Cultivation of the African sleeping sickness trypanosomes from the blood and cerebrospinal fluid of patients and suspects

Abstract

1. The method described made it possible to cultivate T. gambiense and T. rhodesiense readily from patients. 2. Cultures were established with equal ease from blood or from spinal fluid. 3. The method proved to be sensitive, detecting blood and spinal fluid infections ignored by current diagnostic procedures. Thus, approximately 20 per cent. of “negative suspects” from an epidemic area were shown to be infected. Conventional methods were particularly poor for cerebrospinal fluid examination, detecting only 10 per cent. of those obtained by culture. 4. The method is reliable. We have no evidence that trypanosomes failed to grow in pure culture. However, under African field and hospital conditions, many cultures were inconclusive because of contamination. 5. An independent means for estimating the accuracy of conventional diagnostic methods is now provided. It is clear that these conventional methods are often in error, and that the error is always in one direction: that of underestimation. Accordingly, certain earlier investigations require re-evaluation, since failure to detect trypanosomes signifies not that the micro-organisms were absent, as was supposed, but only that the limit of sensitivity of the method had been reached. 6. The culture method should prove to be a useful tool for the investigation of a number of problems which have hitherto resisted analysis.