{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:12:22Z","timestamp":1793661142006,"version":"4.5.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["209511\/Z\/17\/Z"],"award-info":[{"award-number":["209511\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012947","name":"Institut de Recherche pour le D\u00e9veloppement","doi-asserted-by":"publisher","award":["ANR-10-LABX-62-IBEID"],"award-info":[{"award-number":["ANR-10-LABX-62-IBEID"]}],"id":[{"id":"10.13039\/100012947","id-type":"DOI","asserted-by":"publisher"}]},{"name":"French National Agency for Scientific Research","award":["ANR-14-CE14-0019-01"],"award-info":[{"award-number":["ANR-14-CE14-0019-01"]}]},{"name":"French National Agency for Scientific Research","award":["ANR-18-CE15-0012"],"award-info":[{"award-number":["ANR-18-CE15-0012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The diagnosis of gambiense human African trypanosomiasis (gHAT) typically involves 2 steps: a serological screen, followed by the detection of living trypanosome parasites in the blood or lymph node aspirate. Live parasites can, however, remain undetected in some seropositive individuals, who, we hypothesize, are infected with Trypanosoma brucei gambiense parasites in their extravascular dermis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To test this hypothesis, we conducted a prospective observational cohort study in the gHAT focus of Forecariah, Republic of Guinea. Of the 5417 subjects serologically screened for gHAT, 66 were enrolled into our study and underwent a dermatological examination. At 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 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). However, T. brucei parasites were detected in the extravascular dermis of all unconfirmed seropositive individuals and all confirmed cases. Skin biopsies of all treated cases and most seropositive untreated individuals progressively became negative for trypanosomes 6 and 20 months later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results highlight the skin as a potential reservoir for African trypanosomes, with implications for our understanding of this disease\u2019s epidemiology in the context of its planned elimination and underlining the skin as a novel target for gHAT diagnostics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa897","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T07:26:38Z","timestamp":1593069998000},"page":"12-20","source":"Crossref","is-referenced-by-count":71,"title":["Extravascular Dermal Trypanosomes in Suspected and Confirmed Cases of\n                    <i>gambiense<\/i>\n                    Human African Trypanosomiasis"],"prefix":"10.1093","volume":"73","author":[{"given":"Mariame","family":"Camara","sequence":"first","affiliation":[{"name":"Programme National de Lutte Contre la Trypanosomiase Humaine Africaine, Minist\u00e8re de la Sant\u00e9, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alseny M\u2019mah","family":"Soumah","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre la Trypanosomiase Humaine Africaine, Minist\u00e8re de la Sant\u00e9, Conakry, Guinea"},{"name":"Service de Dermatologie, H\u00f4pital de Donka,Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidou","family":"Ilboudo","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre la Trypanosomiase Humaine Africaine, Minist\u00e8re de la Sant\u00e9, Conakry, Guinea"},{"name":"Institut de Recherche en Sciences de la Sant\u00e9 (IRSS)\u2014Unit\u00e9 de Recherche Clinique de Nanoro (URCN), Nanoro, Burkina-Faso"},{"name":"Institut de Recherche pour le D\u00e9veloppement, Unit\u00e9 Mixte de Recherche Institut de Recherche pour le D\u00e9veloppement (IRD)-CIRAD 177 InterTryp, Campus International de Baillarguet, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Travaill\u00e9","sequence":"additional","affiliation":[{"name":"Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Clucas","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary, and Life Sciences, Henry Wellcome Building for Comparative Medical Sciences, Glasgow, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneli","family":"Cooper","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary, and Life Sciences, Henry Wellcome Building for Comparative Medical Sciences, Glasgow, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nono-Raymond","family":"Kuispond Swar","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary, and Life Sciences, Henry Wellcome Building for Comparative Medical Sciences, Glasgow, Scotland, United Kingdom"},{"name":"Department of Parasitology, National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumou","family":"Camara","sequence":"additional","affiliation":[{"name":"Programme National de Lutte Contre la Trypanosomiase Humaine Africaine, Minist\u00e8re de la Sant\u00e9, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Sadissou","sequence":"additional","affiliation":[{"name":"Institut de Recherche pour le D\u00e9veloppement, Unit\u00e9 Mixte de Recherche Institut de Recherche pour le D\u00e9veloppement (IRD)-CIRAD 177 InterTryp, Campus International de Baillarguet, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefania","family":"Calvo Alvarez","sequence":"additional","affiliation":[{"name":"Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Crouzols","sequence":"additional","affiliation":[{"name":"Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Mathieu","family":"Bart","sequence":"additional","affiliation":[{"name":"Institut de Recherche pour le D\u00e9veloppement, Unit\u00e9 Mixte de Recherche Institut de Recherche pour le D\u00e9veloppement (IRD)-CIRAD 177 InterTryp, Campus International de Baillarguet, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Jamonneau","sequence":"additional","affiliation":[{"name":"Institut de Recherche pour le D\u00e9veloppement, Unit\u00e9 Mixte de Recherche Institut de Recherche pour le D\u00e9veloppement (IRD)-CIRAD 177 InterTryp, Campus International de Baillarguet, Montpellier, 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