| Charlie Franck Alfred Compaoré, Jacques Kaboré, Hamidou Ilboudo, Lian Francesca Thomas, Laura Cristina Falzon, Mohamed Bamba, Hassane Sakande, Minayégninrin Koné, Dramane Kaba, Clarisse Bougouma, Ilboudo Adama, Ouedraogo Amathe, Adrien Marie Gaston Belem, Eric Maurice Fèvre, Philippe Büscher, Veerle Lejon, Vincent Jamonneau Journal Article) In: Parasite, vol. 29, pp. 25, 2022, ISSN: 1776-1042. @article{nokey,
title = {Monitoring the elimination of \textit{gambiense} human African trypanosomiasis in the historical focus of Bati\'{e}, South\textendashWest Burkina Faso},
author = {Charlie Franck Alfred Compaor\'{e} and Jacques Kabor\'{e} and Hamidou Ilboudo and Lian Francesca Thomas and Laura Cristina Falzon and Mohamed Bamba and Hassane Sakande and Minay\'{e}gninrin Kon\'{e} and Dramane Kaba and Clarisse Bougouma and Ilboudo Adama and Ouedraogo Amathe and Adrien Marie Gaston Belem and Eric Maurice F\`{e}vre and Philippe B\"{u}scher and Veerle Lejon and Vincent Jamonneau},
url = {https://www.parasite-journal.org/10.1051/parasite/2022024},
doi = {10.1051/parasite/2022024},
issn = {1776-1042},
year = {2022},
date = {2022-01-01},
journal = {Parasite},
volume = {29},
pages = {25},
abstract = {\<p\> The World Health Organisation has targeted the elimination of human African trypanosomiasis (HAT) as zero transmission by 2030. Continued surveillance needs to be in place for early detection of re-emergent cases. In this context, the performance of diagnostic tests and testing algorithms for detection of the re-emergence of \<italic\>Trypanosoma brucei gambiense\</italic\> HAT remains to be assessed. We carried out a door-to-door active medical survey for HAT in the historical focus of Bati\'{e}, South\textendashWest Burkina Faso. Screening was done using three rapid diagnostic tests (RDTs). Two laboratory tests (ELISA/ \<italic\>T. b. gambiense\</italic\> and immune trypanolysis) and parasitological examination were performed on RDT positives only. In total, 5883 participants were screened, among which 842 (14%) tested positive in at least one RDT. Blood from 519 RDT positives was examined microscopically but no trypanosomes were observed. The HAT Sero- \<italic\>K\</italic\> -Set test showed the lowest specificity of 89%, while the specificities of SD Bioline HAT and rHAT Sero-Strip were 92% and 99%, respectively. The specificity of ELISA/ \<italic\>T. b. gambiense\</italic\> and trypanolysis was 99% (98\textendash99%) and 100% (99\textendash100%), respectively. Our results suggest that \<italic\>T. b. gambiense\</italic\> is no longer circulating in the study area and that zero transmission has probably been attained. While a least cost analysis is still required, our study showed that RDT preselection followed by trypanolysis may be a useful strategy for post-elimination surveillance in Burkina Faso. \</p\>},
keywords = {Burkina Faso, Diagnosis, Dried blood spot, Elimination, Human African trypanosomiasis, Rapid diagnostic test, Specificity, Trypanosoma brucei gambiense},
pubstate = {published},
tppubtype = {article}
}
<p> The World Health Organisation has targeted the elimination of human African trypanosomiasis (HAT) as zero transmission by 2030. Continued surveillance needs to be in place for early detection of re-emergent cases. In this context, the performance of diagnostic tests and testing algorithms for detection of the re-emergence of <italic>Trypanosoma brucei gambiense</italic> HAT remains to be assessed. We carried out a door-to-door active medical survey for HAT in the historical focus of Batié, South–West Burkina Faso. Screening was done using three rapid diagnostic tests (RDTs). Two laboratory tests (ELISA/ <italic>T. b. gambiense</italic> and immune trypanolysis) and parasitological examination were performed on RDT positives only. In total, 5883 participants were screened, among which 842 (14%) tested positive in at least one RDT. Blood from 519 RDT positives was examined microscopically but no trypanosomes were observed. The HAT Sero- <italic>K</italic> -Set test showed the lowest specificity of 89%, while the specificities of SD Bioline HAT and rHAT Sero-Strip were 92% and 99%, respectively. The specificity of ELISA/ <italic>T. b. gambiense</italic> and trypanolysis was 99% (98–99%) and 100% (99–100%), respectively. Our results suggest that <italic>T. b. gambiense</italic> is no longer circulating in the study area and that zero transmission has probably been attained. While a least cost analysis is still required, our study showed that RDT preselection followed by trypanolysis may be a useful strategy for post-elimination surveillance in Burkina Faso. </p> |
| Francois Kiemde, Adelaide Compaore, Fla Koueta, Athanase M. Some, Berenger Kabore, Daniel Valia, Toussaint Rouamba, Fadima Yaya Bocoum, Seydou Sawadogo, Macaire Nana, Diane Y. Some, Nadine A. Kone, Valentin Pagbeleguem, Inoussa Sangare, Antonia W. Bere, Massa Achille Bonko, Gautier Tougri, Sylvie Yeri Youl, Henk Schallig, Halidou Tinto Development and evaluation of an electronic algorithm using a combination of a two-step malaria RDT and other rapid diagnostic tools for the management of febrile illness in children under 5 attending outpatient facilities in Burkina Faso (Journal Article) In: Trials, vol. 23, iss. 1, pp. 779, 2022, ISSN: 1745-6215. @article{Kiemde2022,
title = {Development and evaluation of an electronic algorithm using a combination of a two-step malaria RDT and other rapid diagnostic tools for the management of febrile illness in children under 5 attending outpatient facilities in Burkina Faso},
author = {Francois Kiemde and Adelaide Compaore and Fla Koueta and Athanase M. Some and Berenger Kabore and Daniel Valia and Toussaint Rouamba and Fadima Yaya Bocoum and Seydou Sawadogo and Macaire Nana and Diane Y. Some and Nadine A. Kone and Valentin Pagbeleguem and Inoussa Sangare and Antonia W. Bere and Massa Achille Bonko and Gautier Tougri and Sylvie Yeri Youl and Henk Schallig and Halidou Tinto},
editor = {Lucinda Shen},
url = {https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06717-8},
doi = {10.1186/s13063-022-06717-8},
issn = {1745-6215},
year = {2022},
date = {2022-01-01},
journal = {Trials},
volume = {23},
issue = {1},
pages = {779},
abstract = {BACKGROUND In Sub-Saharan Africa (SSA), febrile illnesses remain a major public health problem in children. However, the persistence of hrp2 antigen and the low sensitivity of pLDH RDT negatively affect antimalarials and antibiotics prescription practices. These limitations lead to poor management of febrile diseases and antimicrobial resistance (AMR). To improve the diagnosis of these febrile diseases and subsequent prescription of antimicrobials, it is hypothesized that the implementation of an algorithm including a two-step malaria RDT PfHRP2/pLDH supported by point-of-care (PoC) tests for bacterial infections could significantly improve the management of febrile diseases and thereby tackling AMR. METHODS To assess the value of the proposed algorithm, an open-label randomized controlled trial with three arms, enrolling febrile children from 6 to 59 months is proposed. In the control arm, febrile children will be managed according to the Integrated Management of Childhood Illnesses (IMCI), which is part of the standard of care in Burkina Faso. Treatment will be done according to national guidelines. In the RDT decisional algorithm (RDT-DA) arm (intervention), the clinical examination based on IMIC will be supported by a two-step malaria RDT and bacterial infections RDTs. Prescription will be left to the discretion of the healthcare workers based on clinical examination and PoC test results. In the e-algorithm arm (intervention), artificial intelligence integrating multiple layers of clinical information such as clinical examination, signs/symptoms and medical history, and biological information such as biomarkers (CRP and WBC) and pathogen-specific PoC tests, and oximetry will be developed. The e-algorithm will serve to guide the diagnostic and management of febrile infections in children. In the 3 arms, the case report forms will be digitalized. A final follow-up visit (day 7) will be scheduled for all participants. Patients will be asked to come back to the health facilities before the scheduled visit if the symptoms persist or in case of health condition worsening. DISCUSSION If successful, this study could contribute to improve the management of febrile diseases and reduce inappropriate use of antimicrobials. TRIAL REGISTRATION The trial is registered at ClinicalTrial.gov, NCT05285657. Enrolment started on 4 March 2022 with long-term outcome being assessed completely by 2023.},
keywords = {Artificial intelligence, e-Algorithm, Fever, Prescription, Rapid diagnostic test},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND In Sub-Saharan Africa (SSA), febrile illnesses remain a major public health problem in children. However, the persistence of hrp2 antigen and the low sensitivity of pLDH RDT negatively affect antimalarials and antibiotics prescription practices. These limitations lead to poor management of febrile diseases and antimicrobial resistance (AMR). To improve the diagnosis of these febrile diseases and subsequent prescription of antimicrobials, it is hypothesized that the implementation of an algorithm including a two-step malaria RDT PfHRP2/pLDH supported by point-of-care (PoC) tests for bacterial infections could significantly improve the management of febrile diseases and thereby tackling AMR. METHODS To assess the value of the proposed algorithm, an open-label randomized controlled trial with three arms, enrolling febrile children from 6 to 59 months is proposed. In the control arm, febrile children will be managed according to the Integrated Management of Childhood Illnesses (IMCI), which is part of the standard of care in Burkina Faso. Treatment will be done according to national guidelines. In the RDT decisional algorithm (RDT-DA) arm (intervention), the clinical examination based on IMIC will be supported by a two-step malaria RDT and bacterial infections RDTs. Prescription will be left to the discretion of the healthcare workers based on clinical examination and PoC test results. In the e-algorithm arm (intervention), artificial intelligence integrating multiple layers of clinical information such as clinical examination, signs/symptoms and medical history, and biological information such as biomarkers (CRP and WBC) and pathogen-specific PoC tests, and oximetry will be developed. The e-algorithm will serve to guide the diagnostic and management of febrile infections in children. In the 3 arms, the case report forms will be digitalized. A final follow-up visit (day 7) will be scheduled for all participants. Patients will be asked to come back to the health facilities before the scheduled visit if the symptoms persist or in case of health condition worsening. DISCUSSION If successful, this study could contribute to improve the management of febrile diseases and reduce inappropriate use of antimicrobials. TRIAL REGISTRATION The trial is registered at ClinicalTrial.gov, NCT05285657. Enrolment started on 4 March 2022 with long-term outcome being assessed completely by 2023. |
