Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics
Background: Little is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in Côte d'Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity...
| Autores principales: | , , , , , , , , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Public Library of Science
2021
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/114841 |
| _version_ | 1855542612099858432 |
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| author | Koné, M. Kaba, D. Kaboré, J. Thomas, Lian F. Falzon, Laura C. Koffi, M. Kouamé, C.M. Ahouty, B. Compaoré, C. N'Gouan, E.K. Solano, P. Fèvre, Eric M. Büscher, Philippe Lejon, V. Jamonneau, V. |
| author_browse | Ahouty, B. Büscher, Philippe Compaoré, C. Falzon, Laura C. Fèvre, Eric M. Jamonneau, V. Kaba, D. Kaboré, J. Koffi, M. Koné, M. Kouamé, C.M. Lejon, V. N'Gouan, E.K. Solano, P. Thomas, Lian F. |
| author_facet | Koné, M. Kaba, D. Kaboré, J. Thomas, Lian F. Falzon, Laura C. Koffi, M. Kouamé, C.M. Ahouty, B. Compaoré, C. N'Gouan, E.K. Solano, P. Fèvre, Eric M. Büscher, Philippe Lejon, V. Jamonneau, V. |
| author_sort | Koné, M. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Little is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in Côte d'Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity, and assessed the diagnostic tests' specificity, positive predictive value and agreement. Methods: Clinical suspects were screened with SD Bioline HAT, HAT Sero-K-Set and rHAT Sero-Strip. Seropositives were parasitologically examined, and their dried blood spots tested in trypanolysis, ELISA/Tbg, m18S-qPCR and LAMP. The HAT prevalence in the study population was calculated based on RDT positivity followed by parasitological confirmation. The association between clinical symptoms and signs and RDT positivity was determined using multivariable logistic regression. The tests' Positive Predictive Value (PPV), specificity and agreement were determined. Results: Over 29 months, 3433 clinical suspects were tested. The RDT positivity rate was 2.83%, HAT prevalence 0.06%. Individuals with sleep disturbances (p<0.001), motor disorders (p = 0.002), convulsions (p = 0.02), severe weight loss (p = 0.02) or psychiatric problems (p = 0.04) had an increased odds (odds ratios 1.7-4.6) of being HAT RDT seropositive. Specificities ranged between 97.8%-99.6% for individual RDTs, and 93.3-98.9% for subsequent tests on dried blood spots. The PPV of the individual RDTs was below 14.3% (CI 2-43), increased to 33.3% (CI 4-78) for serial RDT combinations, and reached 67% for LAMP and ELISA/Tbg on RDT positives. Agreement between diagnostic tests was poor to moderate (Kappa ≤ 0.60), except for LAMP and ELISA/Tbg (Kappa = 0.66). Conclusion: Identification of five key clinical symptoms and signs may simplify referral for HAT RDT screening. The results confirm the appropriateness of the diagnostic algorithm presently applied, with screening by SD Bioline HAT or HAT Sero-K-Set, supplemented with trypanolysis. ELISA/Tbg could replace trypanolysis and is simpler to perform. |
| format | Journal Article |
| id | CGSpace114841 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Public Library of Science |
| publisherStr | Public Library of Science |
| record_format | dspace |
| spelling | CGSpace1148412025-12-08T09:54:28Z Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics Koné, M. Kaba, D. Kaboré, J. Thomas, Lian F. Falzon, Laura C. Koffi, M. Kouamé, C.M. Ahouty, B. Compaoré, C. N'Gouan, E.K. Solano, P. Fèvre, Eric M. Büscher, Philippe Lejon, V. Jamonneau, V. african trypanosomiasis disease surveillance diagnosis health Background: Little is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in Côte d'Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity, and assessed the diagnostic tests' specificity, positive predictive value and agreement. Methods: Clinical suspects were screened with SD Bioline HAT, HAT Sero-K-Set and rHAT Sero-Strip. Seropositives were parasitologically examined, and their dried blood spots tested in trypanolysis, ELISA/Tbg, m18S-qPCR and LAMP. The HAT prevalence in the study population was calculated based on RDT positivity followed by parasitological confirmation. The association between clinical symptoms and signs and RDT positivity was determined using multivariable logistic regression. The tests' Positive Predictive Value (PPV), specificity and agreement were determined. Results: Over 29 months, 3433 clinical suspects were tested. The RDT positivity rate was 2.83%, HAT prevalence 0.06%. Individuals with sleep disturbances (p<0.001), motor disorders (p = 0.002), convulsions (p = 0.02), severe weight loss (p = 0.02) or psychiatric problems (p = 0.04) had an increased odds (odds ratios 1.7-4.6) of being HAT RDT seropositive. Specificities ranged between 97.8%-99.6% for individual RDTs, and 93.3-98.9% for subsequent tests on dried blood spots. The PPV of the individual RDTs was below 14.3% (CI 2-43), increased to 33.3% (CI 4-78) for serial RDT combinations, and reached 67% for LAMP and ELISA/Tbg on RDT positives. Agreement between diagnostic tests was poor to moderate (Kappa ≤ 0.60), except for LAMP and ELISA/Tbg (Kappa = 0.66). Conclusion: Identification of five key clinical symptoms and signs may simplify referral for HAT RDT screening. The results confirm the appropriateness of the diagnostic algorithm presently applied, with screening by SD Bioline HAT or HAT Sero-K-Set, supplemented with trypanolysis. ELISA/Tbg could replace trypanolysis and is simpler to perform. 2021-08-30 2021-09-01T06:42:44Z 2021-09-01T06:42:44Z Journal Article https://hdl.handle.net/10568/114841 en Open Access Public Library of Science Koné, M., Kaba, D., Kaboré, J., Thomas, L.F., Falzon, L.C., Koffi, M., Kouamé, C.M., Ahouty, B., Compaoré, C., N'Gouan, E.K., Solano, P., Fèvre, E., Büscher, P., Lejon, V. and Jamonneau, V. 2021. Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics. PLOS Neglected Tropical Diseases 15(8): e0009656. |
| spellingShingle | african trypanosomiasis disease surveillance diagnosis health Koné, M. Kaba, D. Kaboré, J. Thomas, Lian F. Falzon, Laura C. Koffi, M. Kouamé, C.M. Ahouty, B. Compaoré, C. N'Gouan, E.K. Solano, P. Fèvre, Eric M. Büscher, Philippe Lejon, V. Jamonneau, V. Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title | Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title_full | Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title_fullStr | Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title_full_unstemmed | Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title_short | Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics |
| title_sort | passive surveillance of human african trypanosomiasis in cote d ivoire understanding prevalence clinical symptoms and signs and diagnostic test characteristics |
| topic | african trypanosomiasis disease surveillance diagnosis health |
| url | https://hdl.handle.net/10568/114841 |
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