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Volume 13, Number 10—October 2007
Global Poverty and Human Development


Cost-effectiveness of Algorithms for Confirmation Test of Human African Trypanosomiasis

Pascal Lutumba*†, Filip Meheus‡, Jo Robays†, Constantin Miaka*, Victor Kande*, Philippe Büscher†, Bruno Dujardin§, and Marleen Boelaert†Comments to Author 
Author affiliations: *Programmed National de Lutte contre la Trypanosomiase Humaine Africaine, Kinshasa, Democratic Republic of Congo; †Institute of Tropical Medicine, Antwerp, Belgium; ‡Royal Tropical Institute, Amsterdam, the Netherlands; §Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium;

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Table 2

Probabilities used in baseline scenario and plausible range*

Characteristic Baseline value, % Reference Plausible range, % Reference
HAT prevalence 1.0 Annual reports PNLTHA (1995–2002) 0.5–5.0 Annual reports 
PNLTHA (1995-2002)
LNP sensitivity 18.8 (20) 18.8–58.6 (3,4)
LNP specificity 100.0 By convention NA
FBE sensitivity 3.9 (4) 3.9–22.4 (3,4)
FBE specificity 100.0 By convention NA
TBF sensitivity 27.3 (4) 27.3–34.5 (3,4)
TBF specificity 100.0 By convention NA
CTC sensitivity 56.5 (4) 29.0–73.0 (3,7)
CTC specificity 100.0 By convention NA
mAECT sensitivity 75.3 (4) 43.0–88.0 (3,7)
mAECT specificity 100.0 By convention NA
CATT whole blood sensitivity 90.4 (23) 68.8–99.2 (2124); John M (unpub. data)
CATT whole blood specificity 96.5 (23) 83.5–98.4 (21,23,24)
CATT titration sensitivity† 78.8 (4) 78.8–100.0 In absence of data in literature, we considered the maximum of 100%
CATT titration specificity† 59.0 (4) 59.0–100.0 In absence of data in literature, we considered the maximum of 100%
Pentamidine efficacy 98.0 98.0–99.0 (25)
Melarsoprol efficacy 90.0 70.0–96.3 (25,26)
Latrogenic mortality of pentamidine 0.1 0.1–0.7 (25)
Latrogenic mortality of melarsoprol 2.0 2.0–7.0 (2527)

*HAT, human African trypanosomiasis; PNLTHA, Programme National de lutte contre la Trypanosomiase Humaine Africaine; LNP, lymph node puncture; NA, not applicable; FBE, fresh blood examination; TBF, thick blood film; CTC, capillary tube centrifugation; mAECT, mini-anion exchange centrifugation technique; CATT, card agglutination test for trypanosomiasis.
†Conditional values to CATT whole blood positive. The plausible range included the value at different end-titers (4, 16, 32).
‡Data extracted from PNLTHA/RDC annual report 1999.

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