AFRICAN TRYPANOSOMIASIS

African Trypanosomiasis, widely known as “sleeping sickness,” is induced by the Trypanosoma brucei family of parasites. They are transmitted to individuals through the bites of tsetse flies (Glossina genus) infected by animals or people carrying human pathogenic parasites.

Tsetse flies are exclusively found in Sub-Saharan Africa, and only a few species carry the illness. Sleeping sickness is not common in many areas where tsetse flies are present for unknown reasons. The sickness may spread from a single village to a whole region. 

TYPES

African Trypanosomiasis comes in two different forms:

  • Trypanosoma brucei rhodesiense is the agent that causes East African sleeping sickness. Acute illness that lasts for many weeks to months.
  • Trypanosoma brucei gambiense is the parasite that causes West African sleeping sickness. This chronic (long-term) infection can persist for many years.

SYMPTOMS

The bites of tsetse flies can be very severe. Within a week, a painful sore frequently develops at the bite site. It is referred to as a “chancre.”

Typically, symptoms occur one to four weeks following an infection. Symptoms that may appear as the condition worsens include:

  • Insomnia
  • Personality change
  • Difficulty walking and talking
  • Weight loss
  • Extended periods of sleeping
  • Slurred speech
  • Progressive confusion
  • Seizures
  • Loss of concentration
  • Severe headache
  • Insomnia at night
  • Irritability

DIAGNOSIS

African Trypanosomiasis can be diagnosed in three steps:

  • Screening for possible infection. This entails employing serological tests (possible only for T. b.gambiense) and looking for clinical symptoms, particularly enlarged cervical lymph nodes.
  • Diagnosis can be done by examining if the parasite is present in bodily fluids.
  • The procedure of identifying the stage of progression of the disease. This includes a clinical examination as well as the investigation of CSF fluid collected by lumbar puncture in certain circumstances.

To prevent expensive and dangerous therapeutic procedures, a diagnosis must be established as soon as possible to avoid moving to the neurological stage.

TREATMENT

Treatment options for sleeping sickness depend on the parasite’s subspecies and the illness’s stage. Stage one disease requires less invasive and harmful treatment methods than more advanced infections.

Stage One Treatments

In the early stages of African trypanosomiasis, the disease is often treated with two different antimicrobial medications:

  • Pentamidine. Patients with stage one West African sleeping sickness are treated with pentamidine, which is given intravenously or injected.
  • Suramin. East African sleeping sickness is treated with the intravenous administration of suramin.

Stage Two Treatments

If an infection has already crossed the blood-brain barrier, one of the following three medications should be used to treat it:

  • Eflornithine. Patients with stage two West African sleeping sickness are treated with eflornithine. For two weeks straight, it is given intravenously four times every day.
  • Melarsoprol. The second stage of East African sleeping sickness can only be treated with this drug, which also works to treat West African sleeping sickness.
  • Nifurtimo. Nifurtimox is often used with eflornithine to treat West African sleeping sickness, although it is typically used to manage American trypanosomiasis (commonly known as Chagas disease).

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