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For parasitologic confirmation, a posterior cervical lymph node (if present) is punctured and the fluid examined. The yield in lymph node examination varies from about 40% to 80%. Trypanosomes can also be found in blood, however, the yield is low, and concentration techniques (e. g. buffy coat examination, miniature anion-exchange centrifugation technique) are helpful. Serial examinations on consecutive days may be needed.
Low levels of trypanosomes in circulating blood make it difficult to detect the presence of parasites in blood smears, requiring more sophisticated means of detecting trypanosomes such as with the use of miniature anion-exchange / centrifugation (mAEC) technique. In comparison to the East African form, T. b. gambiense has a longer evolutionary history with humans, having successfully adapted to establishing infections in human hosts without manifesting severe symptoms.
Lumsden WH, Kimber CD, Evans DA, Doig SJ. Trypanosoma brucei: miniature anion-exchange centrifugation technique for detection of low parasitaemias: Adaptation for field use. Trans R Soc Trop Med Hyg. 1979; 73:312-7.