title: Human african trypanosomiasis diagnosis in first-line health services of endemic countries, a systematic review.
abstract: While the incidence of Human African Trypanosomiasis (HAT) is decreasing, the control approach is shifting from active population screening by mobile teams to passive case detection in primary care centers. We conducted a systematic review of the literature between 1970 and 2011 to assess which diagnostic tools are most suitable for use in first-line health facilities in endemic countries. Our search retrieved 16 different screening and confirmation tests for HAT. The thermostable format of the Card Agglutination Test for Trypanosomiasis (CATT test) was the most appropriate screening test. Lateral flow antibody detection tests could become alternative screening tests in the near future. Confirmation of HAT diagnosis still depends on visualizing the parasite in direct microscopy. All other currently available confirmation tests are either technically too demanding and/or lack sensitivity and thus rather inappropriate for use at health center level. Novel applications of molecular tests may have potential for use at district hospital level.
authors.affiliation: Department of Tropical Medicine, Parasitology Service, Faculty of Medicine, Kinshasa University, Kinshasa, Democratic Republic of Congo.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mitashi
authors.forename: Epco
authors.initials: E
authors.lastname: Hasker
authors.forename: Veerle
authors.initials: V
authors.lastname: Lejon
authors.forename: Victor
authors.initials: V
authors.lastname: Kande
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Muyembe
authors.forename: Pascal
authors.initials: P
authors.lastname: Lutumba
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
mesh_terms: D003955:Diagnostic Tests, Routine / Q000379:methods*; D019353:Endemic Diseases; D006801:Humans; D010274:Parasitology / Q000379:methods*; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000453:epidemiology*