors.forename: Auguste
authors.initials: A
authors.lastname: Nangouma
authors.forename: Théophile
authors.initials: T
authors.lastname: Josenando
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Jauberteau-Marchan
authors.forename: Bernard
authors.initials: B
authors.lastname: Bouteille
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000032:analysis* / Q000097:blood; D020808:Central Nervous System Protozoal Infections / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology; D002555:Cerebrospinal Fluid / Q000276:immunology* / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005699:Galactosylceramides / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D008297:Male; D008590:Meningoencephalitis / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000276:immunology*; D012680:Sensitivity and Specificity; D014347:Trypanosoma brucei gambiense / Q000276:immunology; D016833:Trypanosoma brucei rhodesiense / Q000276:immunology; D014353:Trypanosomiasis, African / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology*
chemical_list: D000913:Antibodies, Protozoan; D005699:Galactosylceramides; D016900:Neurofilament Proteins