title: A CATT negative result after treatment for human African trypanosomiasis is no indication for cure.
abstract: 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.
authors.affiliation: Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium. vlejon@itg.be
authors.forename: Veerle
authors.initials: V
authors.lastname: Lejon
authors.forename: Dieudonné Mumba
authors.initials: DM
authors.lastname: Ngoyi
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.forename: Philippe
authors.initials: P
authors.lastname: Büscher
mesh_terms: 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
chemical_list: D000913:Antibodies, Protozoan; D014344:Trypanocidal Agents; D010419:Pentamidine; D008549:Melarsoprol; D000518:Eflornithine