Human African trypanosomiasis in two historical foci of the estuaire province, gabon: A case report

Abstract

Human African Trypanosomiasis (HAT) is an infectious disease due to a protozoa parasite of the Trypanosoma genus. In West and Central Africa, this disease is caused by the subspecies Trypanosoma brucei gambiense. Several foci of this disease are currently active and causing the death of hundreds of people in endemic areas. In this article, we report two cases of gambiense HAT in one Indonesian and one Gabonese men in two historical foci of Gabon in 2019. Both patients had fever with temperatures above 38°C, an altered state of consciousness, cachexia, and multiple dermabrasions on the abdomen related to scratching lesions. The diagnostic revealed second-stage infection of both patients with T. b. gambiense; this result was confirmed by a polymerase chain reaction assay. Despite treatment with a combination of eflornithine and nifurtimox, as recommended by the World Health Organization for late-stage T. b. gambiense HAT, one of the two patients died. Thus, these cases highlight the importance of early HAT diagnosis and prompt patient care to fight effectively against this disease.

Prevalence of Haemoparasites among Blood Donors Attending the Regional Hospital Center of Franceville (Southern Gabon)

“…Moreover, the recent detection of Babesia spp and Boophilus decoloratus ticks in livestock imported to Gabon from Cameroon raises concerns for humans [16,36]. The absence of African trypanosomiaisis is consistent with the fact that the Estuaire province not the Haut -Ogooue province is the most active site [11]. These negative results could also be explained by the small size of the study sample.…”

“…This could be explained by the fact that the majority (5/8) of the responders who tested positive falls within this age range and have reported to frequently stay in the villages. Moreover, according to a large scale study conducted in eleven (11) endemic countries in Africa using the Rapid Assessment Procedure for Loiasis (RAPLOA) revealed a prevalence of eye worm history greater than 40% in all Gabonese villages (65) surveyed across the country [41]. In addition, all neighborhoods in the study area are surrounded by vegetation, and thus constitute potential reservoirs of Chrysops or Culicoides.…”

“…The number of HAT cases have significantly decreased in the past decades, from more than 25,000 in 1998 to 663 in 2020 due to control initiatives [10]. HAT is endemic to Gabon and prevalent in seven (7) out the nine (9) provinces of the country [11]. A total of 116 cases have been reported between 2011 and 2020 [10].…”

Molecular Identification of Trypanosome Diversity in Domestic Animals Reveals the Presence of Trypanosoma brucei gambiense in Historical Foci of Human African Trypanosomiasis in Gabon

“…Very little information is available concerning the diversity of trypanosome species circulating in wildlife or domestic fauna in Gabon [18,19], although several ancient foci are known to still be active [28,29]. HAT was reported to be present in seven out of the nine provinces of this country during the 20th century [30].…”

“…HAT was reported to be present in seven out of the nine provinces of this country during the 20th century [30]. Serious cases of infection are recorded each year, sometimes leading to hospitalization or death of patients [29]. Komo-Mondah, located within the province of Estuaire, is the most active focus of HAT, with a mean of 20 cases per year [29,31].…”