Diagnosis of African Trypanosomiasis
In African trypanosomiasis, diagnosis is complex since several diseases are caused by different parasites and occur in different host species giving rise to a variety of parasite–host relationships. At one end of the spectrum we find acute or chronic but
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Diagnosis of African Trypanosomiasis Philippe Bu¨scher
Abstract
In African trypanosomiasis, diagnosis is complex since several diseases are caused by different parasites and occur in different host species giving rise to a variety of parasite–host relationships. At one end of the spectrum we find acute or chronic but fatal diseases, while at the other end long-lasting subclinical and almost commensal infections are observed. The result is that all diagnostic methods, whether clinical or molecular, have their limitations that will define how, where and for what particular trypanosomiasis they will eventually be applied, alone or in combination. Research on diagnosis of African trypanosomiasis perfectly reflects the technological and socio-economical environment wherein it is conducted. After the discovery of African trypanosomes causing sleeping sickness and nagana in the early twentieth century, refinement of clinical diagnosis was soon followed by the development of improved parasitological methods. Later, serological and molecular diagnostics appeared but hardly found their way to the non-academic end user with one exception, a direct agglutination test for gambiense sleeping sickness. Only in the last decade, African trypanosomiases were freed from their status of neglected tropical diseases and received much more attention from public and private financial donors and from researchers. This evolution has led to major breakthroughs in diagnostics development that may have a huge impact on control of human and animal African trypanosomiases.
P. Bu¨scher (*) Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium e-mail: [email protected] S. Magez and M. Radwanska (eds.), Trypanosomes and Trypanosomiasis, DOI 10.1007/978-3-7091-1556-5_8, # Springer-Verlag Wien 2014
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8.1
Introduction
African trypanosomiasis is a complex of parasitic infections caused by various trypanosome species (Trypanosoma brucei, T. congolense, T. evansi, T. equiperdum and T. vivax) and subspecies in many different hosts, including mammals, reptiles and insects (tsetse flies). Among the mammals, we count man and his domestic animals (bovine, buffalo, camel, dog, goat, horse, pig, sheep. . .) as well as a range of wild animals. In mammals, infections can lead not only to acute or chronic but fatal diseases, like sleeping sickness in man, but also to long-lasting subclinical and almost commensal infections, particularly in animals that have evolved over millions of years together with their trypanosome parasites. Related to the diversity of African trypanosomiases is the diversity of the methods to diagnose these infections and their applicability. All diagnostic methods, whether clinical or molecular, have their limitations that will define how, where and for what particular trypanosomiasis they will eventually be applied, alone or combined in a diagnostic algorithm. For instance, the specifications of a diagnostic test used in epidemiological surveys of animal trypanosomiasis are quite different f
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