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Long-term sequelae of congenital gambiense human African trypanosomiasis

Mudji, Junior, Künzli, Esther, Molyneux, David ORCID: https://orcid.org/0000-0001-8537-7947 and Blum, Johannes (2021) 'Long-term sequelae of congenital gambiense human African trypanosomiasis'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Issue trab082. (In Press)

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Abstract

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 Barrés 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.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 705 Trypanosomiasis
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/trab082
Depositing User: Stacy Murtagh
Date Deposited: 13 Jul 2021 16:40
Last Modified: 13 Jul 2021 16:40
URI: https://archive.lstmed.ac.uk/id/eprint/18033

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