[Control of Trypanosoma gambiense trypanosomiasis. Evaluation of a strategy based on the treatment of serologically suspected cases with a single dose of diminazene].

H Bruneel, A van den Eeckhout, D Molisho, J Burke, D Degroof, J Pépin
{"title":"[Control of Trypanosoma gambiense trypanosomiasis. Evaluation of a strategy based on the treatment of serologically suspected cases with a single dose of diminazene].","authors":"H Bruneel,&nbsp;A van den Eeckhout,&nbsp;D Molisho,&nbsp;J Burke,&nbsp;D Degroof,&nbsp;J Pépin","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>A novel method for the control of T.b. gambiense trypanosomiasis was evaluated in an endemic focus of Zaïre where a high incidence had persisted despite massive participation in active case-finding surveys based on lymph node puncture. All inhabitants of 3 villages were examined with a card agglutination serological test (CATT), and parasitological examinations were performed on those who were CATT+. Individuals in whom we detected trypanosomes were treated as usual. A lumbar puncture was carried out on CATT+/parasitology- subjects; those whose cerebrospinal fluid showed more than 3 white blood cell (WBC) per mm3 were treated with a full course of melarsoprol while those with a CSF WBC count between 1 and 3 per mm3 were given a single injection of diminazene (7 mg/kg). Three such surveys were performed, with a 6-month interval, during which 282 \"serological suspects\" received diminazene, 39 \"clinical cases\" were given melarsoprol and 82 \"parasitological cases\" were treated according to standard protocols. The annual incidence of trypanosomiasis decreased rapidly from 10.4-41.1/1.000 inhabitants (mean: 17.6/1.000) during the 10 years before the intervention to 1.1-2.6/1.000 (mean: 1.7/1.000) in the 3 years following the intervention. No major adverse effect was seen with diminazene. Among the 282 serological suspects, an elevated CSF WBC count was later documented in 12 individuals, who were all cured with melarsoprol. The incidence increased 5 years after the intervention (7.1/1.000 in 1992), which may have been avoided had we carried out similar interventions in adjacent foci.</p>","PeriodicalId":7901,"journal":{"name":"Annales de la Societe belge de medecine tropicale","volume":"74 3","pages":"203-15"},"PeriodicalIF":0.0000,"publicationDate":"1994-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annales de la Societe belge de medecine tropicale","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

A novel method for the control of T.b. gambiense trypanosomiasis was evaluated in an endemic focus of Zaïre where a high incidence had persisted despite massive participation in active case-finding surveys based on lymph node puncture. All inhabitants of 3 villages were examined with a card agglutination serological test (CATT), and parasitological examinations were performed on those who were CATT+. Individuals in whom we detected trypanosomes were treated as usual. A lumbar puncture was carried out on CATT+/parasitology- subjects; those whose cerebrospinal fluid showed more than 3 white blood cell (WBC) per mm3 were treated with a full course of melarsoprol while those with a CSF WBC count between 1 and 3 per mm3 were given a single injection of diminazene (7 mg/kg). Three such surveys were performed, with a 6-month interval, during which 282 "serological suspects" received diminazene, 39 "clinical cases" were given melarsoprol and 82 "parasitological cases" were treated according to standard protocols. The annual incidence of trypanosomiasis decreased rapidly from 10.4-41.1/1.000 inhabitants (mean: 17.6/1.000) during the 10 years before the intervention to 1.1-2.6/1.000 (mean: 1.7/1.000) in the 3 years following the intervention. No major adverse effect was seen with diminazene. Among the 282 serological suspects, an elevated CSF WBC count was later documented in 12 individuals, who were all cured with melarsoprol. The incidence increased 5 years after the intervention (7.1/1.000 in 1992), which may have been avoided had we carried out similar interventions in adjacent foci.

冈比亚锥虫病的控制。以单剂量地咪那纳治疗血清学上疑似病例为基础的策略评价]。
一种控制冈比亚锥虫病的新方法在Zaïre的一个地方性焦点进行了评估,尽管大量参与了基于淋巴结穿刺的主动病例发现调查,但该地区的高发病率仍然存在。对3个村的所有居民进行卡凝集血清学试验(CATT),对CATT阳性者进行寄生虫学检查。我们检测到锥虫的个体照常处理。对CATT+/寄生虫学组进行腰椎穿刺;脑脊液白细胞(WBC)每mm3大于3的患者接受全疗程的美拉胂醇治疗,而脑脊液白细胞计数在1至3 / mm3之间的患者接受单次注射(7 mg/kg)。进行了三次这样的调查,间隔6个月,在此期间,282名“血清学疑似病例”接受了迪米那,39名“临床病例”接受了美拉胂醇,82名“寄生虫病例”根据标准方案接受了治疗。在干预前10年,锥虫病的年发病率从10.4-41.1/ 1000人(平均17.6/ 1000人)迅速下降到干预后3年的1.1-2.6/ 1000人(平均1.7/ 1000人)。没有观察到咪唑烯的主要不良反应。在282例血清学疑似病例中,12例经美拉胂醇治疗后发现脑脊液白细胞计数升高。干预后5年发病率增加(1992年为7.1/ 1000),如果我们对邻近病灶进行类似的干预,这是可以避免的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信