Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
Institut de Recherche pour le Développement, CIRAD, University of Montpellier, France.
Bull World Health Organ. 2023 Aug 1;101(8):535-540. doi: 10.2471/BLT.23.290172. Epub 2023 Jun 15.
Human African trypanosomiasis is a life-threatening parasitic infection endemic to sub-Saharan Africa. Around 95% of cases are due to , found in western and central Africa. Clinical signs and symptoms are nonspecific, current diagnostic tests are not sufficiently accurate, and parasitological confirmation of infection requires microscopic examination of body fluids and specialized techniques for concentrating parasites. Moreover, current treatment is not recommended on the basis of suspicion alone because it is not sufficiently safe. The availability of a simple and accurate diagnostic test to identify individuals harbouring parasites would widen treatment and help decrease disease prevalence. A subcommittee of the World Health Organization's Neglected Tropical Diseases Diagnostics Technical Advisory Group has developed a target product profile for a diagnostic tool to identify infection. This tool should have a high sensitivity for detecting but be simple enough to use in rural Africa. Ideally, the tool could be applied by any minimally trained individual in an unsophisticated peripheral health facility, or a mobile team in a village with little infrastructure. The test should be able to function under hot and humid conditions. Basic training should take under 2 hours and the test should involve fewer than five steps. There should be no need for instrumentation or precision liquid handling. The test should yield a qualitative result in under 20 minutes that can be easily observed, and one test should be sufficient for determining treatment. A unit cost below 1 United States dollar (US$) would enable mass screening.
人类非洲锥虫病是一种危及生命的寄生虫感染,流行于撒哈拉以南非洲地区。约 95%的病例是由在西非和中非发现的 引起的。临床症状和体征是非特异性的,目前的诊断检测不够准确,寄生虫感染的确切诊断需要对体液进行显微镜检查和使用专门的寄生虫浓缩技术。此外,由于治疗方法不够安全,不能仅凭怀疑就进行治疗。如果有一种简单而准确的诊断检测方法能够识别携带寄生虫的个体,那么就可以扩大治疗范围,有助于降低疾病的流行率。世界卫生组织被忽视热带病诊断技术咨询小组的一个小组委员会已经为一种诊断工具制定了目标产品概况,以识别 感染。这种工具应该具有很高的敏感性来检测 ,但又足够简单,可以在非洲农村使用。理想情况下,任何经过基本培训的人,甚至是在基础设施薄弱的村庄里的流动医疗队,都可以在简陋的基层卫生保健机构中使用这种工具。该检测应能在炎热和潮湿的条件下运行。基础培训应在 2 小时以内完成,且检测应包含少于 5 个步骤。不需要仪器或精密液体处理。检测应在 20 分钟内得出定性结果,易于观察,一次检测就足以确定治疗方案。单位成本低于 1 美元(USD)将使大规模筛查成为可能。