{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:49:10Z","timestamp":1787827750089,"version":"build-2784847793"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009656","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000}}],"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["DRIA-2014-306-DiTECT-HAT"],"award-info":[{"award-number":["DRIA-2014-306-DiTECT-HAT"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Little is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in C\u00f4te d\u2019Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity, and assessed the diagnostic tests\u2019 specificity, positive predictive value and agreement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Clinical suspects were screened with SD Bioline HAT, HAT Sero-<jats:italic>K<\/jats:italic>-Set and rHAT Sero-Strip. Seropositives were parasitologically examined, and their dried blood spots tested in trypanolysis, ELISA\/<jats:italic>Tbg<\/jats:italic>, m18S-qPCR and LAMP. The HAT prevalence in the study population was calculated based on RDT positivity followed by parasitological confirmation. The association between clinical symptoms and signs and RDT positivity was determined using multivariable logistic regression. The tests\u2019 Positive Predictive Value (PPV), specificity and agreement were determined.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Over 29 months, 3433 clinical suspects were tested. The RDT positivity rate was 2.83%, HAT prevalence 0.06%. Individuals with sleep disturbances (<jats:italic>p<\/jats:italic>&lt;0.001), motor disorders (<jats:italic>p<\/jats:italic> = 0.002), convulsions (<jats:italic>p<\/jats:italic> = 0.02), severe weight loss (<jats:italic>p<\/jats:italic> = 0.02) or psychiatric problems (<jats:italic>p<\/jats:italic> = 0.04) had an increased odds (odds ratios 1.7\u20134.6) of being HAT RDT seropositive. Specificities ranged between 97.8%-99.6% for individual RDTs, and 93.3\u201398.9% for subsequent tests on dried blood spots. The PPV of the individual RDTs was below 14.3% (CI 2\u201343), increased to 33.3% (CI 4\u201378) for serial RDT combinations, and reached 67% for LAMP and ELISA\/<jats:italic>Tbg<\/jats:italic> on RDT positives. Agreement between diagnostic tests was poor to moderate (Kappa \u2264 0.60), except for LAMP and ELISA\/<jats:italic>Tbg<\/jats:italic> (Kappa = 0.66).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Identification of five key clinical symptoms and signs may simplify referral for HAT RDT screening. The results confirm the appropriateness of the diagnostic algorithm presently applied, with screening by SD Bioline HAT or HAT Sero-<jats:italic>K<\/jats:italic>-Set, supplemented with trypanolysis. ELISA\/<jats:italic>Tbg<\/jats:italic> could replace trypanolysis and is simpler to perform.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>ClinicalTrials.gov <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03356665\" xlink:type=\"simple\">NCT03356665<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009656","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T17:38:40Z","timestamp":1630345120000},"page":"e0009656","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":29,"title":["Passive surveillance of human African trypanosomiasis in C\u00f4te d\u2019Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test 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Cristina","family":"Falzon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathurin","family":"Koffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrille Mambo","family":"Kouam\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9851-7435","authenticated-orcid":true,"given":"Bernardin","family":"Ahouty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlie Franck Alfred","family":"Compaor\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel 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