Simplified rapid molecular diagnosis and characterisation of Leishmaniasis and Human African Trypanosomiasis
Human African Trypanosomiasis (HAT), caused by Trypanosoma brucei (T.b.) gambiense or T.b. rhodesiense, affects currently 500.000 people in sub-Saharan Africa. Visceral, cutaneous and mucocutaneous leishmaniases (LEI) are caused by several Leishmania spec ies. Leishmaniases threaten 350 million people with 12 million infected persons in Latin America, Asia, Europe and Africa. Pathology and treatment are different depending on the infecting species and subspecies. The distribution of T.brucei and L.donova ni overlaps in several African countries. In the absence of prophylaxis or vaccination, control of both diseases is based on diagnosis and treatment of patients. Due to limited specificity of serological antibody or antigen detection tests and toxicity of the drugs, treatment is started after confirmation of the parasite presence in blood, lymph node fluid or bone marrow in seropositive persons. since parasitaemia can be extremely low and parasite detection tests can only be performed by trained personnel, quite a number of actually infected persons remain untreated and constitute a non-controlled human reservoir next to the animal reservoir from which the parasite can always return into the human population. Recent innovations in molecular diagnosis such as isothermal RT-PCR (NASBA), rRNA
hybridization with PNA, LNA or other probes and lateral flow detection of PCR and RT-PCR products have opened perspectives for robust and rapid point-of-care molecular tests as a real
alternative for parasitological diagnosis in LEI and HAT together with the potential of differentiating species and subspecies in one test.
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