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 (T. b. rhodesiense or T. b. gambiense) is causing the infection. However, infection with either form will eventually lead to coma and death if not treated.[1][2][3][4]

Symptoms

Symptoms of African trypanosomiasis include:

Symptoms
Systemic
  • Sweating
  • Anxiety
  • Fever
First stage (hemo-lyphatic stage)
  • Headaches
  • Joint pains and itching
Second stage (neurological or meningo-encephalic stage)
  • Changes of behaviour
  • Confusion
  • Sensory disturbances
  • Poor coordination
  • Disturbance of the sleep cycle,

The subspecies that cause African trypanosomiasis have different rates of disease progression, and the clinical features depend on which form of the parasite (T. b. rhodesiense or T. b. 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)

  • A large sore (a chancre) will develop at the site of the tsetse bite
  • Fever, headache, muscle and joint aches, and enlarged lymph node
  • 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)

  • Intermittent fevers, headaches, muscle and joint aches, and malaise.
  • Itching of the skin, swollen lymph nodes, and weight loss
  • Personality changes, daytime sleepiness with nighttime sleep disturbance, and progressive confusion
  • Other neurologic signs, such as partial paralysis or problems with balance or walking may occur, as well as hormonal imbalances
  • The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 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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