1. Diagnostic accuracy and feasibility of serological tests on filter paper samples for outbreak detection of T.b. gambiense human African trypanosomiasis
- Author
-
Marleen Boelaert, Victor Kande, Dieudonné Mumba, Epco Hasker, Jean Jacques Muyembe, Veerle Lejon, Jo Robays, Phillipe Büscher, Joris Menten, and Pascal Lutumba
- Subjects
Veterinary medicine ,Trypanosoma brucei gambiense ,Prevalence ,Serological ,Antibodies, Protozoan ,Serology ,Disease Outbreaks ,Sensitivity ,Direct agglutination test ,Medicine ,African trypanosomiasis ,Evaluation ,Diagnostics ,Accuracy ,Blood Specimen Collection ,Tsetse flies ,Feasibility ,Articles ,Protozoal diseases ,Vectors ,Latex fixation test ,Test kits ,Detection ,Congo-Kinshasa ,Infectious Diseases ,Specificity ,Democratic Republic of the Congo ,ELISA ,Lot quality assurance sampling ,Monte Carlo Method ,Paper ,Enzyme-Linked Immunosorbent Assay ,Filter paper ,Sensitivity and Specificity ,Specimen Handling ,Virology ,Agglutination Tests ,CATT ,Humans ,Africa, Central ,business.industry ,Rapid diagnostic tests ,Outbreaks ,Sleeping sickness ,medicine.disease ,Trypanosomiasis, African ,ROC Curve ,Sample size determination ,Parasitology ,business ,Trypanosomiasis ,Filtration ,Latex Fixation Tests - Abstract
Control of human African trypanosomiasis (HAT) in the Democratic Republic of Congo is based on mass population screening by mobile teams; a costly and labor-intensive approach. We hypothesized that blood samples collected on filter paper by village health workers and processed in a central laboratory might be a cost-effective alternative. We estimated sensitivity and specificity of micro-card agglutination test for trypanosomiasis (micro-CATT) and enzyme-linked immunosorbent assay (ELISA)/T.b. gambiense on filter paper samples compared with parasitology-based case classification and used the results in a Monte Carlo simulation of a lot quality assurance sampling (LQAS) approach. Micro-CATT and ELISA/T.b. gambiense showed acceptable sensitivity (92.7% [95% CI 87.4-98.0%] and 82.2% [95% CI 75.3-90.4%]) and very high specificity (99.4% [95% CI 99.0-99.9%] and 99.8% [95% CI 99.5-100%]), respectively. Conditional on high sample size per lot (> or = 60%), both tests could reliably distinguish a 2% from a zero prevalence at village level. Alternatively, these tests could be used to identify individual HAT suspects for subsequent confirmation.
- Published
- 2010