[Correspondence of the World Health Organization relative to the editorial by T. Ancelle (Med. Trop. 1996; 56: 347-348)].
Explore the source record for details and available documents.
Africa↗
Biomedical subjects
J Jannin
Publications and source records attributed to J Jannin.
[Where is the focus of human trypanosomiasis in Mossaka (Congo)].
The Mossaka focus of sleeping sickness (on the Sangha, Cuvette area, in Congo) has been progressing dramatically for last years. In 1989, after a prospection we had accomplished in the focus, we had insisted on the priority to limit an extension of the disease. Since then the situation get worse, regarding to the number of patients detected (74 in 1987, 171 in 1989, 200 in 1991) and the concerned population. The number of villages where we detected patients is raised from 3 in 1987 to 12 in 1989 and 17 in 1991. If measures are not taken quickly, we can await a dramatic extension of lower Sangha focus.
Congo↗
[African human trypanosomiasis: study of a scoring system of presumptive diagnosis in the Congo].
A case-control study was carried out in the Congo to define a scoring system based on a number of clinical and epidemiological criteria of African trypanosomiasis due to Trypanosoma brucei gambiense which could be used by peripheral health services to establish a diagnosis. The survey comprised 163 cases and 326 controls. Clinical signs and symptoms were fever, headache, pruritus and skin lesions due to scratching, diarrhoea, oedema, cervical adenopathies, sleep rhythm disturbances, changes in appetite, amenorrhoea or impotence, mental confusion, neurological signs, and other minor clinical disturbances. Other criteria were a history of previous trypanosomiasis and the presence of domestic animals in the home environment. Analysis of the results showed that neither a single criterion nor a group of criteria is pathognomonic for the disease. The selected criteria do not allow discrimination of sleeping sickness patients among suspected individuals who present themselves. A scoring system is therefore of little use at the peripheral level of health services, particularly when considering the additional workload involved. The low diagnostic value of these clinical signs and symptoms and other indicators in African trypanosomiasis stresses the difficulty in developing an early warning tool for an integrated control strategy in primary health care.
Adolescent↗
[Current recrudescence of human trypanosomiasis in the Sangha focus (basin) in the Congo].
In the Congo the Sangha focus of sleeping sickness caused more than 500,000 deaths in the early 20th century. Despite many years of quiescence many new cases have been detected since the early eighties. In 1987 an investigation found 43 infected patients within 5 villages (during the same year, 74 cases were detected from both investigation and passive detection). In December 1989 our further investigation found 96 new documented cases (115 for the whole year). The prevalence is increasing and the proportion of early stage in comparison with later stage is decreasing. The age diagram resembles that of the early 20th century. Despite the fact that the survey in 1989, extracted twice as many patients as in 1987 passive detection detected 99 infected patients in 1990, three times as many cases as in 1988, and places the "Sangha focus" in IId place in the Congo, after the "Bouenza focus". As only river transport is available to have access to that focus, the Congo will be faced with considerable difficulties in the future.
Animals↗
[Absence of epidemiologic interrelations between retroviral infection by HIV and human African trypanosomiasis (HAT)].
Authors are reporting results from 3 control-case surveys carried out in sleeping sickness foci in Cameroon, Central African Republic and Congo. HIV seroprevalence rates are comparable among sleeping sickness patients and trypanonegative control persons. These results lead towards the absence of inter-relationships between sleeping sickness and retroviral infection.
Adult↗
Absence of epidemiological inter-relations between HIV infection and African human trypanosomiasis in central Africa.
Explore the source record for details and available documents.
Adult↗
[Interpretation of the CATT (Card Agglutination Trypanosomiasis Test) in the screening for human trypanosomiasis due to Trypanosoma brucei gambiense].
Mass screening for Gambiense sleeping sickness is usually done with the Card Agglutination Trypanosomiasis Test (CATT) in series (total blood CATT followed by a serum CATT if the first test is positive) and the search for trypanosomes in cervical adenopathies. At present, the double positives (blood CATT and serum CATT) as well as the subjects in whom the trypanosome was found (in the blood or gland juice) are treated. The existence of patients whose gland punction was proved positive whereas the total blood CATT remained negative, has led the authors to make a survey with the CATT in parallel (on blood and serum CATT) on a 2,030 subjects sample in the Boko Songho site (Congo-Bouenza area). Whereas the prevalence of the positive cases to blood CATT and serum CATT (CATT in series) is 6.8%, the prevalence of the positive cases to at least one of both CATT's (CATT in parallel) is 19%. The 12.2% discordant results (blood+/serum- or blood-/serum+) have been reexamined a month later with the CATT and with the indirect Fluorescent Antibody Test (IFAT). Among these, 22.3% had become positive to blood and serum, whereas 30.6% had become negative. The latter group presents the problem of cross-reactions. The authors performed an IFAT with Trypanosoma congolense (T.c.) as antigen on an 18 subjects sample with a discordant CATT. All IFAT performed with T.c. were positive to a 1/50th threshold whereas some of the serum remained negative with IFAT when Trypanosoma brucei gambiense had been used as an antigen.(ABSTRACT TRUNCATED AT 250 WORDS)
Agglutination Tests↗
[Endemic leprosy in the People's Republic of Congo. An epidemiological and behavioral analysis].
The authors report the results of a national prevalence survey of leprosy made in 1989 in Popular Republic of Congo. Leprosy is essentially found in rural areas and frequently causes disabilities. The prevalence rate is 5.8 +/- 2.6% among people more than 15 years of age, and 10.5% of all forms are multibacillary. All patients are under DDS monotherapy. One overwhelming risk factor is leprosy cases in the family history; active case-finding and surveillance of contact cases are recommended. Generally, leprosy is poorly understood by the general population; an educational effort is necessary.
Adolescent↗
Serum lipid and lipoprotein abnormalities in human African trypanosomiasis.
We have studied the serum lipoprotein system in human African trypanosomiasis (Trypanosoma brucei gambiense infection). The study was carried out on 74 Congolense patients suffering from sleeping sickness and 34 Congolense control subjects living in the endemic region of Boko Songho. We have determined the serum concentrations of lipids (triglycerides, cholesterol, phospholipids) and apolipoproteins (apolipoprotein A-I and B), and the separation of serum lipoproteins by electrophoresis. For the patients infected with T. b. gambiense, in comparison with control subjects, the results have shown (i) a significant increase in triglyceride concentration and a decrease in cholesterol concentration; (ii) a significant rise in apolipoprotein B concentration and a significant reduction in apolipoprotein A-I concentration; and (iii) an increase in low density lipoproteins and a decrease in high density lipoproteins. We conclude, therefore, that human African trypanosomiasis is associated with marked alterations in the composition and levels of host lipoproteins.
Adolescent↗
[Epidemiology of endemic leprosy in the People's Republic of the Congo. Risk factors and markers].
A national prevalence survey of leprosy was made in june 1989 in Popular Republic of Congo: authors report results. The prevalence rate is 5.8% +/- 2.6% among people more than 15 years of age, and 10.5% of all forms are multibacillary. All patients are under DDS monotherapy. One overwhelming risk factor is leprosy antecedents in the family history; active case-finding and surveillance of contacts are recommended.
Adolescent↗
[A trial treatment with eflornithine of trypanosomiasis caused by Trypanosoma brucei gambiense in the Peoples Republic of the Congo].
In a multiclinic trial in Brazzaville, Congo, 14 patients with late-stage Trypanosoma brucei gambiense trypanosomiasis were treated with eflornithine. All cases had previously been treated with one or several courses of melarsoprol. Eflornithine treatment consisted of 400 mg/kg/day intravenously for 14 days followed by 300 mg/kg/day orally for 21 days. After treatment all patients had a disappearance of trypanosomes from cerebrospinal fluid (CSF), a normalization of CSF WBC count, and, where present prior to study, a clear, rapid and lasting amelioration of neurological signs. Neither clinical nor biological adverse effects necessitated modifying or discontinuing treatment. These encouraging results in melarsoprol-refractory cases demonstrate, despite certain logistical problems, the interest of eflornithine in the treatment of human African trypanosomiasis.
Administration, Oral↗