జర్నల్ ఆఫ్ ఇన్ఫెక్షియస్ డిసీజెస్ & ప్రివెంటివ్ మెడిసిన్
అందరికి ప్రవేశం

నైరూప్య

Passive Human African Trypanosomiasis in Children in Brazzaville from 2004-2020

Ossibi Ibara BR*, Sekangue Obili G, Adoua Doukaga T, Ekat Martin, Mvoumbo G, Bendett P, Kinga F, Nkouka E, Okoueke R, Kitembo L

Objective: To determine the prevalence of Human African Trypanosomiasis (HAT) in children in Congo-Brazzaville and to look for associated factors. Patients and Methods: Retrospective descriptive and analytical study of cases of HAT in children in Congo between January 1, 2004 and December 31, 2020, i.e. 17 years. Results: Out of a total of 3238 people screened as passive, 335 were children and 89 were confirmed sick, i.e. 2.7% of the Total Population Examined (PTE). The mean age was 9.8 ± 5.2 years (10 days-17 years), female (n=48; 53.9%) with a sex ratio of 0.8, from the Ngabé household (n=54; 60.7%), educated (n=44; 49.4%). The most frequently encountered symptoms were fever (n=46; 51.7%), sleep disturbances (n=46; 51.7%) and headache (n=21; 23.6%). CATT was positive in all patients and diluted to 1/32 in 50 cases (56.2%). Lymph node puncture was positive in 49 patients (55.1%) and trypanosomes were isolated from the CTC and the LCS in 28.1% and 41.6%, respectively. The mean cell count in the LCS was 163.9 ± 227.2 (1-1128) and patients were classified as stage 2 in 68 cases (76.4%). DFMO was used in 46 patients (51.7%) and pentamidine in 21 patients (23.6%). The outcome was marked by healing in 77 cases (86.5%). In 7 patients (7.9%), there was a death due to arsenical encephalopathy in 4 cases (57.1%). The female sex (p=0.03), the combination DFMO+Arsobal (p= 0.006) were associated with relapse, while age <5 years (p=0.004) was associated with death. Conclusion: the prevalence of HAT in Congolese children as well as the lethality was high during the study period. Female sex, Age <5 years remains a poor prognostic factor, as does the combined use of DFMO+Arsobal.