Revisiting the immune trypanolysis test to optimise epidemiological surveillance and control of sleeping sickness in West Africa.
Revisiting the immune trypanolysis test to optimise epidemiological surveillance and control of sleeping sickness in West Africa.
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DOI：
10.1371/journal.pntd.0000917
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发表时间：
2010-12-21
影响因子：
3.8
通讯作者：
Büscher P
中科院分区：
文献类型：
--
作者：
Jamonneau V;Bucheton B;Kaboré J;Ilboudo H;Camara O;Courtin F;Solano P;Kaba D;Kambire R;Lingue K;Camara M;Baelmans R;Lejon V;Büscher P
锥虫卡凝集试验（CATT）因其灵敏度高、现场使用方便而被广泛用于昏睡病的大规模筛查。然而，CATT表现出假阳性结果（i）提出了在寄生虫学中为阴性的CATT阳性受试者是否真正暴露于感染的问题，以及（ii）使得难以评估布氏锥虫（T.b.）冈比亚病毒仍在低流行地区传播。本研究的目的是评估免疫锥虫溶解试验（TL）在描述CATT阳性受试者的HAT状态中的价值，并监测西非的HAT消除情况。对从几内亚、科特迪瓦和布基纳法索几个西非HAT疫源地的医学调查中确定的CATT阳性患者采集的血浆进行了TL，这些患者具有不同的流行病学状态（活跃、潜伏或历史）。所有HAT病例均为TL+。生活在非流行区的所有受试者均为TL−。CATT患病率与HAT患病率在研究地区不相关，而使用TL发现了显着的相关性。TL似乎是与TB接触的标志。冈比亚的。TL可以作为一种工具：（i）在个体水平上识别非寄生虫学证实的CATT阳性受试者以及接触过结核病的受试者;冈比亚人感染HAT，并应采取后续行动，（ii）在人口层面确定干预的优先领域，以及（iii）在消除HAT的背景下，确定没有HAT的地区。布氏锥虫（T.b.）致非洲人锥虫病（HAT）冈比亚锥虫病的诊断通常采用两个连续步骤：首先是用于血清学筛查的锥虫卡凝集试验（CATT），然后是寄生虫学方法以确认该疾病。目前，CATT将继续被用作大规模筛查的测试，因为它的简单性和高灵敏度;然而，它作为一种监测工具，在流行率低的地区是穷人，因为它的特异性有限。因此，在消除HAT的背景下，迫切需要更好的结核病接触标记物冈比亚人。我们在这里评估了现有的高度特异性的血清学工具，锥虫溶解试验（TL）。我们在几内亚、科特迪瓦和布基纳法索的活跃、潜在和历史HAT病灶中评估了TL。我们发现TL是暴露于TB的标志物。冈比亚的。我们建议，TL应被用作监测工具，以监测HAT消除。
Because of its high sensitivity and its ease of use in the field, the card agglutination test for trypanosomiasis (CATT) is widely used for mass screening of sleeping sickness. However, the CATT exhibits false-positive results (i) raising the question of whether CATT-positive subjects who are negative in parasitology are truly exposed to infection and (ii) making it difficult to evaluate whether Trypanosoma brucei (T.b.) gambiense is still circulating in areas of low endemicity. The objective of this study was to assess the value of the immune trypanolysis test (TL) in characterising the HAT status of CATT-positive subjects and to monitor HAT elimination in West Africa. TL was performed on plasma collected from CATT-positive persons identified within medical surveys in several West African HAT foci in Guinea, Côte d'Ivoire and Burkina Faso with diverse epidemiological statuses (active, latent, or historical). All HAT cases were TL+. All subjects living in a nonendemic area were TL−. CATT prevalence was not correlated with HAT prevalence in the study areas, whereas a significant correlation was found using TL. TL appears to be a marker for contact with T.b. gambiense. TL can be a tool (i) at an individual level to identify nonparasitologically confirmed CATT-positive subjects as well as those who had contact with T.b. gambiense and should be followed up, (ii) at a population level to identify priority areas for intervention, and (iii) in the context of HAT elimination to identify areas free of HAT. Human African trypanosomiasis (HAT) due to Trypanosoma brucei (T.b.) gambiense is usually diagnosed using two sequential steps: first the card agglutination test for trypanosomiasis (CATT) used for serological screening, followed by parasitological methods to confirm the disease. Currently, CATT will continue to be used as a test for mass screening because of its simplicity and high sensitivity; however, its performance as a tool of surveillance in areas where prevalence is low is poor because of its limited specificity. Hence in the context of HAT elimination, there is a crucial need for a better marker of contact with T.b. gambiense in humans. We evaluated here an existing highly specific serological tool, the trypanolysis test (TL). We evaluated TL in active, latent and historical HAT foci in Guinea, Côte d'Ivoire and Burkina Faso. We found that TL was a marker for exposure to T.b. gambiense. We propose that TL should be used as a surveillance tool to monitor HAT elimination.
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影响因子：
9.8
作者：
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通讯作者：
McCulloch R
影响因子：
56.3
作者：
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通讯作者：
Buscher, Philippe
影响因子：
3.3
作者：
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通讯作者：
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作者：
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通讯作者：
Jamonneau, V.
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影响因子：
3.8
作者：
Giroud, Christiane;Ottones, Florence;Baltz, Theo
通讯作者：
Baltz, Theo