Trypanosoma brucei gambiense in domestic livestock of Kogo and Mbini foci (Equatorial Guinea).

OBJECTIVE: To evaluate Trypanosoma brucei gambiense infection in peri-domestic livestock from Kogo and Mbini foci (Equatorial Guinea) in order to investigate its possible implication in the sleeping sickness transmission cycle in these hypoendemic foci. METHODS: Samples from 698 domestic animals (goats, sheep and pigs) from trypanosomiasis-endemic localities of Kogo and Mbini foci were tested for animal trypanosomes and T. b. gambiense (group I) by species-specific polymerase chain reaction. RESULTS: Trypanosoma brucei s.l., the predominant trypanosome species, was detected in 182 (52.6%) samples from Mbini and in 127 (36.1%) samples from Kogo. T. b. gambiense was only identified in seven (2%) of the Mbini samples and one co-infection (with T. vivax) was observed. CONCLUSION: The occurrence of T. b. gambiense in peri-domestic livestock in Mbini and its absence in Kogo could explain the epidemiological differences between the two foci and could have significant implications for sleeping sickness control in Equatorial Guinea

Effectiveness of a 10-day melarsoprol schedule for the treatment of late-stage human African trypanosomiasis: confirmation from a multinational study (IMPAMEL II).

BACKGROUND: Treatment of late-stage human African trypanosomiasis (HAT) with melarsoprol can be improved by shortening the regimen. A previous trial demonstrated the safety and efficacy of a 10-day treatment schedule. We demonstrate the effectiveness of this schedule in a noncontrolled, multinational drug-utilization study. METHODS: A total of 2020 patients with late-stage HAT were treated with the 10-day melarsoprol schedule in 16 centers in 7 African countries. We assessed outcome on the basis of major adverse events and the cure rate after treatment and during 2 years of follow-up. RESULTS: The cure rate 24 h after treatment was 93.9%; 2 years later, it was 86.2%. However, 49.3% of patients were lost to follow-up. The overall fatality rate was 5.9%. Of treated patients, 8.7% had an encephalopathic syndrome that was fatal 45.5% of the time. The rate of severe bullous and maculopapular eruptions was 0.8% and 6.8%, respectively. CONCLUSIONS: The 10-day treatment schedule was well implemented in the field and was effective. It reduces treatment duration, drug amount, and hospitalization costs per patient, and it increases treatment-center capacity. The shorter protocol has been recommended by the International Scientific Council for Trypanosomiasis Research and Control for the treatment of late-stage HAT caused by Trypanosoma brucei gambiense

Effectiveness of a 10-Day Melarsoprol Schedule for the Treatment of Late-Stage Human African Trypanosomiasis: Confirmation from a Multinational Study (Impamel II)

BackgroundTreatment of late-stage human African trypanosomiasis (HAT) with melarsoprol can be improved by shortening the regimen. A previous trial demonstrated the safety and efficacy of a 10-day treatment schedule. We demonstrate the effectiveness of this schedule in a noncontrolled, multinational drug-utilization study MethodsA total of 2020 patients with late-stage HAT were treated with the 10-day melarsoprol schedule in 16 centers in 7 African countries. We assessed outcome on the basis of major adverse events and the cure rate after treatment and during 2 years of follow-up ResultsThe cure rate 24 h after treatment was 93.9%; 2 years later, it was 86.2%. However, 49.3% of patients were lost to follow-up. The overall fatality rate was 5.9%. Of treated patients, 8.7% had an encephalopathic syndrome that was fatal 45.5% of the time. The rate of severe bullous and maculopapular eruptions was 0.8% and 6.8%, respectively ConclusionsThe 10-day treatment schedule was well implemented in the field and was effective. It reduces treatment duration, drug amount, and hospitalization costs per patient, and it increases treatment-center capacity. The shorter protocol has been recommended by the International Scientific Council for Trypanosomiasis Research and Control for the treatment of late-stage HAT caused by Trypanosoma brucei gambiens

Le foyer de trypanosomiase humaine de Campo (Cameroun) en 1998 : aspects épidémiologiques, état de l'endémie et comparaison des CATT 1.3 et CATT Latex dans le dépistage de masse

Pour la première fois depuis 13 ans, le foyer de trypanosomiase humaine de Campo, à cheval sur la frontière entre Cameroun et Guinée Equatoriale, a été prospecté. Le dépistage s'est fait conjointement des 2 côtés de la frontière. Nous avons profité de cette occasion pour comparer le Card Agglutination Test for Trypanosomiasis (CATT) de type antigénique LiTat 1.3 classiquement utilisé dans les prospections, au CATT Latex, qui consiste en une suspension lyophilisée de latex couvert d'antigènes de surface variables de formes sanguicoles de #Trypanosoma brucei gambiense de types antigéniques LiTat 1.3, 1.5, 1.6. Nous avons également recherché l'existence de réactions sérologiques croisées entre trypanosomes, d'une part, et #plasmodium et microfilaires, d'autre part. Les résultats obtenus montrent que le foyer de Campo est un foyer Camerounais centré sur le village d'Ipono et de faible prévalence (0,3%). La persistance de l'endémie pourrait être liée à la présence d'un réservoir porcin à Ipono. Le CATT Latex a présenté, à la dilution de 1/4, une spécificité nettement supérieure (76,5%) à celle du CATT 1.3 au seuil de 1+ (42,8%). Au seuil de 1/8ème la spécificité du CATT Latex était de 93,8%. Pour les 2 CATT la sensibilité était de 100%. L'utilisation du CATT Latex en place du CATT 1.3 diminuerait, au seuil de 1/8ème, la charge de travail de près de 8 fois et le coût de 3 fois. Il n'y avait pas de réaction croisée avec les $plasmodium$ et les microfilaires. Il reste à le confirmer et à valider le seuil de détection dans un foyer de forte prévalence. (Résumé d'auteur

Screening of Trypanosoma brucei gambiense in domestic livestock and tsetse flies from an insular endemic focus (Luba, Equatorial Guinea).

BACKGROUND: Sleeping sickness is spread over 36 Sub-Saharan African countries. In West and Central Africa, the disease is caused by Trypanosoma brucei gambiense, which produces a chronic clinical manifestation. The Luba focus (Bioko Island, Equatorial Guinea) has not reported autochthonous sleeping sickness cases since 1995, but given the complexity of the epidemiological cycle, the elimination of the parasite in the environment is difficult to categorically ensure. METHODOLOGY/PRINCIPAL FINDINGS: The aim of this work is to assess, by a molecular approach (Polymerase Chain Reaction, PCR), the possible permanence of T. b. gambiense in the vector (Glossina spp.) and domestic fauna in order to improve our understanding of the epidemiological situation of the disease in an isolated focus considered to be under control. The results obtained show the absence of the parasite in peridomestic livestock but its presence, although at very low rate, in the vector. On the other hand, interesting entomological data highlight that an elevated concentration of tsetse flies was observed in two out of the ten villages considered to be in the focus. CONCLUSIONS: These findings demonstrate that even in conditions of apparent control, a complete parasite clearance is difficult to achieve. Further investigations must be focused on animal reservoirs which could allow the parasites to persist without leading to human cases. In Luba, where domestic livestock are scarcer than other foci in mainland Equatorial Guinea, the epidemiological significance of wild fauna should be assessed to establish their role in the maintenance of the infection

Towards static performance guarantees for programs with run-time checks

This document is an extended abstract of the Technical Report CLIP-1/2018.