A CATT negative result after treatment for human African trypanosomiasis is no indication for cure.
BACKGROUND
Cure 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.


RESULTS
The 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
Though 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.
Lejon
Veerle
V
Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium. vlejon@itg.be
Ngoyi
Dieudonné Mumba
DM
Boelaert
Marleen
M
Büscher
Philippe
P
D000372:Agglutination Tests / Q000379:methods*; D000913:Antibodies, Protozoan / Q000097:blood; D000518:Eflornithine / Q000627:therapeutic use; D006801:Humans; D008549:Melarsoprol / Q000627:therapeutic use; D010419:Pentamidine / Q000627:therapeutic use; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014353:Trypanosomiasis, African / Q000188:drug therapy* / Q000276:immunology / Q000469:parasitology
D000913:Antibodies, Protozoan; D014344:Trypanocidal Agents; D010419:Pentamidine; D008549:Melarsoprol; D000518:Eflornithine