Evaluation of immunoassays for diagnosis and management of sleeping sickness in Liberia.

Nineteen parasitologically confirmed Liberian sleeping sickness patients were observed for up to 40 months. Efficacy of suramin therapy was indicated by decrease of serum and CSF immunoglobulins as well as by decreasing IgG and IgM serum antibody levels as determined by ELISA and fluorescence antibody tests. The tendency of serum antibody concentrations to increase again during the second and third years after treatment could be explained in one patient only who experienced relapse or reinfection, confirmed by demonstration of blood trypanosomes. Known endemic and nonendemic areas in Liberia could not be discriminated by the prevalence of Trypanosoma IgG antibodies. Furthermore, IgM antibody was present in 18% of a random sample of sera from non-endemic ares. The possibility of trypanosomes other than T.b. gambiense to stimulate antibody production in man is discussed.