African trypanosomiasis overview
|
African trypanosomiasis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
African trypanosomiasis overview On the Web |
|
American Roentgen Ray Society Images of African trypanosomiasis overview |
|
Risk calculators and risk factors for African trypanosomiasis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid
Overview
Sleeping sickness or African trypanosomiasis is a parasitic disease in people and animals, caused by protozoa of genus Trypanosoma and transmitted by the tsetse fly. The disease is endemic in certain regions of Sub-Saharan Africa, covering about 36 countries and 60 million people.
Historical Perspective
The condition has been present in Africa since at least the 14th century, and probably for thousands of years before that. The causative agent and vector were not identified until 1902–1903 by Sir David Bruce, and the differentiation between protozoa was not made until 1910. The first effective treatment, Atoxyl, an arsenic based drug developed by Paul Ehrlich and Kiyoshi Shiga was introduced in 1910 but blindness was a serious side effect. Numerous drugs designed to treat the disease have been introduced since then. There have been three severe epidemics in Africa over the last century: one between 1896 and 1906, mostly in Uganda and the Congo Basin, one in 1920 in several African countries, and one that began in 1970 and is still in progress. The 1920 epidemic was arrested due to mobile teams systematically screening millions of people at risk. The disease had practically disappeared between 1960 and 1965. After that success, screening and effective surveillance were relaxed and the disease has reappeared in endemic form in several foci over the last thirty years. [1]
Classification
There are two types of African trypanosomiasis; each is named for the region of Africa in which they are found:
- East african trypanosomiasis
- West african trypanosomiasis
Also known as: Sleeping Sickness[2]
Epidemiology and Demographics
It is estimated that 50,000 to 70,000 people are currently infected, the number having declined somewhat in recent years.[3]
Laboratory Findings
The diagnosis of African trypanosomiasis rests upon demonstrating trypanosomes by microscopic examination of chancre fluid, lymph node aspirates,blood,bone marrow, or, in the late stages of infection, cerebrospinal fluid.
Medical Therapy
Medical treatment of East African trypanosomiasis should begin as soon as possible and is based on the infected person’s symptoms and laboratory results. Medication for the treatment of East African trypanosomiasis is available through the CDC. Hospitalization for treatment is necessary. Periodic follow-up exams that include a spinal tap are required for 2 years. If a person fails to receive medical treatment for East African trypanosomiasis, death will occur within several weeks to months.
Medication for the treatment of West African trypanosomiasis is available. Hospitalized treatment of West African trypanosomiasis should begin as soon as possible and is based on the infected person’s symptoms and laboratory results. Hospitalization for treatment is necessary. Periodic follow-up exams that include a spinal tap are required for 2 years. West African trypanosomiasis is fatal if it is not treated.