Human African trypanosomiasis: use of double centrifugation of cerebrospinal fluid to detect trypanosomes

A double-centrifugation technique for the detection of trypanosomes in samples of cerebrospinal fluid is described and evaluated. The results of the analysis of samples of cerebrospinal fluid from 128 patients with Trypanosoma brucei gambiense sleeping sickness from the Daloa area of Côte d'Ivoire, obtained using single centrifugation, are compared with those obtained using the new method. Double centrifugation is at least twice as sensitive as single centrifugation and results in an increase of 37% in the early detection of late-stage case of the disease. The technique is easily implemented under field conditions.