A CATT Negative Result after Treatment for Human African Trypanosomiasis Is No Indication for Cure |
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| Authors: | Veerle Lejon Dieudonné Mumba Ngoyi Marleen Boelaert Philippe Büscher |
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| Institution: | 1. Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium.; 2. Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.; 3. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.;New York University School of Medicine, United States of America |
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| Abstract: | BackgroundCure after treatment for human African trypanosomiasis (HAT) is assessed by examination of the cerebrospinal fluid every 6 months, for a total period of 2 years. So far, no markers for cure or treatment failure have been identified in blood. Trypanosome-specific antibodies are detectable in blood by the Card Agglutination Test for Trypanosomiasis (CATT). We studied the value of a normalising, negative post-treatment CATT result in treated Trypanosoma brucei (T.b.) gambiense sleeping sickness patients as a marker of cure.Methodology/Principal FindingsThe CATT/T.b. gambiense was performed on serum of a cohort of 360 T.b. gambiense patients, consisting of 242 primary and 118 retreatment cases. The CATT results during 2 years of post-treatment follow-up were studied in function of cure or treatment failure. At inclusion, sensitivity of CATT was 98% (234/238) in primary cases and only 78% (91/117) in retreatment cases. After treatment, the CATT titre decreased both in cured patients and in patients experiencing treatment failure.Conclusions/SignificanceThough CATT is a good test to detect HAT in primary cases, a normalising or negative CATT result after treatment for HAT does not indicate cure, therefore CATT cannot be used to monitor treatment outcome. |
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