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[Human African trypanosomiasis in children. A pediatrics service experience in Libreville, Gabon]
J Koko1, D Dufillot, D Gahouma
1Service de Pédiatrie générale, Hôpital pédiatrique d'Dwendo, Libreville, Gabon.
Insights
This study on childhood trypanosomiasis in Gabon found that neurological and psychiatric symptoms were common, often indicating advanced disease. Treatment with melarsoprol and eflornithine showed good initial response, but some children experienced lasting neurological sequelae.
Area of Science:
- Tropical Medicine
- Pediatric Neurology
- Infectious Diseases
Background:
- Human African Trypanosomiasis (HAT) is a significant parasitic disease affecting children in endemic regions.
- Early diagnosis and treatment are crucial to prevent severe neurological complications.
Observation:
- Seven pediatric cases of HAT were admitted to Owendo Pediatric Hospital, Gabon, between 1989 and 1994.
- Common symptoms included somnolence, psychiatric and neurological disorders, asthenia, weight loss, and fever.
- Biological disturbances like elevated sedimentation rate and hypergammaglobulinemia were frequently observed.
Findings:
- All cases tested positive via serodiagnosis (CATT, indirect immunofluorescence).
- The parasite was detected in blood and cerebrospinal fluid (CSF), with six children in the second stage of the disease based on CSF analysis.
- Six patients treated with melarsoprol and one with eflornithine showed good initial tolerance and response.
Implications:
- Neurological and psychiatric manifestations are key indicators of advanced HAT in children.
- Prompt diagnosis and effective treatment are vital, though long-term neurological sequelae can persist.
- Further research into pediatric HAT management and long-term outcomes is warranted.
Abstract:
During a period of six years (1/1/89-12/31/94), seven children with trypanosomiasis were admitted to the Department of Pediatrics of Owendo Pediatric Hospital-Libreville, Gabon. They were 5 boys and 2 girls, aged 4-17 years, five of them under 15 years. The main reasons of hospitalization were somnolence (4 cases), psychical disorders (5 cases), neurological disorders (4 cases), asthenia (3 cases), loss of weight (3 cases) and fever (3 cases). Increased sedimentation rate (5 cases) and hypergammaglobulinemia (6 cases) were the most important biological disturbances. Serodiagnosis (CATT, indirect immunofluorescence test) was positive in all cases. The parasite was detected in blood seven times, and four times in cerebrospinal fluid (CSF). According to CSF status, six children have been classified in second stage of the disease. Six patients were treated by melarsoprol, and one by eflornithine. Tolerance and response to treatment were good in six cases. Three children presented sequels when leaving hospital. No patient was seen again after the study.