The Human African Trypanosomiasis Specimen Biobank: A Necessary Tool to Support Research of New Diagnostics

Human African trypanosomiasis (HAT), or sleeping sickness, is a vectorborne disease caused by trypanosomes (Trypanosoma brucei gambiense and T.b. rhodesiense) mainly affecting impoverished rural areas in sub-Saharan Africa, where the health systems are weak. Over the last decade, the number of HAT cases has shown a decreasing trend as a result of coordinated control efforts [1]. This makes it possible to envisage the elimination of the disease, but a new approach to uphold current results is needed. Sustainability of the control efforts will require integration of control and surveillance activities within a reinforced health system [2]. However, the complexity of the existing diagnostic tools is not compatible with prevailing conditions at basic health facilities in rural areas where the disease is endemic, which hinders the participation of the health system in the control and surveillance of the disease [3]. There is an urgent need for diagnostic tests that are reliable, cheap, and easy to perform at basic health services. In 2006, the Department of Control of Neglected Tropical Diseases (NTD) of the World Health Organization (WHO) established a collaboration with the Foundation for Innovative New Diagnostics (FIND, http://www.finddiagnostics.org/) to develop new diagnostic tools for the control of HAT that meet the requirements of a sustainable elimination approach. In the framework of this agreement, WHO established a HAT specimen biobank as a collection of biological specimens related to HAT, coupled with clinical and epidemiological information of the person who donated the specimens. The specimen biobank is the property of WHO and its main objective is to provide clinical reference material to research institutions to facilitate the development and evaluation of new tests for the diagnosis of HAT. To set up a specimen bank for HAT first requires the collection of specimens while strictly following good clinical practice principles. The specimens have to be collected in the areas where the disease is endemic, usually remote areas with limited health resources and impoverished affected populations. The specimens collected have to be well identified and kept in strict cold chain from the time of collection to the final storage. To fulfill these conditions is challenging, but we have proved that it is not insurmountable.