Attitude towards CATT-positive individuals without parasitological confirmation in the African Trypanosomiasis (T.b. gambiense) focus of Quiçama (Angola)

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Abstract:

Summary

Serologically positive individuals without parasitological confirmation constitute an important problem for trypanosomiasis control programmes because of epidemiological and therapeutical consequences. In July 1997, in the focus of Quiçama (Angola), 4753 individuals were screened using CATT/T.b.gambiense on whole blood. In CATT-positive but parasite-negative individuals, CATT titration on serum was performed. Sixteen individuals showing an end-titre lower than 1/4 were considered noninfected according to the results of a previous study of serological status of parasitologically confirmed cases; 86 individuals with end titres ≥ 1/4 were considered suspected of trypanosomiasis and were followed-up from July 1997 to July 1998 with controls every three months. After one year, 32 individuals whose antibody titres dropped < 1/4 were considered noninfected, 22 were confirmed by demonstration of parasites, 17 were further followed-up because antibody titres remained ≥ 1/8 but parasites could not be found. Fifteen individuals did not show up for testing. Following the usual criterion, only parasitologically confirmed cases were treated. However, if it had been decided to treat parasite-negative individuals with a CATT end-titre > 1/8, 22 initially unconfirmed but infected individuals would have been treated earlier, whereas 5 noninfected individuals would have been treated unnecessarily. CATT titration on diluted serum or plasma is useful for making therapeutical decisions.

Keywords: Angola; CATT; control programme; sleeping sickness; trypanosomiasis

Document Type: Research Article

DOI: http://dx.doi.org/10.1046/j.1365-3156.1999.00494.x

Affiliations: 1: Medicus Mundi Catalunya, Hospital de Muxima, Angola 2: Fundació CIDOB, Centro de Control de la Tripanosomiasis (C.C.T.), Bata, Guinea Ecuatorial 3: Ministerio de Saude, Programa Nacional de Tripanosomiasse, Angola

Publication date: December 1, 1999

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