African trypanosomiasis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid, Jesus Rosario Hernandez, M.D. [2]

The diagnosis of African trypanosomiasis rests on demonstrating trypanosomes by microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow, and cerebrospinal fluid in the late stages of infection.

The diagnosis of African trypanosomiasis rests on demonstrating trypanosomes by microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow or, in the late stages of infection, in cerebrospinal fluid.

• Acute disease is often diagnosed by visual detection of the Trypanosoma brucei rhodesiense parasite on peripheral blood smear.
• Peripheral blood smears are usually stained with Giemsa stain for adequate visualization of the parasite.

Microscopy	Findings
	Thin blood smear stained with Giemsa. Typical trypomastigote stages (the only stages found in patients), with a posterior kinetoplast, a centrally located nucleus, an undulating membrane, and an anterior flagellum.   The two Trypanosoma brucei species that cause human trypanosomiasis, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, are indistinguishable morphologically.   The trypanosome’s length ranges from 14 to 33 µm.
	Parasite exhibiting division (on right).

• Serology is not usually helpful in acute disease.
• Detection of anti-trypanosomal IgG antibodies is helpful in detection of African trypanosomiasis infections.
• Three serological tests are available for detection of the parasite:
  • Micro-CATT (uses dried blood)
  • wb-CATT (uses whole blood)
  • wb-LATEX (uses whole blood)
• wb-CATT is the most efficient test for diagnosis, while wb-LATEX is a better exam for situations in which greater sensitivity is required.^[1]
• Detection of antibodies among infants may be difficult due to the presence of maternal antibodies early following birth. Accordingly, serologic testing for infants is only recommended at least 9 months after birth.

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]
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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL). ^[2]

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