After treatment for Gambian African Trypanosomiasis, the patient should be followed by repeated CSF examinations in order to detect disease relapse. Most patients manifest relapse by a rising WBC counts in the CSF, associated with recurrent symptoms.



Clinical Status

Lumbar Puncture to Monitor CSF


every 6 months for 2 years


less than 6 months

borderline elevations in CSF WBC counts and asymptomatic (20-50 per µL after melarsoprol or eflornithine; 6-19 per µL after pentamidine)

less than 6 months


Definite criteria for relapse:

(1) demonstration of trypanosomes in CSF, blood or lymph nodes


Presumptive diagnosis for relapse after melarsoprol or eflornithine:

(1) CSF WBC count > 50 per µL, AND if greater than previous count

(2) CSF WBC count 20-50 per µL AND higher than last count AND presence of symptom recurrence


Presumptive diagnosis for relapse after pentamidine:

(1) CSF WBC > 20 per µL


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