4.1 Article

Long-term sequelae of congenital gambiense human African trypanosomiasis

出版社

OXFORD UNIV PRESS
DOI: 10.1093/trstmh/trab082

关键词

congenital gHAT; gHAT treatment during pregnancy; Long-term sequelae; neuropsychiatric signs

资金

  1. Royal Society of Tropical Medicine
  2. Sanofi
  3. Swiss Tropical and Public Health Institute

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Congenital gHAT may result in long-lasting sequelae in babies, affecting their future abilities. Our study suggests that women treated for gHAT may still pose risks to the health of their babies, highlighting the need for careful evaluation of treatment risks.
Background: The clinical presentation of gambiense human African trypanosomias (gHAT) is generally considered to be the same among children and adults. In general, when describing the clinical presentation of children with gHAT, no differentiation is made between congenital gHAT and gHAT acquired later. There is a Lack of knowledge regarding the signs and symptoms attributable to congenital gHAT and its Long-term sequelae. Methods: Following an evaluation of the hospital register for gHAT, the authors observed that six children born to mothers with gHAT during their pregnancies still had sequelae of the infection. The six mothers were interviewed about their respective pregnancies and the developmental history of the children borne to the infected mothers. Furthermore, the children then underwent a complete physical examination with a focus on neuropsychiatric signs and symptoms. Results: Five of the six patients are still seriously disabled. Behavioral changes are present in four patients, tremor, speech impairment, involuntary movements and pathologic the Barres test and Mingazzini test in three patients and convulsions, pyramidal signs and decreased muscle tonus in two patients. Two patients cannot work and one has a sphincter disorder. Conclusions: Our study suggests that congenital gHAT may Lead to Long-Lasting sequelae in babies born to mothers treated after delivery. The risk of embryo toxicity of treatment of mothers with gHAT must be balanced against the risk of congenital gHAT with Long-term sequelae.

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