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    African Trypanosomiasis

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    Ahlam Ali
    African trypanosomiasis, also known as sleeping sickness, is caused by infection with Trypanosoma brucei parasites transmitted through bites from tsetse flies. The disease exists in two forms based on the parasite subtype: Gambian sleeping sickness caused by T.b. gambiense and Rhodesian sleeping sickness caused by T.b. rhodesiense. Clinical features include fever, headaches, daytime sleeping, tremors, and eventually coma if untreated. Diagnosis involves microscopic examination of blood, lymph nodes, or spinal fluid for parasites or serological tests. Treatment depends on the disease stage, but may include suramin, melarsoprol, or pentamidine. Control relies on treatment

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    African Trypanosomiasis

    Uploaded by

    Ahlam Ali
    18 views19 pages
    African trypanosomiasis, also known as sleeping sickness, is caused by infection with Trypanosoma brucei parasites transmitted through bites from tsetse flies. The disease exists in two forms based on the parasite subtype: Gambian sleeping sickness caused by T.b. gambiense and Rhodesian sleeping sickness caused by T.b. rhodesiense. Clinical features include fever, headaches, daytime sleeping, tremors, and eventually coma if untreated. Diagnosis involves microscopic examination of blood, lymph nodes, or spinal fluid for parasites or serological tests. Treatment depends on the disease stage, but may include suramin, melarsoprol, or pentamidine. Control relies on treatment

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    African trypanosomiasis, also known as sleeping sickness, is caused by infection with Trypanosoma brucei parasites transmitted through bites from tsetse flies. The disease exists in two forms based on the parasite subtype: Gambian sleeping sickness caused by T.b. gambiense and Rhodesian sleeping sickness caused by T.b. rhodesiense. Clinical features include fever, headaches, daytime sleeping, tremors, and eventually coma if untreated. Diagnosis involves microscopic examination of blood, lymph nodes, or spinal fluid for parasites or serological tests. Treatment depends on the disease stage, but may include suramin, melarsoprol, or pentamidine. Control relies on treatment

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    18 views19 pages

    African Trypanosomiasis

    Uploaded by

    Ahlam Ali
    African trypanosomiasis, also known as sleeping sickness, is caused by infection with Trypanosoma brucei parasites transmitted through bites from tsetse flies. The disease exists in two forms based on the parasite subtype: Gambian sleeping sickness caused by T.b. gambiense and Rhodesian sleeping sickness caused by T.b. rhodesiense. Clinical features include fever, headaches, daytime sleeping, tremors, and eventually coma if untreated. Diagnosis involves microscopic examination of blood, lymph nodes, or spinal fluid for parasites or serological tests. Treatment depends on the disease stage, but may include suramin, melarsoprol, or pentamidine. Control relies on treatment

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 19

    African Trypanosomiasis

    (Sleeping Sickness)

    Prepared by Dr: M. A. Hergeye


    June 2009
    Definition

     Infection with protozoa of the genus


    Trypanosoma, which causes a chronic
    disease with generalized lymph
    adenopathy and often fatal
    meningoencephalitis.
    Aetiology
     Parasite - Trypanosoma brucei ssp
     Trypanosoma brucei rhodesiense
     Trypanosoma brucei Gambians
     Vector - Tse Tse fly
     Glossina mortisans (Eastern Africa)
     Glossina palpalis (Western Africa)
    The Parasite
     Polymorphic spindle-shaped
     Kinetoplast
     Flagella & undulating membrane

    Trypomastigote
    Epimastigote
    Epidemiology
     50 million at risk
     <20% under surveillance
     20,000 new case/year
     Devastating epidemics
     200 endemic foci
    Distribution
    African Trypanosomiasis
    The Life Cycle

    Human Tse fly

    Trypomastigote Trypomastigote
    Stumpy Metacyclic
    Intermediate Epimastigote
    Slender Trypomastigote
    The Vectors
     Glossina
     22 species
     Shady habitat (20-30oC)
     Diurnal feeders
     Parasite development 10-14 days
    African Sleeping Sickness
    T.b.gambiense T.b.rhodesiense

     Virulence Less More


     Reservoir Human/animal Human/animal
     Zoonotic Less More
     Vector G.palpalis G.mortisans
     Distribution Western Africa Eastern Africa
    Clinical features.

     The disease produced by T. b. gambiense


    usually develops chronically whereas in T. b.
    rhodesiense infection the disease tend to be
    more acute, without a clear distinction
    between stages
    Clinical features.

     A papule may develop within a few days to 2


    weeks at the site of the tsetse fly bite.
     Painful, red, indurated nodules may develop
    ( trypanosomal chancre)
     Resolves spontaneously.
     The next phase of illness develops with:
     Intermittent fever, headache, rigors.
     Enlarged lymph nodes in the posterior cervical
    triangle is characteristic of Gambian sleeping
    sickness (Winter bottom's sign).
    Clinical features
    cont.
    CNS involvement causes:
     Persistent headache.
     Inability to concentrate.
     Personality change.
     Daytime somnolence.
     Hyperphagia.
     Tremor, ataxia, and coma.
     Death usually occurs within 9 months
    (Rhodesian form) and 2nd or 3rd year in the
    (Gambian form).
    Clinical Features
    Primary chancre - resolves 2-3 weeks
    Initial symptoms - fever & headaches
    Day time sleeping
    Tremors & Convulsions
    Coma & Death

    Enlarged cervical lymph nodes


    Winterbottoms sign
    Clinical Features

    On physical examination there may be


    erythematous circinate papules on the trunk,
    disproportionate pain to soft tissue pressure
    (Kerandel's sign) and discrete enlargement of
    lymph nodes, liver and spleen. Pancarditis is
    common in the more acute forms, when it
    constitutes a major cause of death. Some
    degree of anemia, thrombocytopenia,
    leukocytosis, hypogonadism, renal disease
    and thymus atrophy may be seen.
    Clinical Features

    The CNS manifestation that gave the disease its


    name is the disappearance of the circadian
    distribution of sleep and wakefulness, which are
    therefore fragmented throughout the day and night.
    Other CNS manifestations include altered reflexes,
    paresthesiae, pareses, dyskinesia, choreoathetosis,
    epilepsy, slurred speech, mood changes, lethargy,
    delirium and psychosis. Without treatment, nearly all
    patients will develop neural involvement and die
    Diagnosis
     Direct microscopy
     Blood.
     Lymph node aspirate.
     Lumbar puncture.
     Serology
     Animal inoculation
    Chemotherapy
     Early stage - most recover
     Suramin 1 gr I.V for day 1,3,7,14 and 21
     Melasporol (drug of choice for CNS disease) 2-3
    MG/KG I.V for 3 days. Repeated at 1 and 2 wk
     Pentamidine
     Late stage - upto 5% relapse
     Only Melasporol
     10% encephalitis - 5% fatal
    Control and prevention
     Destruction of animal reservoir
     Vector Control
     Diagnosis & treatment
     Avoiding endemic areas
     Protects against tsetse flies.
    Trypanosome Elimination
     Antibody mediated
     Destruction by Kupffer cells
     Splenic macrophages minor role ( malaria)
     Uptake - C3b - C3bi - direct
     C mediated lysis not important
     Trypanosome destroyed within minutes

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