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Volume 11, Number 6—June 2005

Research

Trypanosomiasis Relapse after Melarsoprol Therapy, Democratic Republic of Congo, 1982–2001

Jacques Pépin*Comments to Author  and Bokelo Mpia†
Author affiliations: *Centre for International Health and Department of Microbiology and Infectious Diseases, University of Sherbrooke, Sherbrooke, Quebec, Canada; †Nioki Hospital, Nioki, Democratic Republic of Congo

Main Article

Table 2

Demographic and clinical characteristics of patients with Trypanosoma brucei gambiense trypanosomiasis treated with melarsoprol in Nioki hospital, 1982–2001*

1982–1985 (%)
(n = 587) 1986–1989 (%)
(n = 543) 1990–1993 (%)
(n = 417) 1994–1997 (%)
(n = 320) 1998-2001 (%)
(n = 354) p value
Sex <0.001
Females 368 (63) 269 (50) 214 (51) 143 (45) 151 (43)
Males 219 274 203 177 203
Age 0.003
≤14 84 (16) 115 (21) 74 (19) 62 (19) 62 (18)
15–49 341 (66) 354 (66) 272 (69) 229 (72) 254 (72)
≥50 95 (18) 71 (13) 48 (12) 28 (9) 38 (11)
Area of residence <0.001
Nioki town 94 (17) 117 (22) 116 (28) 79 (25) 104 (29)
Mfimi River 304 (54) 201 (37) 112 (27) 88 (28) 113 (32)
Molibampe River 25 (4) 45 (8) 48 (12) 47 (15) 48 (14)
Baboma/Basengele 95 (17) 91 (17) 46 (11) 46 (14) 42 (12)
Out of district 43 (8) 89 (16) 95 (23) 60 (19) 47 (13)
Trypanosomes in lymph node aspirate <0.001
Yes 323 (55) 232 (43) 134 (32) 112 (35) 125 (35)
No 264 311 283 208 229
Trypanosomes in blood <0.001
Yes 151 (26) 197 (36) 106 (25) 88 (28) 114 (32)
No 436 346 311 232 240
Trypanosomes in CSF <0.001
Yes 116 (20) 237 (44) 220 (53) 179 (56) 184 (52)
No 471 306 197 141 170
CSF leukocyte count (per mm3) <0.001
1–5 22 (4) 23 (4) 4 (6) 16 (5) 9 (3)
6–19 158 (27) 114 (21) 30 (7) 18 (6) 38 (11)
20–99 161 (27) 131 (24) 106 (25) 89 (28) 109 (31)
≥100 246 (42) 275 (51) 257 (62) 197 (62) 198 (56)
Median CSF leukocyte count (per mm3) 65 101 135 140 116 <0.001
Melarsoprol regimens <0.001
1 series of 3 injections 17 (3) 7 (1) 26 (7) 14 (5) 5 (1)
2 series of 3 injections 163 (29) 123 (24) 31 (8) 11 (4) 3 (1)
3 series of 3 injections 152 (27) 353 (69) 341 (86) 192 (64) 184 (54)
3 series of 4 injections 221 (40) 29 (6) 0 0 0
3 series of 3, incremental 0 0 0 44 (15) 24 (7)
10 daily injections 0 0 0 38 (13) 127 (37)
Prednisolone
Yes 177 (30) 339 (62) 341 (82) 320 (100) 354 (100)
No 410 204 76 0 0
Melarsoprol-induced encephalopathy 0.002
Yes 31 (5.3) 35 (6.4) 9 (2.2) 11 (3.4) 8 (2.3)
No 556 508 408 309 346
Death during treatment 0.25
Yes 34 (5.8) 31 (5.7) 19 (4.6) 21 (6.6) 11 (3.1)
No 553 512 398 299 343
All relapses after treatment† 0.004
Yes 31 (5.6) 35 (6.8) 18 (4.5) 34 (11.4) 17 (5.0)
No 522 477 380 265 326
Relapses within 2 y of treatment† <0.001
Yes 21 (3.8) 29 (5.7) 15 (3.8) 32 (10.7) 16 (4.7)
No 532 483 383 267 327

*CSF: cerebrospinal fluid. †Excluding patients who died during treatment.

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