early prediction of treatment efficacy in second-stage gambiense human african trypanosomiasis早期治疗疗效的预测阶段gambiense非洲人类锥虫病.pdfVIP

Early Prediction of Treatment Efficacy in Second-Stage Gambiense Human African Trypanosomiasis 1 2 1 3 1,4 Gerardo Priotto *, Franc¸ois Chappuis , Mathieu Bastard , Laurence Flevaud , Jean-Franc¸ois Etard * ´ ` 1 Epicentre, Paris, France, 2 Operational Centre Geneva, Medecins sans Frontieres, Geneva University Hospitals, Geneva, Switzerland, 3 Operational Centre Barcelona- ´ ` ´ Athens, Medecins sans Frontieres, Barcelona, Spain, 4 Institut de Recherche pour le Developpement/UMI 233, Montpellier, France Abstract Background: Human African trypanosomiasis is fatal without treatment. The long post-treatment follow-up (24 months) required to assess cure complicates patient management and is a major obstacle in the development of new therapies. We ´ ` analyzed individual patient data from 12 programs conducted by Medecins Sans Frontieres in Uganda, Sudan, Angola, Central African Republic, Republic of Congo and Democratic Republic of Congo searching for early efficacy indicators. Methodology/Principal Findings: Patients analyzed had confirmed second-stage disease with complete follow-up and confirmed outcome (cure or relapse), and had CSF leucocytes counts (CSFLC) performed at 6 months post-treatment. We excluded patients with uncertain efficacy outcome: incomplete follow-up, death, relapse diagnosed with CSFLC below 50/ mL and no trypanosomes. We analyzed th