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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of trypanosoma brucei gambiense sleeping sickness
PLoS ONE, Volume 7, No. 7, Article e40909, Year 2012
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Description
Background: Sleeping sickness, or human African trypanosomiasis (HAT), is a protozoan disease that affects rural communities in sub-Saharan Africa. Determination of the disease stage, essential for correct treatment, represents a key issue in the management of patients. In the present study we evaluated the potential of CXCL10, CXCL13, ICAM-1, VCAM-1, MMP-9, B2MG, neopterin and IgM to complement current methods for staging Trypanosoma brucei gambiense patients. Methods and Findings: Five hundred and twelve T. b. gambiense HAT patients originated from Angola, Chad and the Democratic Republic of the Congo (D.R.C.). Their classification as stage 2 (S2) was based on the number of white blood cells (WBC) (>5/μL) or presence of parasites in the cerebrospinal fluid (CSF). The CSF concentration of the eight markers was first measured on a training cohort encompassing 100 patients (44 S1 and 56 S2). IgM and neopterin were the best in discriminating between the two stages of disease with 86.4% and 84.1% specificity respectively, at 100% sensitivity. When a validation cohort (412 patients) was tested, neopterin (14.3 nmol/L) correctly classified 88% of S1 and S2 patients, confirming its high staging power. On this second cohort, neopterin also predicted both the presence of parasites, and of neurological signs, with the same ability as IgM and WBC, the current reference for staging. Conclusions: This study has demonstrated that neopterin is an excellent biomarker for staging T. b. gambiense HAT patients. A rapid diagnostic test for detecting this metabolite in CSF could help in more accurate stage determination. © 2012 Tiberti et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3399808/bin/pone.0040909.s001.tif
https://efashare.b-cdn.net/share/pmc/articles/PMC3399808/bin/pone.0040909.s002.docx
Authors & Co-Authors
Tiberti, Natalia
Switzerland, Geneva
Université de Genève
Hainard, Alexandre
Switzerland, Geneva
Université de Genève
Lejon, Veerle
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Courtioux, Bertrand
France, Limoges
Institut D’epidémiologie Neurologique et de Neurologie Tropicale
Matovu, Enock
Uganda, Kampala
Makerere University
Enyaru, John Charles Kiboko
Uganda, Kampala
Makerere University
Robin, Xavier
Switzerland, Geneva
Université de Genève
Turck, Natacha
Switzerland, Geneva
Université de Genève
Kristensson, Krister S.
Sweden, Stockholm
Karolinska Institutet
Mumba Ngoyi, Dieudonné
Congo
Institut National de Recherche Biomédicale
Vatunga, Gedeão M.L.
Angola, Luanda
Instituto de Combate e Controlo Das Tripanossomiases
Krishna, Prof Sanjeev
United Kingdom, London
St George’s, University of London
Büscher, Philippe
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Bisser, Sylvie
France, Limoges
Institut D’epidémiologie Neurologique et de Neurologie Tropicale
Ndung'U, Joseph Mathu
Switzerland, Geneva
Foundation for Innovative new Diagnostics, Switzerland
Sánchez, Jean Charles
Switzerland, Geneva
Université de Genève
Statistics
Citations: 47
Authors: 16
Affiliations: 9
Identifiers
Doi:
10.1371/journal.pone.0040909
e-ISSN:
19326203
Study Design
Cohort Study
Study Locations
Angola
Chad
Congo