Comparison of operational criteria for treatment outcome in gambiense human African trypanosomiasis

被引：8

作者：

Ngoyi, D. Mumba ^{[3
]}

Lejon, V. ^{[1
]}

N'Siesi, F. X. ^{[2
]}

Boelaert, M. ^{[1
]}

Buscher, P. ^{[1
]}

机构：

[1] Inst Trop Med, Natl Str 155, B-2000 Antwerp, Belgium

[2] Minist Hlth, Kinshasa, DEM REP CONGO

[3] Inst Natl Rech Biomed, Kinshasa, DEM REP CONGO

来源：

TROPICAL MEDICINE & INTERNATIONAL HEALTH | 2009年 / 14卷 / 04期

关键词：

African trypanosomiasis; African sleeping sickness; Trypanosoma brucei gambiense; treatment outcome; cerebrospinal fluid; white blood cell count; sensitivity; specificity; relapse; BRUCEI-GAMBIENSE; SLEEPING SICKNESS; COMBINATION THERAPY; CEREBROSPINAL-FLUID; CLINICAL-TRIAL; MELARSOPROL; EFLORNITHINE; NIFURTIMOX; EFFICACY; SCHEDULE;

D O I：

10.1111/j.1365-3156.2009.02248.x

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

To develop a simple and standard operational decision tool for the diagnosis of relapse after treatment for human African trypanosomiasis (HAT), by evaluating the performance of several criteria currently used by HAT control programs and research projects. We identified 10 different criteria for relapse, based on trypanosome presence and/or white blood cell count in cerebrospinal fluid, and compared their specificity, sensitivity and time to diagnosis on a data set containing 63 relapsed and 247 cured T.b. gambiense patients. At any time point, the criterion 'Trypanosomes present and/or a cerebrospinal white blood cell count >= 50/mu l' allowed accurate and timely detection of HAT relapse, irrespective of disease stage. This criterion was 13-25% more sensitive (P <= 0.013) than trypanosome detection alone and was > 97% specific. Lumbar punctures at the end of treatment and at 3-month post-treatment provided limited clinical information. Adequate detection of relapse was possible with a simple criterion but these findings should be validated in a prospective study before adoption in clinical practice.

引用

页码：438 / 444

页数：7

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