Centre for Infectious Diseases, Division of Pathway Medicine, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Summerhall, Edinburgh, EH9 1QH.
Parasitology. 2011 Oct;138(12):1480-7. doi: 10.1017/S0031182011000230. Epub 2011 Apr 18.
Trypanosoma brucei gambiense sleeping sickness follows a long asymptomatic phase and persists in ancient foci from which epidemic clinical disease arises. A putative focus of T. b. gambiense infections has been identified, initially in mothers and young children, on the Lake Albert shoreline of Western Uganda leading to mass screening of 6207 individuals in September 2008. T. b. gambiense infections were identified by Card Agglutination Test for Trypanosomiasis (CATT) and sub-species-specific PCR although parasitological methods failed to confirm any patent trypanosome infections. In April 2009, CATT positives were re-visited; diagnosis of individuals by CATT and PCR was unstable over the two time points and parasites remained undetected, even using mini Anion Exchange Centrifugation Technique (mAECT). These observations suggest the possibility of a silent focus of disease, where all infected individuals are in a latent stage, and highlight our limited understanding of the local natural history and disease progression of T. b. gambiense in children and adults.
布氏冈比亚锥虫昏睡病（又称非洲睡眠病）在无症状期持续时间较长，并在古老的疫源地持续存在，这些疫源地会出现流行病。在乌干达西部沿维多利亚湖的岸边，最初在母亲和幼儿中发现了一种可能的布氏冈比亚锥虫感染的疫源地，导致 2008 年 9 月对 6207 人进行了大规模筛查。通过锥虫病补体结合试验（CATT）和亚种特异性 PCR 发现了布氏冈比亚锥虫感染，尽管寄生虫学方法未能确认任何显性锥虫感染。2009 年 4 月，再次对 CATT 阳性者进行了检查；在这两个时间点，CATT 和 PCR 对个体的诊断并不稳定，寄生虫仍然未被检测到，即使使用微型阴离子交换离心技术（mAECT）也是如此。这些观察结果表明，存在一个沉默的疾病疫源地的可能性，即所有受感染的个体都处于潜伏期，这突显了我们对儿童和成人中布氏冈比亚锥虫的当地自然史和疾病进展的了解有限。
