Trypanosomiasis
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Over 60 million people are at risk of contracting Human African Trypanosomiasis (HAT) and there are about 300,000 currently infected patients. A severely neglected disease according to WHO criteria, Human African Trypanosomiasis typically affects poor rural populations that live in the endemic areas from 36 sub-Saharan African countries, generally far away from primary health facilities. Seven countries are severely affected, including Sudan, Uganda, Congo, Democratic Republic of Congo and Angola. Human African Trypanosomiasis or sleeping sickness is an infectious disease caused by two subspecies of the Trypanosoma brucei parasite that is transmitted to humans by the tsetse fly.
Human African Trypanosomiasis patients present symptoms from fever, headache and joint pains to neurological, sensorial and motor dysfunction. The neurological disorders, e.g. epileptic seizures and the patient being in coma, that are due to the fact that the parasites enter the central nervous system of the patient, are the most typical symptoms of the disease. The patients inevitably die without treatment after a prolonged period of grave illness. Treatment is difficult and not without any risks as the drugs used to treat trypanosomiasis are very toxic. The problem is being exacerbated due to the occurrence of drug resistance.
It is of great importance to diagnose the disease as early as possible, in particular before the parasite enters the central nervous system. The diagnosis is being made by microscopical examination of blood samples or spinal fluid. In addition, serology using the card agglutination test for trypanosomiasis (CATT) is possible.
The current available methods for diagnosis and parasite identification, which is essential to install proper treatment, are insufficient. Furthermore, there is a need to develop new medicines. Research towards trypanosomiasis is being hampered by a severe lack of funding. The development of new, less toxic drugs, is not a priority for pharmaceutical companies.
Approach
KIT Biomedical Research participates, via an EU supported research consortium, in the development and evaluation of new molecular diagnostic methods for Human African Trypanosomiasis. The developed test must meet specifications of simplicity and robustness and will be used under harsh field conditions in HAT-endemic countries.
KIT Biomedical Research also provides training facilities for researchers from HAT-affected countries. The training is focused on the use of molecular biological tools, including PCR and nucleic acid sequence based amplification technology.
Focal points
- Identification of target sequences in Trypanosoma DNA/RNA for the development of new diagnostic tools
- Development of new molecular tests for the diagnosis HAT
- Improved storage of bio-clinical samples (preferably adapted to local circumstances)
- Improved, efficient and rapid DNA/RNA methods
- Training of MSc and PhD students
Example
A network comprising four European, including KIT Biomedical Research, and four African countries (Uganda, Sudan, Kenya and DR Congo) have joined resources to develop innovative research toward the development of new diagnostic tools for trypanosomiasis and leishmaniasis (TRYLEIDIAG). The TRYLEIDIAG network activities aim at developing new diagnostic tools that will have impact on disease control at three levels:
- Improvement of disease and drug resistance surveillance since diagnostic tools will improve systematic screening of communities at risk
- Improvement of Leishmaniasis and Human African Trypanosomiasis case-finding and case-management with appropriate treatment
- Improvement of efficacy monitoring in clinical trials since diagnostic tools will be highly specific and sensitive.
TRYLEIDIAG's main objectives are:
- Contribute to strengthening institutional research in African countries
- Identify RNA- or DNA-specific sequences that can be the basis for the development of primers and probes in molecular diagnostic tests for HAT.
- Develop and validate novel rapid and sensitive field and laboratory molecular tests for HAT diagnosis. These tests comprise point-of-care and laboratory formats for detection and identification of the parasites.
- Establish protocols for sampling, preparation and storage of bioclinical material under field conditions. Bioclinical samples from patients will be collected for the development and evaluation of the diagnostic tests. This will be implemented after appropriate training of medical and laboratory personnel involved in bioclinical sample collection.
Projects
- Simplified and rapid molecular assays for the diagnosis and characterisation of Leishmaniasis and Human African Trypanosomiasis and parasite (sub-)species identification (TRYLEIDIAG)
- Development of a single format test for IgM quantification in CSF of sleeping sickness patients