However, the same authors showed that the accuracy of this approach can rapidly vary according to a number of conditions, including retreatment cases, for which a very low sensitivity was reported [57]. The interesting diagnostic potential of PCR is also weakened by its low applicability as a field test, since it requires high-tech instruments and trained personnel. The most promising alternative amplification method, with huge potential for field application, find more is the loop-mediated isothermal amplification of DNA (LAMP) [58]. This technique, originally

developed for the detection of a variety of pathogens [58] and [59], was recently adapted for the diagnosis of sleeping sickness [60]. LAMP relies on the isothermal amplification of multiple specific DNA regions in the parasites,

followed by the visualization of the results through the development of a fluorescence signal or turbidity [61]. Mugasa et al. systematically analyzed the most accurate studies focusing on the evaluation of the diagnostic accuracy of the different molecular diagnostic methods for HAT. They reported 98.7% SE and 99.8% SP in case-control studies, and 98.6% SE and 94.5% SP in non case-control studies [62]. Due to the novelty of the LAMP as a new diagnostic tool for HAT, few studies are available in the literature and a meta-analysis evaluation of the overall accuracy of this approach cannot be done yet. Despite the huge efforts made to identify new tools to accurately diagnose HAT, few of them click here focused Rutecarpine on the systematic evaluation of the effects induced by the presence of parasites in the host. A widely used approach to discover diagnostic biomarkers is the application of different omics approaches to investigate human body fluids in healthy and pathological conditions: these include proteomics, transcriptomics and metabolomics [63], [64] and [65].

These approaches, whether considered individually or together, have shown themselves to be useful for a number of different applications, however only a few studies have been published on sleeping sickness. The most important proteomics study for HAT diagnostic application is probably the work of Papadopoulos and colleagues [66]. By using SELDI-TOF MS, they aimed to identify new serum biomarkers for the diagnosis of HAT through the detection of specific HAT serum proteomics signatures [66]. The authors identified some protein signatures that were able to significantly discriminate between parasitologically confirmed HAT patients and control patients suffering from other illnesses. However, none of their protein signatures was accurate enough and only combinations obtained using different data mining algorithms could improve the diagnostic accuracy of the putative marker signatures.