Journal
TROPICAL MEDICINE & INTERNATIONAL HEALTH
Volume 12, Issue 11, Pages 1361-1368Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1365-3156.2007.01918.x
Keywords
human African trypanosomiasis; drug resistance; allele-specific PCR; T. brucei adenosine transporter; melarsopro
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OBJECTIVE To assess the application of allele-specific PCR (AS-PCR) as a fast, cheap and reliable method for detecting mutant TbAT1 associated with melarsoprol relapse in Trypanosoma brucei gambiense isolates from northwest Uganda. METHODS A total of 105 trypanosome isolates were analysed using SfaN1 restriction fragment length polymorphism (RFLP) and AS-PCR, the former used as the gold standard. Sensitivity, specificity, positive and negative predictive values of AS-PCR as well as agreement between the tests were determined. RESULTS Eleven trypanosome isolates had mutant TbATI while 94 exhibited the wild-type TbAT1 genes. There was a highly significant agreement between SfaN1 RFLP and AS-PCR with kappa and intra-class correlation values of 1.0. The sensitivity and specificity of AS-PCR were both 100%, while the positive and negative predictive values were found to be equal to 1.0. Cost and time analyses were performed and AS-PCR was 4.3 times cheaper than SfaN1 RFLP, in addition to the less time required for its execution. CONCLUSION AS-PCR should be the test of choice for screening for mutant TbAT1 in the ever-increasing numbers of field trypanosome isolates.
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