Multicentre evaluation of an antigen-detection ELISA for the diagnosis of Trypanosoma brucei rhodesiense sleeping sickness.

The performance of an enzyme-linked immunosorbent assay (antigen ELISA) for the detection, in serum or cerebrospinal fluid, of an invariant trypanosome antigen to diagnose Trypanosoma brucei rhodesiense sleeping sickness was evaluated in four clinical treatment centres. The test, which was carried out in polystyrene test-tubes, was positive in 88 (88.9%) of 99 parasitologically confirmed cases that were tested at the National Institute for Medical Research, Tabora, United Republic of Tanzania; 99 (94.3%) of 105 cases tested at the National Sleeping Sickness Control Programme, Jinja, Uganda; 86 (87.8%) of 98 cases tested at the Uganda Trypanosomiasis Research Organisation, Tororo, Uganda; and 59 (96.7%) of 61 cases tested at the Tropical Diseases Research Centre, Ndola, Zambia. The overall detection rate was 91.5%. There was no cross-reactivity with the agents of the common bacterial, viral, or parasitic diseases prevalent in the areas where the studies were conducted. The only false-positive result involved a blood donor from a trypanosomiasis endemic focus. The test was simple to perform, was read visually, and is therefore a potential tool for diagnosing human African trypanosomiasis.

HIV infection in newly diagnosed tuberculosis patients in Ndola, Zambia.

Between June and December 1987, 131 patients newly admitted to the tuberculosis wards of the Ndola Central Hospital, underwent a history and examination, chest radiography, sputum examination and an enzyme linked immuno sorbent assay (ELISA) (Wellcome), for human immuno deficiency virus (HIV) antibodies. For all sera testing positive, the ELISA was repeated on two different occasions before HIV seropositivity was confirmed. Eighty-three patients (67 pc) had tubercle bacilli on microscopy, whilst 76 patients (58 pc) were HIV positive (7 patients had no sputum on admission). Nine patients (7 pc) had signs of disseminated tuberculosis while the rest had evidence of pulmonary tuberculosis. Four patients (3 pc) had normal chest radiography, whereas the remainder had intrapulmonary lesions in their films. No association was found between presence or absence of bacilli and HIV seropositivity (P greater than 0.05). HIV seropositive tuberculosis patients were more likely to be younger and female when compared to HIV seronegative tuberculosis patients (P less than 0.05). It was concluded that HIV infection is common in newly diagnosed tuberculosis patients and that young and female patients are more likely to be HIV seropositive than their male counterparts.

PIP: Between June-December 1987, 131 patients newly admitted to the tuberculosis wards of the Ndola Central Hospital underwent a history and examination, chest radiography, sputum examination, and an enzyme linked immunosorbent assay (ELISA, Wellcome) to test for human immunodeficiency virus (HIV) antibodies. For all sera testing positive, the ELISA was repeated on 2 different occasions before HIV seropositivity was confirmed. 83 patients (67%) had tubercule bacilli on microscopy while 76 (58%) were HIV positive (7 patients had no sputum on admission). 9 patients (7%) had signs of disseminated tuberculosis while the remainder had evidence of pulmonary tuberculosis. 4 patients (3%) had normal chest radiography, whereas the rest of the group had intrapulmonary lesions on their films. No association was seen between presence or absence of bacilli and HIV seropositivity (;0.05). HIV seropositive tuberculosis patients were more likely to be younger and female as compared with the HIV seronegative tuberculosis patients (p0.05). It was concluded that HIV infection is common in newly diagnosed tuberculosis patients and that young female patients are more likely to be HIV seropositive than their male counterparts.