Rapid diagnostic tests for neurological infections in central Africa

Yansouni, CP; Bottieau, E; Lutumba, P; Winkler, AS; Lynen, L; Buscher, P; Jacobs, J; Gillet, P; Lejon, V; Alirol, E; Polmann, K; Utzinger, J; Miles, MA; Peeling, RW; Muyembe, JJ; Chappuis, F; Boelaert, M; (2013) Rapid diagnostic tests for neurological infections in central Africa. The Lancet infectious diseases, 13 (6). pp. 546-558. ISSN 1473-3099 DOI: https://doi.org/10.1016/S1473-3099(13)70004-5

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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 meningoencephalifis. 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.

Item Type: Article
Keywords: mediated isothermal amplification, herpes-simplex-virus, neglected, tropical diseases, central-nervous-system, real-time pcr, of-care test, cerebrospinal-fluid, bacterial-meningitis, tuberculous meningitis, schistosoma-mansoni
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Pathogen Molecular Biology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 23623369
Web of Science ID: 319539700029
URI: http://researchonline.lshtm.ac.uk/id/eprint/1105211


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