Innovative digital technologies for quality assurance of diagnosis of human African trypanosomiasis

The diagnostic algorithm for HAT involves two steps: first, a screening by an antibody detection test such as the card agglutination test for trypanosomiasis (CATT)/T.b. gambiense or a Rapid Diagnostic Test (RDT) to identify suspects, followed by a set of confirmation tests, usually the direct microscopic examination of lymph node puncture aspirate and/or Giemsa-stained thick blood film, followed by a concentration method on blood such as the microhematocrit centrifugation technique (mHCT) or the mini-Anion Exchange Centrifugation Technique (mAECT) (Fig 1). The same limitations that apply to storing slides would apply to proficiency panels being sent out by a reference lab. Because of these obvious constraints, HAT control programs have so far only focused on IQA. [...]it may happen that false negative slides do occur, and depending on the threshold chosen in the LQAS approach, a certain number of false negatives may be accepted [6]. [...]QA in HAT diagnostics is needed and is technically feasible.