Abstract
Gambiense human African trypanosomiasis (gHAT), also known as gambiense sleeping sickness, is a parasitic infection caused by Trypanosoma brucei gambiense. During the last decades, gHAT incidence has been brought to an all-time low. Newly developed serological tools and drugs for its diagnosis and treatment put the WHO goal of interruption of transmission by 2030 within reach. However, further research is needed to efficiently adapt these new advances to new control strategies. We assessed the serological evolution of cured gHAT patients over a two-year period using four different tests: the rapid diagnostic test (RDT) HAT Sero K-SeT, ELISA/T.b. gambiense, Trypanosoma brucei gambiense inhibition ELISA (iELISA), and the immune trypanolysis test. High seropositive rates were observed in all the tests, although sero-reversion rates were different in each test: ELISA/T.b. gambiense was the test most likely to become negative two years after treatment, whereas RDT HAT Sero-K-SeT was the least likely. iELISA and trypanolysis showed intermediate and comparable probabilities to become negative. Stage 1 patients were also noted to be more likely to become negative than Stage 2 patients in all four serological tests. Our results confirm previous findings that trypanosome-specific antibody concentrations in blood may persist for up to two years, implying that HAT control programs should continue to take the history of past HAT episodes into consideration.
Highlights
Human African trypanosomiasis (HAT) or sleeping sickness is caused by the parasites Trypanosoma brucei gambiense (T.b. gambiense) in West and Central Africa and by T.b. rhodesiense in East Africa. Gambiense human African trypanosomiasis (gHAT) is the chronic form and accounts for >85% of the reported HAT cases
At the end of the treatment, high seropositivity rates were observed in all tests: 100% with the rapid diagnostic test (RDT), inhibition enzyme-linked immunosorbent assay (ELISA) (iELISA), and TL and 94% with ELISA
With the perspective of a ‘screen and treat’ strategy for the elimination of gHAT, we conducted this study to assess if the antibody response is still detectable in cured patients up to two years after treatment with the different serological tests that are expected to be used in gHAT control in the near future
Summary
Human African trypanosomiasis (HAT) or sleeping sickness is caused by the parasites Trypanosoma brucei gambiense (T.b. gambiense) in West and Central Africa (gambiense HAT or gHAT) and by T.b. rhodesiense in East Africa (rhodesiense HAT or rHAT). gHAT is the chronic form and accounts for >85% of the reported HAT cases. Human African trypanosomiasis (HAT) or sleeping sickness is caused by the parasites Trypanosoma brucei gambiense (T.b. gambiense) in West and Central Africa (gambiense HAT or gHAT) and by T.b. rhodesiense in East Africa (rhodesiense HAT or rHAT). After a major peak in gHAT cases in the late 1990s, much progress has been made in recent years and the disease is at its lowest incidence ever; globally, less than 1000 annual cases were reported in 2019 and 2020 [4]. Encouraged by these successes, WHO has set a target of elimination of transmission of gHAT by 2030 [5]. Mainly by mobile teams who screen populations at-risk with the Card Agglutination Test for Trypanosomiasis (CATT) or rapid diagnostic tests (RDTs) and who treat parasitologically confirmed patients, have led to this remarkable progress [6]
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