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We describe rates of follow-up and the risk factors for relapse in a cohort of adult patients treated for Trypanosoma brucei gambiense African trypanosomiasis. 812 patients were discharged from hospital between 6 January 1983 and 16 January 1992. The numbers who did not attend a scheduled follow-up appointment at 6,12,18 and 24 months were 383 (47%), 467 (58%), 536 (66%) and 533 (66%), respectively. Thirty-two patients relapsed over the 2 years follow-up: 24 (75%) before the 12-month follow-up appointment. The presence of antibody to trypanosomes in the cerebrospinal fluid (CSF) at discharge from hospital was associated significantly with the risk of relapse at any time. When the analysis was restricted to a follow-up of 1 year, a protein level in the CSF above the median and the presence of antibody in the CSF (both at discharge) were associated in univariate analysis with relapse. A high number of patients were lost to follow-up, which may have resulted in bias. From the data available, the majority of the relapses were recorded within 12 months and the presence of antibody in the CSF at hospital discharge was identified as an independent predictor of future relapse at any time.

The treatment and post therapeutic follow up of patients diagnosed with HAT are important for HAT control. A longitudinal survey was implemented in the focus of Daloa (Côte d'Ivoire). A total of 812 patients infected with Trypanosoma brucei gambiense in meningoencephalitic stage and treated with melarsoprol were included, this study pointed out the biological characteristics of patients after treatment. The relapse occurs between 1 and 24 months after treatment. It is essentially neurological, and characterised by the presence in the CSF of antibodies, by the increase of cell count compared with value immediately after treatment, or by the presence of trypanosomes. The cure can be confirmed from 18 months after treatment, and is characterised by the absence of antibodies and trypanosomes in the CSF, by a normal cell count and a normal proteinorachy. Biological scares were recorded on some of the patients after 18 months of follow up, but no relapse occurred among them.