Pyana P. P. auteur aut IRD Sere M. auteur aut IRD Kabore J. auteur aut IRD De Meeûs Thierry auteur aut IRD MacLeod A. auteur aut IRD Bucheton Bruno auteur aut IRD Van Reet N. auteur aut IRD Buscher P. auteur aut IRD Belem A. M. G. auteur aut IRD Jamonneau Vincent auteur aut IRD text journalArticle eng text/pdf born digital access Human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC) is caused by the protozoan Trypanosoma brucei gambiense. Until recently, all patients in the second or neurological stage of the disease were treated with melarsoprol. At the end of the past and the beginning of the present century, alarmingly high relapse rates in patients treated with melarsoprol were reported in isolated HAT foci. In the Mbuji-Mayi focus of DRC, a particular mutation that confers cross resistance for pentamidine and melarsoprol was recently found for all strains studied. Nevertheless, treatment successfully cured a significant proportion of patients. To check for the existence of other possible genetic factors of the parasites, we genotyped trypanosomes isolated from patients before and after treatment (relapsing patients) with eight microsatellite markers. We found no evidence of any genetic correlation between parasite genotype and treatment outcome and we concluded that relapse or cure probably depend more on patients' factors such as disease progression, nutritional or immunological status or co-infections with other pathogens. The existence of a melarsoprol and pentamidine resistance associated mutation at such high rates highlights an increasing problem, even for other drugs, especially those using the same transporters as melarsoprol and pentamidine. specialized Trypanosoma brucei gambiense Sleeping sickness Population genetics Treatment failure Democratic Republic of the Congo REPUBLIQUE DEMOCRATIQUE DU CONGO 052 020 050 30 128-133 2015 1567-1348 https://www.documentation.ird.fr/hor/fdi:010064041 10.1016/j.meegid.2014.12.017 1567-1348 [F B010064041] https://www.documentation.ird.fr/hor/fdi:010064041 https://www.documentation.ird.fr/intranet/publi/2015/04/010064041.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2015-05-04 2017-08-23 fdi:010064041 fre