Noninvasive Biological Samples to Detect and Diagnose Infections due to Trypanosomatidae Parasites: A Systematic Review and Meta-Analysis

Abstract

Unicellular eukaryotes of the Trypanosomatidae family include human and animal pathogens that belong to the Trypanosoma and Leishmania genera. Diagnosis of the diseases they cause requires the sampling of body fluids (e.g., blood, lymph, peritoneal fluid, cerebrospinal fluid) or organ biopsies (e.g., bone marrow, spleen), which are mostly obtained through invasive methods. Body fluids or appendages can be alternatives to these invasive biopsies but appropriateness remains poorly studied. To further address this question, we perform a systematic review on clues evidencing the presence of parasites, genetic material, antibodies, and antigens in body secretions, appendages, or the organs or proximal tissues that produce these materials. Paper selection was based on searches in PubMed, Web of Science, WorldWideScience, SciELO, Embase, and Google. The information of each selected article (n = 333) was classified into different sections and data were extracted from 77 papers. The presence of Trypanosomatidae parasites has been tracked in most of organs or proximal tissues that produce body secretions or appendages, in naturally or experimentally infected hosts. The meta-analysis highlights the paucity of studies on human African trypanosomiasis and an absence on animal trypanosomiasis. Among the collected data high heterogeneity in terms of the I 2 statistic (100%) is recorded. A high positivity is recorded for antibody and genetic material detection in urine of patients and dogs suffering leishmaniasis, and of antigens for leishmaniasis and Chagas disease. Data on conjunctival swabs can be analyzed with molecular methods solely for dogs suffering canine visceral leishmaniasis. Saliva and hair/bristles showed a pretty good positivity that support their potential to be used for leishmaniasis diagnosis. In conclusion, our study pinpoints significant gaps that need to be filled in order to properly address the interest of body secretion and hair or bristles for the diagnosis of infections caused by Leishmania and by other Trypanosomatidae parasites.

Transmission patterns of Leishmania tropica around the Mediterranean basin: Could Morocco be impacted by a zoonotic spillover?

“…The molecular detection of Leishmania from swab samples was less sensitive than the traditional techniques, and this could be due to the low parasitic load obtained from swab samples [ 75 ]. Moreover, to assess Leishmania infection, patients urine was also found to be useful as a diagnostic tool in the surveillance of CL and VL [ 76 ].…”

Diagnosis of animal trypanosomoses: proper use of current tools and future prospects

“…Several diagnostic methods are available to detect HAT due to T. brucei gambiense or T. b. rhodesiense in various samples. such as blood, lymph node juice, cerebrospinal fluid (CSF) and, more recently, dermis exploration [ 108 , 109 ]. The methodologies used are: (i) direct examination by HCT, GSBS, quantitative buffy coat (QBC) or the miniature anion exchange centrifugation technique (mAECT) [ 24 , 110 , 111 ]; (ii) serological methods, such as the CATT for T. brucei gambiense [ 112 ] and the trypanolysis test (TL [ 113 , 114 ]); (iii) the in vitro isolation kit (KIVI) [ 24 , 115 ]; (iv) molecular detection methods specific to species or subspecies [ 73 , 74 , 116 ]; and even (v) the xenodiagnostic method used in the past [ 117 ].…”

“…Crude blood is used for parasitological techniques (HCT/PCV, GSBS, QBC, MIT); DNA purification is necessary for molecular techniques (DNA extraction from blood or buffy coat); and cell separation is required for serological tests on serum or plasma. A recent review [ 109 ] listed other samples used, including lymph node juice, CSF and lachrymal, preputial or vaginal secretions; however, it is not possible to obtain sterile conditions for some of these samples. Blood samples must be cooled slowly and kept cool (2–4 °C) to keep parasites alive and slow down microbial proliferation.…”

Comparison of DNA Extracted from Pediatric Saliva, Gingival Crevicular Fluid and Site-Specific Biofilm Samples

“…Due to the non-invasive nature of saliva collection, many methods have been used to isolate and collect DNA from saliva samples for microbial screening [ 1 , 2 , 3 ]. Screening methods for these samples have included highly specific and technical procedures involving immunofluorescence microscopy, proteomic analysis and next-generation sequencing [ 3 , 4 , 5 , 6 ].…”