Diversity of response to Trypanosoma brucei gambiense infections in the Forecariah mangrove focus (Guinea): perspectives for a better control of sleeping sickness

Unravelling Human Trypanotolerance: IL8 is Associated with Infection Control whereas IL10 and TNFα Are Associated with Subsequent Disease Development

“…As previously reported in Guinea [7], follow-up of SERO TL+ individuals over a 2-years period showed that this group is heterogeneous. Interestingly, SERO TL+ with the highest IL10 levels and none detectable TNFα at study inclusion had a markedly increased risk of being confirmed by microscopy as HAT patients during their follow-up (OR = 13.09 [2.19–124.29] and OR = 10.49 [1.72–101.12] respectively).…”

“…gambiense and that some of them are able to control infection to levels that cannot be detected by microscopy. This hypothesis is supported by the fact that parasite DNA can be detected by PCR in this category of subjects [7], [8] and that direct microsatellite typing of trypanosomes from blood samples detected the same genotypes as those found in HAT patients [9]. Overall, these field observations are in line with the idea that trypanotolerance exists in humans, too, as demonstrated in some West African taurine breeds and in inbred mice models displaying differential susceptibility toinfection [10], [11].…”

“…All subjects included in this study were identified during medical surveys organized by the National Control Programme (NCP) between November 2007 and May 2011, according to the WHO and NCP policies, as described previously [7]. During the surveys a total of 41,311 individuals were screened, blood (5 ml) was collected in heparanized tubes from all individuals who tested positive to the CATT mass screening test, and a twofold plasma dilution series was tested to determine the CATT end titer.…”

“…Furthermore, individuals with (i) high responses to the card agglutination test for trypanosomiasis (CATT); (ii) serological positivity to the highly specific T. b. gambiense immune trypanolysis test (TL) and (iii) negative parasitological results (SERO TL+) have been reported from a number of endemic foci in West Africa [5], [6]. Noteworthy, follow-up studies showed that only some of these subjects develop HAT (parasite can be detected by microscopy in body fluids) while others are able to maintain high and specific serological responses over long periods of time [7]. These observations suggest that SERO TL+ individuals have been in contact with T.b.…”

Human African trypanosomiasis control: Achievements and challenges

“…However, modelling, historical investigations, and practical interventions demonstrate the significant role that vector control can play in the control of Gambiense HAT [14, 6, 15], especially given the possibility of long-term carriage of trypanosomes in both human and animal reservoirs [16,17]. Recent models suggest vector control will be essential if we are to reach the set target of elimination of the disease as a public health problem by 2020 [18].…”