A Comparison Of Methods Of Investigating Human Sleeping Sickness (Human African Trypanosomiasis: Hat) In Nigeria

Abstract

The difficulty in the diagnosis of Human African Trypanosomiasis (HAT) remains a major set-back in the control of the disease. Without systematic screening of a population at risk and confirmation of diagnosis of the disease, all infected people who remain untreated will die even in the face of massive immune responses.
In this study, card agglutination test for trypanosomiasis (CATT) screening, blood, lymph node juice (LNJ) and cerebrospinal fluid (CSF) studies were conducted among 852 subjects aged between 15 and 65 years and the results compared. One hundred and twenty two (14.3%), 84 (9.9%) and 73 (8.6%) subjects were CATT positive by whole blood, plasma dilution 1:2 and 1:4 respectively. Twelve (1.4%) cases were confirmed that were seropositive by the plasma 1:4 dilution with 2 (0.2%) in the early haemolymphatic phase I and 10 (1.2%) in the late CNS phase II. Of the confirmed, all were positive by Haematocrit concentration technique (HCT), 10 (1.2%) by CSF microscopy, 6 (0.2%) by LNJ microscopy, 1(0.8%) by Giemsa thick film and none (0%) by thin film. There were twenty-two (18.0%) malaria cases seen among the unconfirmed cases. There were 24 (19.7%) cases of loiasis, 10(1.2%) of which occurred concomitantly with trypanosomiasis which was diagnosed in 6(4.9%) patients who were Phase1, 4(3.3%) patients in phase 11 and 14(1.4%) were among the unconfirmed. The pattern of concomitant and non concomitant infections among seropositive and confirmed subjects reported here warrants further study, in order to document reliable indices of suspicion among serosuspects when confirmation proves difficult.


Keywords: Trypanosomiasis, diagnostic methods, concomitant, non concomitant infections

Journal of Mining and Geology Vol. 5 (1&2) 2006: pp. 13-22