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dc.contributor.authorEperon, G
dc.contributor.authorSchmid, C
dc.contributor.authorLoutan, L
dc.contributor.authorChappuis, F
dc.date.accessioned2008-02-29T08:57:26Z
dc.date.available2008-02-29T08:57:26Z
dc.date.issued2007-01
dc.identifier.citationClinical Presentation and Treatment Outcome of Sleeping Sickness in Sudanese Pre-School Children. 2007, 101 (1):31-9 Acta Trop.en
dc.identifier.issn0001-706X
dc.identifier.pmid17207760
dc.identifier.doi10.1016/j.actatropica.2006.12.002
dc.identifier.urihttp://hdl.handle.net/10144/19397
dc.description.abstractBACKGROUND: Existing data on human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense among children are limited. Here, we described the demographic, clinical, diagnostic, treatment and outcome characteristics of HAT in pre-school children from Kajo-Keji County, South Sudan in comparison with older patients. METHODS: We did a retrospective analysis of HAT patients treated at the Kiri Sleeping Sickness Treatment Centre (SSTC), Kajo-Keji County, from June 2000 to December 2002. RESULTS: Of 1958 HAT patients, 119 (6.1%) were pre-school children (<6 years) including 56 (47%) in first-stage illness and 63 (53%) in second-stage. The proportion of children in second-stage HAT was significantly higher in very young children (<2 years). Walking and speech disturbances were more frequent in second-stage HAT but other neurological symptoms and signs were not associated with disease stage. Pentamidine treatment for first-stage illness was very safe and effective among pre-school children. In contrast, 4.9% of pre-school children in second-stage illness died during melarsoprol treatment and 46% had > or = 1 severe adverse event(s). Macular rash, jaundice and skin necrosis on injection site were significantly more frequent in this age group (p<0.05). Melarsoprol-induced encephalopatic syndrome was less frequent but more severe than in older age groups. CONCLUSION: The clinical features of T. b. gambiense HAT among pre-school children are insufficiently stage-specific. Therefore, laboratory-based staging is mandatory to prevent unnecessary harm to HAT patients caused by the high toxicity of melarsoprol.
dc.language.isoenen
dc.relation.urlhttp://www.sciencedirect.com/science/journal/0001706X.
dc.rightsArchived on this site with kind permission from Elsevier copyright 2007.en
dc.subject.meshAdolescenten
dc.subject.meshAge Factorsen
dc.subject.meshAnimalsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfusions, Intravenousen
dc.subject.meshInjections, Intramuscularen
dc.subject.meshMelarsoprolen
dc.subject.meshPentamidineen
dc.subject.meshRetrospective Studiesen
dc.subject.meshSudanen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTrypanocidal Agentsen
dc.subject.meshTrypanosoma brucei gambienseen
dc.subject.meshTrypanosomiasis, Africanen
dc.titleClinical Presentation and Treatment Outcome of Sleeping Sickness in Sudanese Pre-School Children.en
dc.contributor.departmentMédecins Sans Frontières, Rue de Lausanne 78, 1202 Geneva, Switzerland.en
dc.identifier.journalActa Tropicaen
html.description.abstractBACKGROUND: Existing data on human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense among children are limited. Here, we described the demographic, clinical, diagnostic, treatment and outcome characteristics of HAT in pre-school children from Kajo-Keji County, South Sudan in comparison with older patients. METHODS: We did a retrospective analysis of HAT patients treated at the Kiri Sleeping Sickness Treatment Centre (SSTC), Kajo-Keji County, from June 2000 to December 2002. RESULTS: Of 1958 HAT patients, 119 (6.1%) were pre-school children (<6 years) including 56 (47%) in first-stage illness and 63 (53%) in second-stage. The proportion of children in second-stage HAT was significantly higher in very young children (<2 years). Walking and speech disturbances were more frequent in second-stage HAT but other neurological symptoms and signs were not associated with disease stage. Pentamidine treatment for first-stage illness was very safe and effective among pre-school children. In contrast, 4.9% of pre-school children in second-stage illness died during melarsoprol treatment and 46% had > or = 1 severe adverse event(s). Macular rash, jaundice and skin necrosis on injection site were significantly more frequent in this age group (p<0.05). Melarsoprol-induced encephalopatic syndrome was less frequent but more severe than in older age groups. CONCLUSION: The clinical features of T. b. gambiense HAT among pre-school children are insufficiently stage-specific. Therefore, laboratory-based staging is mandatory to prevent unnecessary harm to HAT patients caused by the high toxicity of melarsoprol.


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