Le diagnostic de la trypanosomose humaine africaine

It is guided by an inflammatory syndrome (increased C reactive protein and erythrocyte sedimentation rate), plasmocytosis (Mott cells) and elevated IgM titers in the serum. The diagnosis of the first stage requires demonstration of parasites in blood or lymph-nodes aspirates. Sensitivity is improved by the use of haematocrit centrifuge technique (Woo test) or by miniature anion exchange centrifugation technique. During the second stage the examination of cerebrospinal fluid (CSF) may show high level of Immunoglobulin M, increased cells count (>5 cell/μl) or protein concentration in the CSF (>450 mg/L). The diagnosis of the neurological stage is confirmed by the detection of trypanosomes by double CSF centrifugation technique. There are many immunological techniques to detect specific antibodies in the serum (indirect immunofluorescence, ELISA…). Almost every control programme in endemic areas used the card agglutination test for trypanosomiasis which is simple, quick and easy to perform. New molecular techniques improve the diagnostic of the parasite infection and the stage determination.