Card Agglutination Test for Trypanosomiasis (CATT) End-Dilution Titer and Cerebrospinal Fluid Cell Count as Predictors of Human African Trypanosomiasis (Trypanosoma brucei gambiense) Among Serologically Suspected Individuals in Southern Sudan.

Hdl Handle:
http://hdl.handle.net/10144/17233
Title:
Card Agglutination Test for Trypanosomiasis (CATT) End-Dilution Titer and Cerebrospinal Fluid Cell Count as Predictors of Human African Trypanosomiasis (Trypanosoma brucei gambiense) Among Serologically Suspected Individuals in Southern Sudan.
Authors:
Chappuis, F; Stivanello, E; Adams, K; Kidane, S; Pittet, A; Bovier, P A
Journal:
American Journal of Tropical Medicine and Hygiene
Abstract:
The diagnosis of human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense relies on an initial serologic screening with the card agglutination test for trypanosomiasis (CATT) for T. b. gambiense, followed by parasitologic confirmation in most endemic areas. Unfortunately, field parasitologic methods lack sensitivity and the management of serologically suspected individuals (i.e., individuals with a positive CATT result but negative parasitology) remains controversial. In Kajo-Keji County in southern Sudan, we prospectively collected sociodemographic and laboratory data of a cohort of 2,274 serologically suspected individuals. Thirty-three percent (n = 749) attended at least one follow-up visit and HAT was confirmed in 64 (9%) cases. Individuals with lower initial CATT-plasma (CATT-P) end-dilution titers had lowest risks (10.4 and 13.8/100 person-years for 1:4 and 1:8 titers, respectively) that significantly increased for higher dilutions: relative risks = 5.1 (95% confidence interval [CI] = 2.6-9.5) and 4.6 (95% CI = 2.8-9.8) for 1:16 and 1:32 titers, respectively. The cumulative yearly risk was also high (76%) in individuals found with 11-20 cells in the cerebrospinal fluid, but this involved only eight patients. Adjustment for potential confounders did not affect the results. In conclusion, treatment with pentamidine should be considered for all serologically suspected individuals with a CATT-P end-dilution titer >/= 1:16 in areas of a moderate to high prevalence of HAT.
Affiliation:
Médecins Sans Frontières, Swiss Section, Geneva, Switzerland. francois.chappuis@hcuge.ch
Publisher:
Published by: American Society of Tropical Medicine and Hygiene
Issue Date:
Sep-2004
URI:
http://hdl.handle.net/10144/17233
PubMed ID:
15381812
Additional Links:
http://www.ajtmh.org
Language:
en
ISSN:
0002-9637
Appears in Collections:
Trypanosomiasis/Sleeping Sickness

Full metadata record

DC FieldValue Language
dc.contributor.authorChappuis, F-
dc.contributor.authorStivanello, E-
dc.contributor.authorAdams, K-
dc.contributor.authorKidane, S-
dc.contributor.authorPittet, A-
dc.contributor.authorBovier, P A-
dc.date.accessioned2008-01-31T14:50:11Z-
dc.date.available2008-01-31T14:50:11Z-
dc.date.issued2004-09-
dc.identifier.citationCard Agglutination Test for Trypanosomiasis (CATT) End-Dilution Titer and Cerebrospinal Fluid Cell Count as Predictors of Human African Trypanosomiasis (Trypanosoma brucei gambiense) Among Serologically Suspected Individuals in Southern Sudan. 2004, 71 (3):313-7 Am. J. Trop. Med. Hyg.-
dc.identifier.issn0002-9637-
dc.identifier.pmid15381812-
dc.identifier.urihttp://hdl.handle.net/10144/17233-
dc.description.abstractThe diagnosis of human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense relies on an initial serologic screening with the card agglutination test for trypanosomiasis (CATT) for T. b. gambiense, followed by parasitologic confirmation in most endemic areas. Unfortunately, field parasitologic methods lack sensitivity and the management of serologically suspected individuals (i.e., individuals with a positive CATT result but negative parasitology) remains controversial. In Kajo-Keji County in southern Sudan, we prospectively collected sociodemographic and laboratory data of a cohort of 2,274 serologically suspected individuals. Thirty-three percent (n = 749) attended at least one follow-up visit and HAT was confirmed in 64 (9%) cases. Individuals with lower initial CATT-plasma (CATT-P) end-dilution titers had lowest risks (10.4 and 13.8/100 person-years for 1:4 and 1:8 titers, respectively) that significantly increased for higher dilutions: relative risks = 5.1 (95% confidence interval [CI] = 2.6-9.5) and 4.6 (95% CI = 2.8-9.8) for 1:16 and 1:32 titers, respectively. The cumulative yearly risk was also high (76%) in individuals found with 11-20 cells in the cerebrospinal fluid, but this involved only eight patients. Adjustment for potential confounders did not affect the results. In conclusion, treatment with pentamidine should be considered for all serologically suspected individuals with a CATT-P end-dilution titer >/= 1:16 in areas of a moderate to high prevalence of HAT.-
dc.language.isoen-
dc.publisherPublished by: American Society of Tropical Medicine and Hygiene-
dc.relation.urlhttp://www.ajtmh.org-
dc.rightsArchived on this site with the kind permission of the American Society of Tropical Medicine and Hygiene, www.astmh.orgen_GB
dc.subject.meshAdolescent-
dc.subject.meshAgglutination Tests-
dc.subject.meshAnimals-
dc.subject.meshCell Count-
dc.subject.meshCerebrospinal Fluid-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshCohort Studies-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfant-
dc.subject.meshInfant, Newborn-
dc.subject.meshMale-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshRetrospective Studies-
dc.subject.meshSudan-
dc.subject.meshTrypanosoma brucei gambiense-
dc.subject.meshTrypanosomiasis, African-
dc.titleCard Agglutination Test for Trypanosomiasis (CATT) End-Dilution Titer and Cerebrospinal Fluid Cell Count as Predictors of Human African Trypanosomiasis (Trypanosoma brucei gambiense) Among Serologically Suspected Individuals in Southern Sudan.-
dc.contributor.departmentMédecins Sans Frontières, Swiss Section, Geneva, Switzerland. francois.chappuis@hcuge.ch-
dc.identifier.journalAmerican Journal of Tropical Medicine and Hygiene-

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