Blood-cerebrospinal fluid barrier and intrathecal immunoglobulins compared to field diagnosis of central nervous system involvement in sleeping sickness.

Diagnosis of central nervous system (CNS) involvement in sleeping sickness is crucial in order to give an appropriate treatment regimen. Neurological symptoms occur late, therefore field diagnosis is based on white blood cell count, total protein concentration and presence of trypanosomes in cerebrospinal fluid (CSF). More sensitive and specific parameters are now available.

The situation of sleeping sickness in Angola: a calamity.

Although nearly one-fifth of the Angolan population is at risk of becoming infected with trypanosomiasis, only 6% currently have access to surveillance and treatment because of the war and its resultant destruction of the country's infrastructure. The paper outlines the history of human African trypanosomiasis (HAT) control activities in Angola and sums up what measures need to be taken to re-establish them.

[African human trypanosomiasis. Therapeutic strategies].

Although therapeutic strategies for trypanosomiasis appear to be straightforward, their application in the field raises a number of questions which are successively examined below. After a quick reminder of the available drugs, we discuss: Criteria for eligibility: problems of beginning treatment for immunological suspects and determination of the development phase. Present-day problems: availability of drugs; side effects; therapeutic failures.

Plasma melatonin rhythm is maintained in human African trypanosomiasis.

In human African trypanosomiasis (sleeping sickness), sleep and wake episodes are sporadically distributed throughout the day and the night. Plasma melatonin, sleep-wakefulness and rectal temperature rhythms were studied in 9 Congolese patients suffering from sleeping sickness compared to 6 healthy controls submitted to the same light/dark regime. The circadian distribution of the sleep-wake cycle was disturbed in relation to the severity of the disease.

Effect of melarsoprol treatment on circulating IL-10 and TNF-alpha levels in human African trypanosomiasis.

The pathogenesis of human African trypanosomiasis (HAT) has been the object of considerable research interest but has remained incompletely understood. The importance of cytokines in the pathophysiology of this protozoan infection is now widely recognized, but the full spectrum of cytokines involved has yet to be determined. In the present investigation we compared the plasma concentrations of TNF-alpha and IL-10 in normal African controls and patients suffering from advanced meningocephalic (late-stage) Trypanosomiasis brucei (T.

[Contribution of biochemical tests in the diagnosis of the nervous phase of human African trypanosomiasis].

The stage of human African trypanosomiasis (HAT) is important to define precisely as far as it is directly related to the type of treatment used. The beginning of the neurological involvement is difficult to find out because there is no known specific clinical or biological sign. This study is trying to look for a precise marker and has been realized in Congo.

Disruption of endocrine rhythms in sleeping sickness with preserved relationship between hormonal pulsatility and the REM-NREM sleep cycles.

In human African trypanosomiasis (sleeping sickness), sleep and wake episodes are sporadically distributed throughout the day and the night. To determine whether these sleep disturbances affect the 24-h hormone profiles and the normal relationships between hormone pulsatility and sleep stages, polygraphic sleep recordings and concomitant hormone profiles were obtained in 6 African patients with sleeping sickness and in 5 healthy African subjects selected from Abidjan on the Ivory Coast. Polysomnographic recordings were continuous, and blood was taken every 10 min throughout the 24-h period.

BalI and MspI polymorphisms of the dopamine D3 receptor gene in African Blacks and Caucasians.

An exonic BalI polymorphism and an intronic MspI polymorphism of the dopamine D3 gene were genotyped in 101 Caucasians from the Alsace and in 56 people from the Congo. This is the first study of the BalI polymorphism in sub-Saharan Africa and the first population study of the MspI site. BalI allele 1 was rare in the Congo (0.

[First case of multiforme granuloma in Congo].

We report a case of multiform granuloma observed in a young woman of 28 years from Brazzaville, Congo. Extended lesions on the arms, back, face, legs and feet appeared over one month. They consisted of slightly squamous erythemato-oedematous plaques, with polycyclical margins and raised papular borders.

[Drug sensitivity of Plasmodium falciparum in vivo and in vitro in Brazzaville (Congo)].

Various projects were launched in 1993 to monitor the chemosensitivity of Plasmodium falciparum in Congo. Resistance of 34 strains in Brazzaville to chloroquine, quinine and mefloquine and of 35 to halofantrine was investigated in an in vitro survey using an isotopic micro test. The resistance rates were 61.

[Maintenance of the relation between the pulsed secretion of hormones and the internal sleep structure in human African trypanosomiasis].

In order to determine whether sleep disturbances would affect the hormonal patterns and the normal relationships between hormone pulses and sleep stages, the 24-hour profiles of cortisol, prolactin and plasma renin activity (PRA) were analysed in 6 sleeping sickness patients studied at Brazzaville and in 5 healthy African controls studied in Abidjan. Polysomnographic recordings were done continuously and blood was taken every 10 minutes throughout the 24-hour period. Plasma was analyzed for cortisol, prolactin and PRA.

[The nyctohemeral rhythm of melatonin is preserved in human African trypanosomiasis].

We studied plasma melatonin profiles by radioimmunoassay in nine patients suffering from human african trypanosomiasis and six healthy controls matched according to the age and the photoperiodic conditions. The circadian periodicity of the sleep-wake cycle was disturbed proportionally to the degree of severity of the disease. On the contrary, the patients' plasma melatonin profile was similar to the controls' one.

[The distribution of sleep and wakefulness in human African trypanosomiasis].

Last century, patients with human African trypanosomiasis were described as sleepy by day and restless by night, and physicians referred to this condition as sleeping sickness. Such a description could have evoked a disturbance of circadian rhythms. However, it is only in 1989 that the first 24-hour recording was performed by our team in Niamey (Niger) in a patient with sleeping sickness.

[The detection of anti-galactocerebroside autoantibodies in human African trypanosomiasis].

The pathogenesis of the central nervous system (CNS) damage in human african trypanosomiasis (HAT) is unknown. In view of an immunological mechanism, as in another trypanosomiasis, Chagas' disease, the causative agent of which is Trypanosoma cruzi, we have searched autoantibodies directed against glycosphingolipids of CNS. Detection and characterization of autoantibodies were performed by ELISA and detection after thin-layer chromatography of glycolipids with sera of an experimental model of HAT in sheep and sera of patients suffering of HAT from Côte d'Ivoire and Congo.

[Epidemiological aspects of human African trypanosomiasis in south Chad].

The authors are recording results of a clinical, parasitological and immunological sample survey about african human trypanosomiasis in the South Chad where old focus has been reexplored. In 1988 the situation ever remains as a problem in some areas (Tapol, Ranga) where high prevalence rates are found again.

[Trypanosomiasis caused by T. b. gambiense: methods of control].

This paper reviews the different ways currently available for screening sleeping sickness. These ways are then integrated and discussed by the author in proposing different strategic and methodologic solutions after emphasizing the role of each of the technical stages. Altogether, there isn't one standard solution but adaptations around a main plan, according to contexts and having regard to efficiency and profitability.

[Epidemic of yellow fever in the southeastern region of Upper Volta (October-December, 1983). Epidemiological study. Preliminary results].

An epidemic of yellow fever raged during the last three months of 1983 in South East of Upper Volta. It spread on about ten thousand square kilometers, in a bushy savanna area, affecting only populations living in contact with forest galleries, belonging especially to the peul ethnical group. The transmission of the virus was effected by sylvatic vectors, essentially Aedes furcifer.

[Technics of detection and diagnosis of African trypanosomiasis in humans].

The authors review the most recent and sophisticated laboratory techniques for screening and diagnosis of human african trypanosomiasis. Immunological screening: indirect immunofluorescence, card agglutination test. Parasitological diagnosis: hematocrit centrifuge technique, miniature anion exchange/centrifugation, cerebrospinal fluid centrifugation.

[The epidemiology of human trypanosomiasis due to Trypanosoma gambiense in a focus of the Ivory Coast. I. The distribution of the disease in the population (author's transl)].

The authors have studied the distribution of trypanosomiasis in the population of the focus around Vavoua in the Ivory Coast. Because of numerous immigrants from Upper Volta who have settled in the area, the composition of the population differs from the general population of the Ivory Coast. The cases diagnosed from 1977 to 1979 were studied by village, ethnic group, sex and age.

[Human trypanosomiasis foci in OCCGE member countries: present situation (author's transl)].

Using official epidemiological informations, authors study evolution of sleeping sickness epidemiological situation in seven OCCGE countries: Benin, Ivory Coast, Upper Volta, Mali, Niger, Senegal and Togo. 745 new cases were diagnosed in 1977 and more than 600 in 1978. We observe the extinction of historic foci in Niger and Senegal, the persistance of foci in Upper Volta and Mali and the reviviscence of foci in Benin, Ivory Coast and Togo.