Rapid Diagnostic Test for Second-Stage Sleeping Sickness Shows 100% Sensitivity in Field Study
A phase III diagnostic accuracy study evaluated the HAT Sero K-SeT rapid test for diagnosing second-stage human African trypanosomiasis in a rural hospital in the Democratic Republic of the Congo. The test achieved 100% sensitivity and 97% specificity against a composite reference standard using cerebrospinal fluid examination. These results support the use of this point-of-care test to reliably rule out sleeping sickness in clinical suspects in endemic settings.
The original study
A Phase III Diagnostic Accuracy Study of a Rapid Diagnostic Test for Diagnosis of Second-Stage Human African Trypanosomiasis in the Democratic Republic of the Congo.
- Authors
- Boelaert M, Mukendi D, Bottieau E, Kalo Lilo JR, Verdonck K, Minikulu L, et al.
- Journal
- EBioMedicine
- Type
- Clinical Trial, Phase III, Journal Article
- PMID
- 29246478
Original abstract
OBJECTIVES: To estimate the diagnostic accuracy of HAT Sero K-SeT for the field diagnosis of second-stage human African trypanosomiasis (HAT). DESIGN: A phase III diagnostic accuracy design. Consecutive patients with symptoms clinically suggestive of HAT were prospectively enrolled. We compared results of the index test HAT Sero K-SeT with those of a composite reference standard: demonstration of trypanosomes in cerebrospinal fluid (CSF), or trypanosomes detected in any other body fluid AND white blood cell count in CSF >5/μl. SETTING: Rural hospital in the Democratic Republic of the Congo. PARTICIPANTS: All patients above five years old presenting at Mosango hospital with a neurological problem of recent onset at the exclusion of trauma. INTERVENTIONS: n.a. MAIN OUTCOME MEASURES: Sensitivity and specificity of HAT Sero K-SeT test. RESULTS: The sensitivity of the HAT Sero K-SeT was 8/8 or 100.0% (95% confidence interval: 67.6 to 100.0%) and the specificity was 258/266 or 97.0% (94.2% to 98.5%). CONCLUSION: The high sensitivity of the HAT Sero K-SeT is in line with previously published estimates, though the sample of HAT cases in this study was small. The specificity estimate was very high and precise. This test, when negative, allows the clinician to rule out HAT in a clinical suspect in a hospital setting in this endemic region.