TITLE:
Epidemiological, Clinical and Evolutionary Aspects of Human African Trypanosomiasis in Children in Nola
AUTHORS:
Brice Olivier Bogning Mejiozem, Gaspard Tékpa, Synthia Ningatoloum Nazita, Jocelyn Tony Nengom, Danebera Lydie Verlaine, Carine Judith Kiteze Nguinzanémou, Rostand Juste Koyangboi Kombaya, Iris Vanessa Gaspiet Sonny, Jean Chrysostome Gody
KEYWORDS:
Morbidity-Mortality, Child, HAT, Nola, CAR
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.14 No.2,
March
18,
2024
ABSTRACT: Background: Human African
trypanosomiasis (HAT) occurs in three historical foci in the Central African
Republic. Objective: To describe the morbi-mortality of childhood HAT in
rural Central African Republic with the aim of early management. Methods: Descriptive
and analytic cross-sectional study conducted from January 1, 2017 to March 30,
2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the
diagnosis of HAT was confirmed. Statistical analysis was performed using
Epi-info software. Results: Forty children were included from Bilolo (60%), Nola
(30%) and Salo (10%). The sex ratio was 0.66
with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence
(67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were
adenopathy (52.5%), paresthesia (30%), decreased
cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%),
hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in
65% of cases, and meningoencephalitis in 35%. Pentamidine was
administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under
5, Bilolo’s focus, the children’s history and the severity of the
disease. Age under 5, gender, household, children’s activity, history and
occurrence of sequelae were also associated. Conclusion: HAT
remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders
must be treated with caution.