African trypanosomiasis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid, Aditya Ganti M.B.B.S. [2]

Overview

The clinical course of human African trypanosomiasis has two stages. In the first stage, the parasite is found in the peripheral circulation but it has not yet invaded the central nervous system. Once the parasite crosses the blood-brain barrier and infects the central nervous system, the disease enters the second stage. The subspecies that cause African trypanosomiasis have different rates of disease progression, and the clinical features depend on which form of the parasite (Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense) is causing the infection. However, infection with either form will eventually lead to coma and death if not treated.

History

Obtaining the history is the most important aspect of making a diagnosis of African trypanosomiasis. It provides insight into cause, precipitating factors, and associated comorbid conditions. A patient suffering from African trypanosimiasis may present with the following history:

  • Recent travel to the endemic areas
  • Any ill contact with similar complaints

Symptoms

Symptoms of African trypanosomiasis include:[1][2][3][4]

Stages of infection Symptoms
Systemic
First stage (hemo-lyphatic stage)
Second stage (neurological or meningoencephalic stage)

The subspecies that cause African trypanosomiasis have different rates of disease progression and the clinical features depend on which form of the parasite (Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense) is causing the infection.

Disease Pathogen Geographic

distrubution

Progression Symptoms
First stage Second stage
East African sleeping sickness Trypanosoma brucei rhodesiense East and Southeast Africa Rapid

(1-2 weeks)

  • Mental deterioration and other neurologic problems. Death ensues usually within months.
West African sleeping sickness Trypanosoma brucei gambiense West and Central Africa Slow

(1-2 years)

References

  1. Brun R, Blum J, Chappuis F, Burri C (2010). "Human African trypanosomiasis". Lancet. 375 (9709): 148–59. doi:10.1016/S0140-6736(09)60829-1. PMID 19833383.
  2. Masocha W, Rottenberg ME, Kristensson K (2007). "Migration of African trypanosomes across the blood-brain barrier". Physiol. Behav. 92 (1–2): 110–4. doi:10.1016/j.physbeh.2007.05.045. PMID 17582444.
  3. Checchi F, Filipe JA, Haydon DT, Chandramohan D, Chappuis F (2008). "Estimates of the duration of the early and late stage of gambiense sleeping sickness". BMC Infect. Dis. 8: 16. doi:10.1186/1471-2334-8-16. PMC 2259357. PMID 18261232.
  4. Odiit M, Kansiime F, Enyaru JC (1997). "Duration of symptoms and case fatality of sleeping sickness caused by Trypanosoma brucei rhodesiense in Tororo, Uganda". East Afr Med J. 74 (12): 792–5. PMID 9557424.

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