The second option was recently improved and is the most sensitive technique for trypanosome detection of the blood [37]. examinations of lymph aspirated from enlarged cervical lymph nodes or of blood films to assess the presence of the parasite in the lymph or blood [30]. If the CATT remains positive at a dilution of 1 1 in 8 or higher and trypanosomes are seen in the blood film (or lymph), the subject is diagnosed with HAT [31, 32]. However, the event of instances with positive CATT without parasites is definitely common, and considering the high toxicity of the trypanocidal medicines (actually those used to treatment the 1st stage), the management of such instances is definitely debated and constitutes an important issue [33]. Therefore, as you can substitute of low level of sensitivity current parasite detection methods has been suggested, molecular methods are far more sensitive [33, 34]. Generally, lots in the blood are low, and molecular methods request concentration techniques to increase the detection of these ADOS parasites [25]. Such techniques include capillary tube centrifugation, quantitative buffy coating, and minianion exchange centrifugation technique (mAECT) [35, 36]. The second option was recently improved and is the most sensitive technique for trypanosome detection of the blood [37]. The mAECT technique is made up in the separation of trypanosomes by anion exchange chromatography on diethylaminoethyl cellulose and low-speed centrifugation to concentrate the eluted trypanosomes. The parasites can then become detected by direct microscopic examination of the sediment inside a transparent collector Rabbit Polyclonal to RBM26 tube [25, 33]. This test presents the advantage of applicability in the field conditions and is powerful and less cumbersome than previous versions which required mounting a collector tube in water for microscopic exam [38]. However, the main bottleneck and issues offered ADOS by this test as presently formulated are the need of qualified staff to perform it [39, 40], the short-time stability (1 year maximum at 37C), as glucose is integrated in the column buffer [25], and the need of very specific apparatus rarely found in the hospital of rural areas where the disease is definitely endemic [41]. Another attempt to characterize the HAT status of CATT-positive subjects is represented from the immune trypanolysis test, a technique assessing the absence of nonspecific trypanolytic activity in the plasma [26]. Studies evaluating this technique were performed on plasma collected from CATT-positive subjects with varied epidemiological status recognized during medical studies in Guinea, Ivory Coast, and Burkina Faso HAT foci. This test appeared to be a marker for contact with and should become adopted up [26]. Also of interest are the polymerase chain reaction (PCR) and nucleic acid sequence-based amplification techniques revised by coupling to oligochromatography for easy and fast visualization of products [33]. These techniques appeared to be very sensitive and specific for analysis of in studies performed on blood samples from DRC HAT individuals. However, they failed to become as sensitive and specific for detection on blood samples from Uganda HAT individuals [42]. Of high interest for the development of less invasive HAT diagnosis tests are the motivating results from studies performed on saliva samples from HAT individuals using optimized test formats on the basis of enzyme-linked immunosorbent assay (ELISA) antibody detection technique. As ELISAs performed on serum and CATT performed on whole blood or serum, ADOS ELISAs performed on saliva appeared to be more than 90% sensitive and specific for the detection of trypanosome-specific antibodies in the saliva [43C45]. Contrarily to CATT which cannot be successfully performed with saliva due to its insufficient analytical sensitivity and the event of unspecific agglutination reactions, ELISA presents the advantage of a high specificity [38]. Regrettably, ELISA is not relevant for mass screening of the population at risk in sub-Saharan Africa ADOS rural areas, as this technique requires large quantities of pure water, pipettes, and many secondary antibodies and conjugates that are not stable at ambient temps [46]. Besides, the test takes a few hours [45]. Overall, there is still no accurate serological screening test for HAT. However, up to now, many of these techniques still need to be revised and adapted to field conditions in order to reach the individuals. The development of simple and standardized checks applicable to.