by Ngay Lukusa I, Van Reet N, Mumba Ngoyi D, Miaka EM, Masumu J, Patient Pyana P, Mutombo W, Ngolo D, Kobo V, Akwaso F, Ilunga M, Kaninda L, Mutanda S, Mpoyi Muamba D, Valverde Mordt O, Tarral A, Rembry S, Büscher P, Lejon V. PLOS Neglected Tropical Diseases 2021;15(9): e0009739. doi: 10.1371/journal.pntd.0009739
Summary: Diagnosis of human African trypanosomiasis relies on demonstration of trypanosomes, which may occur at concentrations too low to detect by microscopy. Measurement of spliced leader trypanosome RNA, which is detectable only in the presence of live trypanosomes, offers an alternative approach to diagnosis. The authors found that the sensitivity of SL-RNA detection in blood was higher than that of combined blood and lymph microscopy, while in CSF the sensitivity was similar. Detection of SL-RNA in blood and CSF allows sensitive demonstration of active gambiense HAT infection, even when trypanosomes remain undetectable in blood or lymph. As this condition often occurs in treatment failures, this method deserves further investigation for early detection of relapses after treatment.