Asonganyi T, Doua F, Kibona S N, Nyasulu Y M, Masake R, Kuzoe F
Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon.
Ann Trop Med Parasitol. 1998 Dec;92(8):837-44. doi: 10.1080/00034989858871.
A version of the card indirect agglutination test for trypanosomiasis, the TrypTect CIATT, was evaluated for the diagnosis of Trypanosoma brucei gambiense and T. b. rhodesiense sleeping sickness. The results of this antigen-detection test indicated high relative sensitivity (99.3%) and specificity (99.4%), and also much higher prevalences of infection in the general population of endemic foci (27.9% for T. b. gambiense and 21.8% for T. b. rhodesiense) than detected by parasitological diagnosis (1.6% and 1.1%, respectively). TrypTect CIATT detected (and could therefore be used for the diagnosis of) non-patent infections. Among the suspected cases (i.e. those initially found to be parasite-negative but to be antigen-positive), trypanosomes were detected in 29 (4.2%) of those checked at a 3-month follow-up, and 17 more such suspects when they were followed up at 6-18 months. Moreover, a high proportion of blood samples from a random sample of the rest of the suspects tested positive for trypanosome-specific DNA by PCR (79.9% for T. b. gambiense and 13.9% for T. b. rhodesiense). ELISA also demonstrated the presence of anti-trypanosome antibodies in many of the suspects tested (63%, 38%, 24% and 66.9% of those in Cameroon, Côte d'Ivoire, Tanzania, and Malawi, respectively). A follow-up of 164 patients treated with melarsoprol revealed that, by 9 months post-treatment, 113 (69.0%) had no detectable trypanosome antigens in their peripheral blood. The test could therefore be used for evaluating chemotherapeutic cure, as well as for diagnosis.
对一种用于锥虫病的卡片间接凝集试验（TrypTect CIATT）进行了评估，以诊断布氏冈比亚锥虫和布氏罗得西亚锥虫引起的昏睡病。这种抗原检测试验的结果显示出较高的相对敏感性（99.3%）和特异性（99.4%），并且在流行地区的普通人群中，感染率也比寄生虫学诊断检测到的高得多（布氏冈比亚锥虫为27.9%，布氏罗得西亚锥虫为21.8%，而寄生虫学诊断分别为1.6%和1.1%）。TrypTect CIATT检测到了（因此可用于诊断）非显性感染。在疑似病例中（即那些最初被发现寄生虫阴性但抗原阳性的病例），在3个月随访时检查的病例中有29例（4.2%）检测到锥虫，在6至18个月随访时有17例更多此类疑似病例检测到锥虫。此外，对其余疑似病例随机抽样的血液样本进行PCR检测，发现很大一部分样本锥虫特异性DNA呈阳性（布氏冈比亚锥虫为79.9%，布氏罗得西亚锥虫为13.9%）。ELISA也证明在许多检测的疑似病例中存在抗锥虫抗体（喀麦隆、科特迪瓦、坦桑尼亚和马拉维的疑似病例中分别为63%、38%、24%和66.9%）。对164例接受美拉胂醇治疗的患者进行随访发现，治疗后9个月时，113例（69.0%）外周血中未检测到锥虫抗原。因此，该试验可用于评估化疗疗效以及诊断。
