Extravascular dermal trypanosomes in suspected and confirmed cases of gambiense Human African Trypanosomiasis
In: ISSN: 1058-4838, 2020
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posté sur MedRxiv le 25 février 2020 : https://www.medrxiv.org/content/10.1101/2020.02.24.20026211v1 ; International audience ; Background The diagnosis of Human African Trypanosomiasis (HAT) typically involves two steps: a serological screen, followed by the detection of living trypanosome parasites in the blood or lymph node aspirate. Live parasites can, however, remain undetected in some seropositive individuals, who we hypothesize are infected with Trypanosoma brucei gambiense parasites in their extravascular dermis. Methods and findings To test this hypothesis, we conducted a prospective observational cohort study in the gambiense HAT (gHAT) focus of Forecariah, in the Republic of Guinea. 5,417 subjects in this disease foci underwent serological screening for gHAT. Of these individuals, 66 were enrolled into our study, of whom 40 were seronegative, 8 were seropositive but unconfirmed, and 18 confirmed gHAT cases. Enrolled individuals underwent a dermatological examination, and had blood samples and skin biopsies taken and examined for trypanosomes by molecular and immuno-histological methods. In confirmed cases, dermatological symptoms were significantly more frequent, relative to seronegative controls. T. b. gambiense parasites were present in the blood of all confirmed cases but not in unconfirmed seropositive individuals. However, trypanosomes were detected in the dermis of all unconfirmed seropositive individuals and confirmed cases. After 6 and 20 months of treatment, dermal trypanosome numbers in skin biopsies of confirmed cases progressively reduced. Conclusions Our results thus highlight the skin as a potential reservoir for trypanosomes, with implications for our understanding of this disease's epidemiology in the context of its planned elimination and highlighting the skin as a novel target for gHAT diagnostics.
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Extravascular dermal trypanosomes in suspected and confirmed cases of gambiense Human African Trypanosomiasis
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Autor/in / Beteiligte Person: | M'mah Soumah, Alseny ; Swar, Nono-Raymond ; Camara, Mariame ; Soumah, Alseny M’mah ; Ilbouldo, Hamidou ; Travaillé, Christelle ; Clucas, Caroline ; Cooper, Anneli ; Kuispond Swar, Nono-Raymond ; Camara, Oumou ; Sadissou, Ibrahim ; Calvo Alvarez, Estefania ; Crouzols, Aline ; Bart, Jean-Mathieu ; Jamonneau, Vincent ; Camara, Mamadou ; Macleod, Annette ; Bucheton, Bruno ; Rotureau, Brice ; Ministère de la Santé Conakry, Guinea ; College of Medical, Veterinary and Life Sciences Glasgow ; Wellcome Trust Centre for Molecular Parasitology ; Biologie cellulaire des Trypanosomes - Trypanosome Cell Biology ; Institut Pasteur Paris -Institut National de la Santé et de la Recherche Médicale (INSERM) ; University of Kinshasa (UNIKIN) ; Institut de Recherche pour le Développement (IRD) ; Interactions hôtes-vecteurs-parasites-environnement dans les maladies tropicales négligées dues aux trypanosomatides (UMR INTERTRYP) ; Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Université de Bordeaux (UB) ; Laboratoire de l'intégration, du matériau au système (IMS) ; Centre National de la Recherche Scientifique (CNRS)-Institut Polytechnique de Bordeaux-Université Sciences et Technologies - Bordeaux 1 ; University of Glasgow ; This work was supported by the Wellcome Trust (209511/Z/17/Z), the Institut de Recherche pour le Développement, the Institut Pasteur, the French Government Investissement d'Avenir programme - Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases (ANR-10-LABX-62-IBEID) and the French National Agency for Scientific Research (projects ANR-14-CE14-0019-01 EnTrypa and ANR-18-CE15-0012 TrypaDerm). None of these funding sources has a direct scientific or editorial role in the present study. ; ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010) ; ANR-14-CE14-0019,ENTRYPA,Dynamique des étapes précoces de l'infection de l'hôte mammifère par les trypanosomes africains(2014) ; ANR-18-CE15-0012,TrypaDerm,Comprendre la biologie des trypanosomes africains dans la peau(2018) |
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Zeitschrift: | ISSN: 1058-4838, 2020 |
Veröffentlichung: | HAL CCSD ; Oxford University Press (OUP), 2020 |
Medientyp: | academicJournal |
DOI: | 10.1101/2020.02.24.20026211 |
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