Phase II Evaluation of Sensitivity and Specificity of PCR and NASBA Followed by Oligochromatography for Diagnosis of Human African Trypanosomiasis in Clinical Samples from D.R. Congo and Uganda

Autor: George W. Lubega, Gerard J. Schoone, Rosine Ali Ekangu, Philippe Büscher, Henk D. F. H. Schallig, Stijn Deborggraeve, Claire M. Mugasa, Thierry Laurent, Enock Matovu
Přispěvatelé: Faculteit der Geneeskunde, KIT: Biomedical Research, Medical Microbiology and Infection Prevention
Rok vydání: 2010
Předmět:
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Adult
Trypanosoma brucei rhodesiense
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
Trypanosoma brucei gambiense
Biology
Polymerase Chain Reaction
Sensitivity and Specificity
law.invention
Young Adult
law
parasitic diseases
medicine
Humans
Uganda
African trypanosomiasis
Child
Self-Sustained Sequence Replication
Polymerase chain reaction
Aged
Aged
80 and over
Chromatography
lcsh:Public aspects of medicine
Infectious Diseases/Protozoal Infections
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Middle Aged
bacterial infections and mycoses
medicine.disease
NASBA
Virology
Trypanosomiasis
African
Infectious Diseases
Infectious Diseases/Neglected Tropical Diseases
Parasitology
Case-Control Studies
Democratic Republic of the Congo
Trypanosomiasis
Research Article
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, 4(7). Public Library of Science
PLoS neglected tropical diseases, 4(7). Public Library of Science
PLoS Neglected Tropical Diseases, Vol 4, Iss 7, p e737 (2010)
ISSN: 1935-2735
1935-2727
DOI: 10.1371/journal.pntd.0000737
Popis: Background The polymerase chain reaction (PCR) and nucleic acid sequence-based amplification (NASBA) have been recently modified by coupling to oligochromatography (OC) for easy and fast visualisation of products. In this study we evaluate the sensitivity and specificity of the PCR-OC and NASBA-OC for diagnosis of Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense human African trypanosomiasis (HAT). Methodology and Results Both tests were evaluated in a case-control design on 143 HAT patients and 187 endemic controls from the Democratic Republic of Congo (DRC) and Uganda. The overall sensitivity of PCR-OC was 81.8% and the specificity was 96.8%. The PCR-OC showed a sensitivity and specificity of 82.4% and 99.2% on the specimens from DRC and 81.3% and 92.3% on those from Uganda. NASBA-OC yielded an overall sensitivity of 90.2%, and a specificity of 98.9%. The sensitivity and specificity of NASBA-OC on the specimens from DRC was 97.1% and 99.2%, respectively. On the specimens from Uganda we observed a sensitivity of 84.0% and a specificity of 98.5%. Conclusions/Significance The tests showed good sensitivity and specificity for the T. b. gambiense HAT in DRC but rather a low sensitivity for T. b. rhodesiense HAT in Uganda.
Author Summary Diagnosis plays a central role in the control of human African trypanosomiasis (HAT) whose mainstay in disease control is chemotherapy. However, accurate diagnosis is hampered by the absence of sensitive techniques for parasite detection. Without concentrating the blood, detection thresholds can be as high as 10,000 trypanosomes per milliliter of blood. The polymerase chain reaction (PCR) and nucleic acid sequence-based amplification (NASBA) are promising molecular diagnostics that generally yield high sensitivity and could improve case detection. Recently, these two tests were coupled to oligochromatography (OC) for simplified and standardized detection of amplified products, eliminating the need for electrophoresis. In this study, we evaluated the diagnostic accuracy of these two novel tests on blood specimens from HAT patients and healthy endemic controls from D.R. Congo and Uganda. Both tests exhibited good sensitivity and specificity compared to the current diagnostic tests and may be valuable tools for sensitive and specific parasite detection in clinical specimens. These standardized molecular test formats open avenues for improved case detection, particularly in epidemiological studies and in disease diagnosis at reference centres.
Databáze: OpenAIRE
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