In vitro assays to determine drug sensitivities of African trypanosomes: a review.

In vitro test methods have been developed both for determining the sensitivity of isolates of pathogenic African trypanosomes and for evaluating new compounds for antitrypanosomal activity. The principles of the assays and their main advantages or drawbacks are presented and discussed. In vitro assays which do not require trypanosomes pre-adapted to culture conditions are the Drug Incubation Infectivity Test (DIIT) and the [3H]Hypoxanthine Incorporation Assay. Chemosensitivity tests which do require continuous growth of trypanosomes in vitro include photometric, fluorescence, growth inhibition, long-term viability and metacyclic incubation assays. Evidence is presented to use metacyclic or bloodstream forms in such assays but to avoid procyclic trypanosomes. The drug sensitivity of a homogeneous trypanosome population can be quantified by using photometric, fluorescence or growth inhibition assays lasting 1-3 days. Small numbers of resistant organisms hidden in a sensitive population can be detected employing long-term viability assays (7-10 days). Final selection of the assay to be employed will depend on the parameter to be investigated, and the equipment available.