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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
refterms.dateFOA2019-03-04T08:56:12Z
html.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.


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