Rapid diagnostic tests for neurological infections in central Africa
Summary Infections are a leading cause of life-threatening neuropathology worldwide. In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe s...
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| Veröffentlicht in: | The Lancet infectious diseases 2013-06, Vol.13 (6), p.546-558 |
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| creator | Yansouni, Cedric P, Dr Bottieau, Emmanuel, Prof Lutumba, Pascal, Prof Winkler, Andrea S, MD Lynen, Lut, Prof Büscher, Philippe, Prof Jacobs, Jan, Prof Gillet, Philippe, PhD Lejon, Veerle, PhD Alirol, Emilie, PhD Polman, Katja, PhD Utzinger, Jürg, Prof Miles, Michael A, Prof Peeling, Rosanna W, Prof Muyembe, Jean-Jacques, Prof Chappuis, François, MD Boelaert, Marleen, Prof |
| description | Summary Infections are a leading cause of life-threatening neuropathology worldwide. In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe sequelae. Confirmatory microbiological and parasitological tests are essential because clinical features of most neurological infections are not specific, brain imaging is seldom feasible, and treatment regimens are often prolonged or toxic. Recognition of this diagnostic bottleneck has yielded major investment in application of advances in biotechnology to clinical microbiology in the past decade. We review the neurological pathogens for which rapid diagnostic tests are most urgently needed in central Africa, detail the state of development of putative rapid diagnostic tests for each, and describe key technical and operational challenges to their development and implementation. Promising field-suitable rapid diagnostic tests exist for the diagnosis of human African trypanosomiasis and cryptococcal meningoencephalitis. For other infections—eg, syphilis and schistosomiasis—highly accurate field-validated rapid diagnostic tests are available, but their role in diagnosis of disease with neurological involvement is still unclear. For others—eg, tuberculosis—advances in research have not yet yielded validated tests for diagnosis of neurological disease. |
| doi_str_mv | 10.1016/S1473-3099(13)70004-5 |
| format | Article |
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In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe sequelae. Confirmatory microbiological and parasitological tests are essential because clinical features of most neurological infections are not specific, brain imaging is seldom feasible, and treatment regimens are often prolonged or toxic. Recognition of this diagnostic bottleneck has yielded major investment in application of advances in biotechnology to clinical microbiology in the past decade. We review the neurological pathogens for which rapid diagnostic tests are most urgently needed in central Africa, detail the state of development of putative rapid diagnostic tests for each, and describe key technical and operational challenges to their development and implementation. Promising field-suitable rapid diagnostic tests exist for the diagnosis of human African trypanosomiasis and cryptococcal meningoencephalitis. For other infections—eg, syphilis and schistosomiasis—highly accurate field-validated rapid diagnostic tests are available, but their role in diagnosis of disease with neurological involvement is still unclear. For others—eg, tuberculosis—advances in research have not yet yielded validated tests for diagnosis of neurological disease.</description><identifier>ISSN: 1473-3099</identifier><identifier>EISSN: 1474-4457</identifier><identifier>DOI: 10.1016/S1473-3099(13)70004-5</identifier><identifier>PMID: 23623369</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Africa, Central ; Biological and medical sciences ; Biotechnology ; Diagnostic Techniques, Neurological ; Human mycoses ; Human protozoal diseases ; Humans ; Infection - diagnosis ; Infectious Disease ; Infectious diseases ; Medical sciences ; Meningitis, Cryptococcal - diagnosis ; Microbiology ; Miscellaneous mycoses ; Mycoses ; Nervous System Diseases - diagnosis ; Nervous System Diseases - microbiology ; Nervous System Diseases - parasitology ; Parasitic diseases ; Preventable deaths ; Protozoal diseases ; Schistosomiasis ; Sexually transmitted diseases ; STD ; Syphilis ; Trypanosomiasis ; Trypanosomiasis, African - diagnosis ; Tuberculosis ; Vector-borne diseases</subject><ispartof>The Lancet infectious diseases, 2013-06, Vol.13 (6), p.546-558</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Jun 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-e7ef31ca4eeaeacbd6d790c99600cd53e897c90f5f4fb5d776b3f1c5b4faea9c3</citedby><cites>FETCH-LOGICAL-c478t-e7ef31ca4eeaeacbd6d790c99600cd53e897c90f5f4fb5d776b3f1c5b4faea9c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1354337204?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27407469$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23623369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yansouni, Cedric P, Dr</creatorcontrib><creatorcontrib>Bottieau, Emmanuel, Prof</creatorcontrib><creatorcontrib>Lutumba, Pascal, Prof</creatorcontrib><creatorcontrib>Winkler, Andrea S, MD</creatorcontrib><creatorcontrib>Lynen, Lut, Prof</creatorcontrib><creatorcontrib>Büscher, Philippe, Prof</creatorcontrib><creatorcontrib>Jacobs, Jan, Prof</creatorcontrib><creatorcontrib>Gillet, Philippe, PhD</creatorcontrib><creatorcontrib>Lejon, Veerle, PhD</creatorcontrib><creatorcontrib>Alirol, Emilie, PhD</creatorcontrib><creatorcontrib>Polman, Katja, PhD</creatorcontrib><creatorcontrib>Utzinger, Jürg, Prof</creatorcontrib><creatorcontrib>Miles, Michael A, Prof</creatorcontrib><creatorcontrib>Peeling, Rosanna W, Prof</creatorcontrib><creatorcontrib>Muyembe, Jean-Jacques, Prof</creatorcontrib><creatorcontrib>Chappuis, François, MD</creatorcontrib><creatorcontrib>Boelaert, Marleen, Prof</creatorcontrib><title>Rapid diagnostic tests for neurological infections in central Africa</title><title>The Lancet infectious diseases</title><addtitle>Lancet Infect Dis</addtitle><description>Summary Infections are a leading cause of life-threatening neuropathology worldwide. In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe sequelae. Confirmatory microbiological and parasitological tests are essential because clinical features of most neurological infections are not specific, brain imaging is seldom feasible, and treatment regimens are often prolonged or toxic. Recognition of this diagnostic bottleneck has yielded major investment in application of advances in biotechnology to clinical microbiology in the past decade. We review the neurological pathogens for which rapid diagnostic tests are most urgently needed in central Africa, detail the state of development of putative rapid diagnostic tests for each, and describe key technical and operational challenges to their development and implementation. Promising field-suitable rapid diagnostic tests exist for the diagnosis of human African trypanosomiasis and cryptococcal meningoencephalitis. For other infections—eg, syphilis and schistosomiasis—highly accurate field-validated rapid diagnostic tests are available, but their role in diagnosis of disease with neurological involvement is still unclear. For others—eg, tuberculosis—advances in research have not yet yielded validated tests for diagnosis of neurological disease.</description><subject>Africa, Central</subject><subject>Biological and medical sciences</subject><subject>Biotechnology</subject><subject>Diagnostic Techniques, Neurological</subject><subject>Human mycoses</subject><subject>Human protozoal diseases</subject><subject>Humans</subject><subject>Infection - diagnosis</subject><subject>Infectious Disease</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Meningitis, Cryptococcal - diagnosis</subject><subject>Microbiology</subject><subject>Miscellaneous mycoses</subject><subject>Mycoses</subject><subject>Nervous System Diseases - diagnosis</subject><subject>Nervous System Diseases - microbiology</subject><subject>Nervous System Diseases - parasitology</subject><subject>Parasitic diseases</subject><subject>Preventable deaths</subject><subject>Protozoal diseases</subject><subject>Schistosomiasis</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Syphilis</subject><subject>Trypanosomiasis</subject><subject>Trypanosomiasis, African - diagnosis</subject><subject>Tuberculosis</subject><subject>Vector-borne 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In central African countries affected by endemic diseases such as human African trypanosomiasis, tuberculosis, HIV/AIDS, and schistosomiasis, delayed diagnosis and treatment often lead to avoidable death or severe sequelae. Confirmatory microbiological and parasitological tests are essential because clinical features of most neurological infections are not specific, brain imaging is seldom feasible, and treatment regimens are often prolonged or toxic. Recognition of this diagnostic bottleneck has yielded major investment in application of advances in biotechnology to clinical microbiology in the past decade. We review the neurological pathogens for which rapid diagnostic tests are most urgently needed in central Africa, detail the state of development of putative rapid diagnostic tests for each, and describe key technical and operational challenges to their development and implementation. 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| ispartof | The Lancet infectious diseases, 2013-06, Vol.13 (6), p.546-558 |
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| subjects | Africa, Central Biological and medical sciences Biotechnology Diagnostic Techniques, Neurological Human mycoses Human protozoal diseases Humans Infection - diagnosis Infectious Disease Infectious diseases Medical sciences Meningitis, Cryptococcal - diagnosis Microbiology Miscellaneous mycoses Mycoses Nervous System Diseases - diagnosis Nervous System Diseases - microbiology Nervous System Diseases - parasitology Parasitic diseases Preventable deaths Protozoal diseases Schistosomiasis Sexually transmitted diseases STD Syphilis Trypanosomiasis Trypanosomiasis, African - diagnosis Tuberculosis Vector-borne diseases |
| title | Rapid diagnostic tests for neurological infections in central Africa |
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