The actigraphy sleep score: a new biomarker for diagnosis, disease staging, and monitoring in human African trypanosomiasis (HAT)

Njamnshi, A. K. et al. (2020) The actigraphy sleep score: a new biomarker for diagnosis, disease staging, and monitoring in human African trypanosomiasis (HAT). American Journal of Tropical Medicine and Hygiene, 103(6), pp. 2244-2252. (doi: 10.4269/ajtmh.20-0340) (PMID:33078699)

Abstract

Human African trypanosomiasis (HAT) remains a serious public health problem with diagnostic and treatment challenges in many African countries. The absence of a gold-standard biomarker has been a major difficulty for accurate disease staging and treatment follow-up. We therefore attempted to develop a simple, affordable, and noninvasive biomarker for HAT diagnosis and staging. Simultaneous actigraphy and polysomnography as well as CSF white blood cell (WBC) count, trypanosome presence, and CXCL-10 cytokine levels were performed in 20 HAT patients and nine healthy individuals (controls) using standard procedures. The International HIV Dementia Scale (IHDS) was scored in some patients as a surrogate for clinical assessment. From actigraphic parameters, we developed a novel sleep score and used it to determine correlations with other HAT markers, and compared their performance in differentiating between patients and controls and between HAT stages. The novel actigraphy sleep score (ASS) had the following ranges: 0-25 (healthy controls), 67-103 (HAT stage I), 111-126 (HAT intermediate), and 133-250 (HAT stage II). Compared with controls, stage I patients displayed a 7-fold increase in the ASS (P < 0.01), intermediate stage patients a 10-fold increase (P < 0.001), and HAT stage II patients an almost 20-fold increase (P < 0.001). CXCL-10 showed high interindividual differences. White blood cell counts were only marked in HAT stage II patients with a high interindividual variability. The International HIV Dementia Scale score negatively correlated with the ASS. We report the development and better performance of a new biomarker, ASS, for HAT diagnosis, disease staging, and monitoring that needs to be confirmed in large cohort studies.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Kennedy, Professor Peter
• Authors: Njamnshi, A. K., Seke Etet, P. F., Ngarka, L., Perrig, S., Olivera, C. G., Nfor, L. N., Njamnshi, W. Y., Acho, A., Muyembe, J.-J., Bentivoglio, M., Rottenberg, M., and Kennedy, P. G.E.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Journal Name: American Journal of Tropical Medicine and Hygiene
• Publisher: American Society of Tropical Medicine and Hygiene
• ISSN: 0002-9637
• ISSN (Online): 1476-1645
• Published Online: 19 October 2020
• Copyright Holders: Copyright © 2020 American Society of Tropical Medicine and Hygiene
• First Published: First published in American Journal of Tropical Medicine and Hygiene 103(6):2244-2252
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher