The detection and treatment of human African trypanosomiasis
Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT) is caused by the injection of Trypanosoma brucei (T. b.) gambiense or T. b. rhodesien...
Main Authors: | , |
---|---|
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Dove Medical Press
2012
|
Subjects: | |
Online Access: | https://doaj.org/article/4836f4f97a07464aada3858bb9fc4037 |
id |
ftdoajarticles:oai:doaj.org/article:4836f4f97a07464aada3858bb9fc4037 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:4836f4f97a07464aada3858bb9fc4037 2023-05-15T15:13:36+02:00 The detection and treatment of human African trypanosomiasis Bouteille B Buguet A 2012-06-01T00:00:00Z https://doaj.org/article/4836f4f97a07464aada3858bb9fc4037 EN eng Dove Medical Press http://www.dovepress.com/the-detection-and-treatment-of-human-african-trypanosomiasis-a10089 https://doaj.org/toc/1179-7282 1179-7282 https://doaj.org/article/4836f4f97a07464aada3858bb9fc4037 Research and Reports in Tropical Medicine, Vol 2012, Iss default, Pp 35-45 (2012) Arctic medicine. Tropical medicine RC955-962 article 2012 ftdoajarticles 2022-12-31T00:50:14Z Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT) is caused by the injection of Trypanosoma brucei (T. b.) gambiense or T. b. rhodesiense by Glossina, the tsetse fly. Three historical eras followed the exclusive clinical approach of the 19th century. At the turn of the century, the “initial research” era was initiated because of the dramatic spread of HAT throughout intertropical Africa, and scientists discovered the agent and its vector. Two entities, recurrent fever and sleeping sickness, were then considered a continuum between hemolymphatic stage 1 and meningoencephalitic stage 2. Treatments were developed. Soon after World War I, specific services and mobile teams were created, initiating the “epidemiological” era, during which populations were visited, screened, and treated. As a result, by 1960, annual new cases were rare. New mass screening and staging tools were then developed in a third, “modern” era, especially to counter a new epidemic wave. Currently, diagnosis still relies on microscopic detection of trypanosomes without (wet and thick blood films) or with concentration techniques (capillary tube centrifugation, miniature anion-exchange centrifugation technique). Staging is a vital step.Stage 1 patients are treated on site with pentamidine or suramin. However, stage 2 patients are treated in specialized facilities, using drugs that are highly toxic and/or that require complex administration procedures (melarsoprol, eflornithine, or nifurtimox-eflornithine combination therapy). Suramin and melarsoprol are the only medications active against Rhodesian HAT. Staging still relies on cerebrospinal fluid examination for trypanosome detection and white blood cell counts: stage 1, absence of trypanosomes, white blood cell counts ≤ 5/µL; stage 2, presence of trypanosomes, white blood cell counts ≥ 20/µL; T. b. gambiense HAT intermediate stage, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Noire ENVELOPE(140.019,140.019,-66.666,-66.666) Pointe Noire ENVELOPE(-62.583,-62.583,-64.667,-64.667) |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Bouteille B Buguet A The detection and treatment of human African trypanosomiasis |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 |
description |
Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT) is caused by the injection of Trypanosoma brucei (T. b.) gambiense or T. b. rhodesiense by Glossina, the tsetse fly. Three historical eras followed the exclusive clinical approach of the 19th century. At the turn of the century, the “initial research” era was initiated because of the dramatic spread of HAT throughout intertropical Africa, and scientists discovered the agent and its vector. Two entities, recurrent fever and sleeping sickness, were then considered a continuum between hemolymphatic stage 1 and meningoencephalitic stage 2. Treatments were developed. Soon after World War I, specific services and mobile teams were created, initiating the “epidemiological” era, during which populations were visited, screened, and treated. As a result, by 1960, annual new cases were rare. New mass screening and staging tools were then developed in a third, “modern” era, especially to counter a new epidemic wave. Currently, diagnosis still relies on microscopic detection of trypanosomes without (wet and thick blood films) or with concentration techniques (capillary tube centrifugation, miniature anion-exchange centrifugation technique). Staging is a vital step.Stage 1 patients are treated on site with pentamidine or suramin. However, stage 2 patients are treated in specialized facilities, using drugs that are highly toxic and/or that require complex administration procedures (melarsoprol, eflornithine, or nifurtimox-eflornithine combination therapy). Suramin and melarsoprol are the only medications active against Rhodesian HAT. Staging still relies on cerebrospinal fluid examination for trypanosome detection and white blood cell counts: stage 1, absence of trypanosomes, white blood cell counts ≤ 5/µL; stage 2, presence of trypanosomes, white blood cell counts ≥ 20/µL; T. b. gambiense HAT intermediate stage, ... |
format |
Article in Journal/Newspaper |
author |
Bouteille B Buguet A |
author_facet |
Bouteille B Buguet A |
author_sort |
Bouteille B |
title |
The detection and treatment of human African trypanosomiasis |
title_short |
The detection and treatment of human African trypanosomiasis |
title_full |
The detection and treatment of human African trypanosomiasis |
title_fullStr |
The detection and treatment of human African trypanosomiasis |
title_full_unstemmed |
The detection and treatment of human African trypanosomiasis |
title_sort |
detection and treatment of human african trypanosomiasis |
publisher |
Dove Medical Press |
publishDate |
2012 |
url |
https://doaj.org/article/4836f4f97a07464aada3858bb9fc4037 |
long_lat |
ENVELOPE(140.019,140.019,-66.666,-66.666) ENVELOPE(-62.583,-62.583,-64.667,-64.667) |
geographic |
Arctic Noire Pointe Noire |
geographic_facet |
Arctic Noire Pointe Noire |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Research and Reports in Tropical Medicine, Vol 2012, Iss default, Pp 35-45 (2012) |
op_relation |
http://www.dovepress.com/the-detection-and-treatment-of-human-african-trypanosomiasis-a10089 https://doaj.org/toc/1179-7282 1179-7282 https://doaj.org/article/4836f4f97a07464aada3858bb9fc4037 |
_version_ |
1766344139740282880 |