Discussion
The HAT prevalence observed among the study participants during the 3 years of passive screening was 2.0%. The overall HAT prevalence reported by the national program in passive screening in the same prefectures in 2017 and 2018 was respectively 0.98 and 0.39% [Although there may be geographical and stage specific variations, the clinical picture of HAT has been described in detail [The combined seroprevalence during this study was 5.2%, ranging from 1.9 to 4.7% for the individual RDTs. As for the HAT prevalence, this was again higher than the overall seroprevalence of 1.72% and 0.98% previously reported in 2017 and 2018 [Evaluation of the diagnostic performance of the parasitological tests was not an objective of our study and not all tests were systematically performed on all RDT positives, but our results confirm the relatively high sensitivity of lymph examination in Guinea [Unfortunately, DBS were missing for a relatively high number of RDT positives. The specificity of the 4 reference laboratory tests in this study was similar as for passive screening in Côte d’Ivoire [Some limitations of this multi-country study have already been discussed in detail elsewhere [The actual study also has important strengths. The high HAT prevalence in Guinea allowed us to assess the association between clinical symptoms and signs and HAT in Guinea and the diagnostic performance of the combination of 4 key clinical presentations, 3 RDTs, and consequent reference laboratory tests on DBS of RDT positives. A similar study in Côte d’Ivoire [