Volume 11, Number 6—June 2005
Research
Trypanosomiasis Relapse after Melarsoprol Therapy, Democratic Republic of Congo, 1982–2001
Jacques Pépin*
and Bokelo Mpia†
and Bokelo Mpia†
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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