Neuro‐psychiatric Syndromes Associated With Human Trypanosomiasis in Tropical Africa

Lambo, T. Adeoye

doi:10.1111/j.1600-0447.1966.tb06179.x

Cited by 14 publications

(5 citation statements)

References 2 publications

(1 reference statement)

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“…Other authors (Tooth, 1950;Laubscher, 1937) insisted that before a diagnosis could be reached, organic mental disorders must be rigorously excluded. This caution was based upon the fact that many African encephalitides may mimic schizophrenia (Lambo, 1966b). Some of the brief psychoses observed in African populations would obviously fit into the schizophreniform diagnostic group of DSM-ill-R or similar diagnostic group in ICD-10 but some workers (Tewfik, 1958) found great difficulty in assigning the diagnostic label of schizophrenia to many patients.…”

Section: Schizophreniamentioning

confidence: 99%

Psychiatry in Africa: Special Problems and Unique Features

Ilechukwu¹

1991

Transcultural Psychiatric Research Review

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Section: Schizophreniamentioning

confidence: 99%

Psychiatry in Africa: Special Problems and Unique Features

Ilechukwu¹

1991

Transcultural Psychiatric Research Review

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“…Descriptions of how to recognise a case of HAT syndromically abound in the historic and contemporary HAT literature [3], [27], [35], [36], [37], [38], [39], [40], [41], [42] and the presence of one particular sign, cervical adenopathy, was the most important pre-condition for laboratory testing in AS campaigns over most of the 20th Century. On the other hand, formal guidance discusses the challenge of operationalising existing syndromic detection techniques, preferring instead to advocate widespread use of the more sensitive diagnostic technologies developed and refined over the last three decades to avoid the risk of under-detection of a fatal disease [5], [6], [43].…”

Section: Discussionmentioning

confidence: 99%

Syndromic Algorithms for Detection of Gambiense Human African Trypanosomiasis in South Sudan

Palmer

Surur²,

Goch³

et al. 2013

PLoS Negl Trop Dis

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BackgroundActive screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan.Methodology/Principal FindingsSymptom data from 462 patients (27 cases) presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss), with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9–92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4–8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive.Conclusions/SignificanceIn the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT programmes. The algorithms proposed here, though promising, should be validated elsewhere.

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“…Emaciation, exhaustion, anemia, meningoencephalitis, and neurologic behavioral symptoms commonly occur during infection in both man and domestic mammals. The behavioral symptoms coincide with the onset of meningoencephalitis, and in man include stupor, ataxia, incoordination, tremors, depression (sometimes interrupted by periods of mania and violence), and irregular, prolonged sleep episodes (Kellersberger, 1933;Duggan and Hutchinson, 1966;Lambo, 1966). Incidence of neurologic behavioral symptoms among patients is about 80-90% (Lambo, 1966).…”

Section: 1253-1256 (1984)mentioning

confidence: 99%

“…The behavioral symptoms coincide with the onset of meningoencephalitis, and in man include stupor, ataxia, incoordination, tremors, depression (sometimes interrupted by periods of mania and violence), and irregular, prolonged sleep episodes (Kellersberger, 1933;Duggan and Hutchinson, 1966;Lambo, 1966). Incidence of neurologic behavioral symptoms among patients is about 80-90% (Lambo, 1966). Duggan and Hutchinson (1966) observed that excessive, irregular, and uncontrollable sleep was a symptom in 25 of 66 patients at the time of diagnosis and in virtually all patients in the terminal stage of the disease.…”

Section: 1253-1256 (1984)mentioning

confidence: 99%

Effects of African Trypanosomiasis on Brain Levels of Dopamine, Serotonin, 5‐Hydroxyindoleacetic Acid, and Homovanillic Acid in the Rabbit

Stibbs

1984

Journal of Neurochemistry

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Serotonin (5-HT) levels fell by 21% in the mid-brain-thalamus-hypothalamus (MTH) region of the rabbit brain after chronic infection with the protozoan Trypanosoma brucei gambiense. 5-HT did not decrease significantly in the caudate/putamen (CP) or the pons/medulla (PM) region. 5-Hydroxyindoleacetic acid (5-HIAA) levels were unchanged in the MTH and caudate/putamen (CP) but increased by 17% in the pons/medulla (PM) after infection. Dopamine (DA) levels rose by 19% and homovanillic acid (HVA) by 33% in the PM during infection. DA and HVA tended to be lower in the CP of infected rabbits, but the apparent decreases were not statistically significant. DA and HVA levels in the MTH were also unchanged by infection. These neurochemical changes may be involved in the behavioral symptoms that frequently accompany this disease in man and cattle.

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Neuro‐psychiatric Syndromes Associated With Human Trypanosomiasis in Tropical Africa

Cited by 14 publications

References 2 publications

Psychiatry in Africa: Special Problems and Unique Features

Psychiatry in Africa: Special Problems and Unique Features

Syndromic Algorithms for Detection of Gambiense Human African Trypanosomiasis in South Sudan

Effects of African Trypanosomiasis on Brain Levels of Dopamine, Serotonin, 5‐Hydroxyindoleacetic Acid, and Homovanillic Acid in the Rabbit

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