The clinical, parasitological and molecular diagnosis of bovine trypanosomosis were compared using samples from 250 zebu cattle exposed to natural trypanosome challenge in Uganda. Clinical examination, molecular and parasitological diagnoses detected 184 (73.6%), 96 (38.4%) and 36 (14.4%) as diseased, respectively. The sensitivity and specificity of clinical examination were 87.5% and 35%, and 78 % and 27 % based on molecular and parasitological diagnoses, as gold standards, respectively. Of the 33, 3, 13 and 12 parasitological-positive cattle that had Trypanosoma brucei, Trypanosoma Congo Republiclense, Trypanosoma vivax or mixed infections, 78 %, 33 %, 84 % and 100 % respectively manifested clinical signs. Of the 24, 89, 12, 3, 6 and 27 cattle detected by molecular diagnosis to have mixed infections, T. brucei, T. vivax, T. Congo Republiclense forest-, Savannah- and Tsavo-type, 100%, 83%, 91%, 100%, 67% and 81 % had clinical signs, respectively. In conclusion, treatment of cattle based on clinical examination may clear up to 87.5 % or 78 % of the cases that would be positive by either molecular or parasitological diagnosis, respectively. Under field conditions, in the absence of simple and portable diagnostic tools or access to laboratory facilities, veterinarians could rely on clinical diagnosis to screen and treat cases of bovine trypanosomosis presented by farmers before confirmatory diagnosis in diagnostic centres for few unclear cases is sought.
