@article{fdi:010080144,
  title = {{E}xtravascular dermal trypanosomes in suspected and confirmed cases of gambiense {H}uman {A}frican {T}rypanosomiasis},
  author = {{C}amara, {M}. and {M}'mah {S}oumah, {A}. and {I}lboudo, {H}. and {T}ravaill{\'e}, {C}. and {C}lucas, {C}. and {C}ooper, {A}. and {S}war, {N}.{R}.{K}. and {C}amara, {O}. and {S}adissou, {I}brahim and {C}alvo-{A}lvarez, {E}. and {C}rouzols, {A}. and {B}art, {J}ean-{M}athieu and {J}amonneau, {V}incent and {C}amara, {M}. and {M}ac{L}eod, {A}. and {B}ucheton, {B}runo and {R}otureau, {B}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {T}he diagnosis of gambiense human {A}frican trypanosomiasis (g{HAT}) typically involves 2 steps : a serological screen, followed by the detection of living trypanosome parasites in the blood or lymph node aspirate. {L}ive parasites can, however, remain undetected in some seropositive individuals, who, we hypothesize, are infected with {T}rypanosoma brucei gambiense parasites in their extravascular dermis. {M}ethods : {T}o test this hypothesis, we conducted a prospective observational cohort study in the g{HAT} focus of {F}orecariah, {R}epublic of {G}uinea. {O}f the 5417 subjects serologically screened for g{HAT}, 66 were enrolled into our study and underwent a dermatological examination. {A}t enrollment, 11 seronegative, 8 unconfirmed seropositive, and 18 confirmed seropositive individuals had blood samples and skin biopsies taken and examined for trypanosomes by molecular and immunohistological methods. {R}esults : {I}n seropositive individuals, dermatological symptoms were significantly more frequent, relative to seronegative controls. {T}.b. gambiense parasites were present in the blood of all confirmed cases (n = 18) but not in unconfirmed seropositive individuals (n = 8). {H}owever, {T}. brucei parasites were detected in the extravascular dermis of all unconfirmed seropositive individuals and all confirmed cases. {S}kin biopsies of all treated cases and most seropositive untreated individuals progressively became negative for trypanosomes 6 and 20 months later. {C}onclusions : {O}ur results highlight the skin as a potential reservoir for {A}frican trypanosomes, with implications for our understanding of this disease's epidemiology in the context of its planned elimination and underlining the skin as a novel target for g{HAT} diagnostics.},
  keywords = {{GUINEE}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {73},
  numero = {1},
  pages = {ciaa897 [12--20]},
  ISSN = {1058-4838},
  year = {2021},
  DOI = {10.1093/cid/ciaa897},
  URL = {https://www.documentation.ird.fr/hor/fdi:010080144},
}