Trypanosomiasis (African):Treatment, symptoms, advice and help
About trypanosomiasis (African)
Trypanosomiasis (African) or sleeping sickness is infection with organisms called trypanosomes conveyed to humans by the bites of infected tsetse files. It results in swelling of the brain.
Trypanosomiasis (African): Incidence, age and sex
Rural populations engaged in agriculture, fishing and animal husbandry are most susceptible. Local people and tourists visiting forests infested with tsetse flies and animal reservoirs may become infected.
Symptoms and signs of trypanosomiasis (African)
A bite by a tsetse fly is painful and commonly becomes inflamed, but if trypanosomes are introduced, the site becomes painful and swollen about 10 days later (‘trypanosomal chancre’) and the regional lymph nodes enlarge. Within 2-3 weeks of infection the trypanosomes invade the blood stream. The disease is characterized by an early haematolymphatic stage and a late encephalitic stage in which the parasite crosses the blood-brain barrier and chronic encephalopathy develops leading to drowsiness during the day, but insomnia at night. Sleep becomes uncontrollable as the disease gets worse, and eventually leads to coma.
Thick and thin blood films, stained as for the detection of malaria, will reveal trypanosomes. The trypanosomes may be seen in the blood or from puncture of the primary lesion in the earliest stages of infection, but it is usually easier to demonstrate them by puncture of a lymph node.
Causes and prevention of Trypanosomiasis (African):
African sleeping sickness is caused by trypanosomes conveyed to humans by the bites of infected tsetse flies, and is unique to sub-saharan Africa. Two trypanosomes affect humans in Africa: Trypanosoma brucei gambiense and T.rhodesiense.
Prevention: In endemic gambiense areas, various measures may be taken against tsetse flies, and field teams help to detect and treat early human infection. In rhodesiense areas, control is difficult.
Trypanosomiasis (African): Complications
Complications include injury related to falling asleep while driving or performing other activities, and progressive damage to the nervous system.
Trypanosomiasis (African): Treatment
The prognosis is good if treatment is begun early before the brain has been invaded. At this stage intravenous suramin, after a test done of 100 – 200 mg should be given, 1 g on days 1, 3, 7, 14 and 21 for rhodesiense infections. For gambiense infection, intramuscular or intravenous pentamidine 4mg / kg for 10 days is given .Once the nervous system is affected, treatment with melarsoprol (an arsenical) is effective.