Sleeping sickness is a vector-borne parasitic disease with variable, non-specific and inconstant symptoms. Thus, clinical signs are insufficient for diagnosis. Definite diagnosis relies on evidence demonstration of trypanosome in body fluids through parasitological techniques. For reasons related to costs, workload and technical incapacities, these technics are not always performed and sleeping sickness examination is thus limited to serological and clinical investigations. We report a false alarm due to incorrect diagnosis about a sudden outbreak of sleeping sickness in a focus under control. This report shows that inadequate diagnosis methods can lead to downward and upward errors in the prevalence of a disease. There is a need to reinforce material and technical capacities of health centers in endemic areas.
Key words: Sleeping sickness, diagnosis flow chart, case report.
Abbreviations: CATT, Card agglutination test for trypanosomiasis; CSF, cerebrospinal fluid; CTC, centrifugation en tube capillaire; HAT, human African trypanosomiasis;MAECT, mini anion exchange centrifugation technique; NGO, non-governmental organization; PNLTHA, programme National de lutte contre la trypanosomiase humaine Africaine; PPV, positive predictive value; WHO, world health organization.
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