title: Rapid diagnostic tests for neurological infections in central Africa.
abstract: Infections are a leading cause of life-threatening neuropathology worldwide. In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe sequelae. Confirmatory microbiological and parasitological tests are essential because clinical features of most neurological infections are not specific, brain imaging is seldom feasible, and treatment regimens are often prolonged or toxic. Recognition of this diagnostic bottleneck has yielded major investment in application of advances in biotechnology to clinical microbiology in the past decade. We review the neurological pathogens for which rapid diagnostic tests are most urgently needed in central Africa, detail the state of development of putative rapid diagnostic tests for each, and describe key technical and operational challenges to their development and implementation. Promising field-suitable rapid diagnostic tests exist for the diagnosis of human African trypanosomiasis and cryptococcal meningoencephalitis. For other infections-eg, syphilis and schistosomiasis-highly accurate field-validated rapid diagnostic tests are available, but their role in diagnosis of disease with neurological involvement is still unclear. For others-eg, tuberculosis-advances in research have not yet yielded validated tests for diagnosis of neurological disease.
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. cedric.yansouni@mail.mcgill.ca
authors.forename: Cedric P
authors.initials: CP
authors.lastname: Yansouni
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bottieau
authors.forename: Pascal
authors.initials: P
authors.lastname: Lutumba
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Winkler
authors.forename: Lut
authors.initials: L
authors.lastname: Lynen
authors.forename: Philippe
authors.initials: P
authors.lastname: Büscher
authors.forename: Jan
authors.initials: J
authors.lastname: Jacobs
authors.forename: Philippe
authors.initials: P
authors.lastname: Gillet
authors.forename: Veerle
authors.initials: V
authors.lastname: Lejon
authors.forename: Emilie
authors.initials: E
authors.lastname: Alirol
authors.forename: Katja
authors.initials: K
authors.lastname: Polman
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Michael A
authors.initials: MA
authors.lastname: Miles
authors.forename: Rosanna W
authors.initials: RW
authors.lastname: Peeling
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Muyembe
authors.forename: François
authors.initials: F
authors.lastname: Chappuis
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
mesh_terms: D000350:Africa, Central; D003943:Diagnostic Techniques, Neurological; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D016919:Meningitis, Cryptococcal / Q000175:diagnosis; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology; D014353:Trypanosomiasis, African / Q000175:diagnosis