Overview of the Diagnostic Methods Used in the Field for Human African Trypanosomiasis: What Could Change in the Next Years?
Sleeping sickness is a parasitic infection caused by two species of trypanosomes (Trypanosoma brucei gambiense and rhodesiense), transmitted by the tsetse fly. The disease eventually affects the central nervous system, resulting in severe neurological symptoms. Without treatment, death is inevitable. During the first stage of the disease, infected patients are mildly symptomatic and early detection of infection allows safer treatment (administered on an outpatient basis) which can avoid death; routine screening of the exposed population is necessary, especially in areas of high endemicity. The current therapeutic treatment of this disease, especially in stage 2, can cause complications and requires a clinical surveillance for several days. A good stage diagnosis of the disease is the cornerstone for delivering the adequate treatment. The task faced by the medical personnel is further complicated by the lack of support from local health infrastructure, which is at best weak, but often nonexistent. Therefore it is crucial to look for new more efficient technics for the diagnosis of stage which are also best suited to use in the field, in areas not possessing high-level health facilities. This review, after an overview of the disease, summarizes the current diagnosis procedures and presents the advances in the field.
INSERM, U1094, Tropical Neuroepidemiology, Limoges, France ; UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, Université de Limoges, CNRS FR 3503 GEIST, 87000 Limoges, France.
Julien
J
Bonnet
INSERM, U1094, Tropical Neuroepidemiology, Limoges, France ; UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, Université de Limoges, CNRS FR 3503 GEIST, 87000 Limoges, France.
Clotilde
C
Boudot
INSERM, U1094, Tropical Neuroepidemiology, Limoges, France ; UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, Université de Limoges, CNRS FR 3503 GEIST, 87000 Limoges, France.
Bertrand
B
Courtioux
D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods / Q000639:trends; D010274:Parasitology / Q000379:methods / Q000639:trends; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000469:parasitology / Q000635:transmission; D014370:Tsetse Flies / Q000469:parasitology
D000913:Antibodies, Protozoan