An evaluation of the reactivity of the card agglutination test for trypanosomiasis (CATT) reagent in the Fontem sleeping sickness focus, Cameroon.

The TestrypR Card Agglutination Test for Trypanosomiasis (CATT) used for the serodiagnosis of gambiense trypanosomiasis is based on the variant antigen type (VAT) LiTat 1.3. This antigen is rarely expressed by trypanosomes in the Fontem focus of Cameroon, but the CATT has been used for serodiagnosis in the focus since 1985. We give here a summary of results obtained with the CATT in Fontem from 1985 to 1989. The CATT is specific for trypanosome antibodies since: (a) sera from persons with other parasitoses from areas non endemic for trypanosomiasis fail to react and (b) an enzyme-linked immunosorbent assay (ELISA) based on the detection of antibodies to somatic antigens of T.b gambiense from Fontem concorded with the CATT. CATT reactions in Fontem seem to be specific for the variant surface glycoprotein (VSG) since absorption of CATT reactive sera with formalin fixed bloodstream T. gambiense from Fontem and with culture produced procyclics of T. gambiense from Fontem failed to abrogate CATT reactivity. CATT on serum failed to confirm 37% of CATT positive cases on whole blood. Although immunoconglutinin (IK), anti-human red blood cell (RBC) antibodies and complement fixing immune complexes (ICs) were found in sera from Fontem, our results failed to incriminate immunoconglutination of RBCs, reactions of RBCs with their autoantibodies and immune adherence hemagglutination as contributory factors in this lack of agreement between CATT on serum and whole blood. Further, comparison of whole blood and serum CATT results of parasitologically confirmed patients leads to the conclusion that screening with the CATT in the Fontem focus should be done on whole blood, not serum or plasma. CATT reactions in Fontem are based on cross-reactions with as yet undefined VATs.

[Epidemiological, clinical, therapeutic and evolutionary aspects of pulmonary aspergilloma in Dakar]. / Aspects épidémiologiques, cliniques, thérapeutiques et évolutifs de l'aspergillome pulmonaire à Dakar.

INTRODUCTION: The presentation of pulmonary aspergilloma is dominated by haemoptysis, the results of medical treatment are disappointing and there is significant morbidity and mortality following surgery; the only really curative treatment. These facts emphasise the gravity of this condition. We undertook a study to estimate the current profile of the disease and its management in Senegal. PATIENTS AND METHODS: A retrospective study took place between January 2004 and September 2008 including all the cases of pulmonary aspergilloma diagnosed in private practice and\or the thoracic and cardiovascular surgery service of the Fann Hospital, Dakar. RESULTS: Thirty-five patient records were collected. The sex ratio was four males to one female. The average age of the patients was 43.7 years. All the patients had a history of pulmonary tuberculosis. Serology was positive for Aspergillus fumigatus at 22 patients out of 29 (75.86%). Histological examination of surgical biopsies confirmed the diagnosis in 88.46%. The treatment was essentially surgical with no recorded mortality. Nine cases of haemorrhage and eight of suppuration were reported. CONCLUSION: Surgery remains the reference treatment for pulmonary aspergilloma. In view of the morbidity of this condition we emphasize the importance of early screening and correct treatment of tuberculosis, particularly in endemic countries, to achieve clinical cure and prevent serious after effects.