Trypanosomiasis


Trypanosomiasis
Trypanosomiasis
Classification and external resources
ICD-10 B56-B57
ICD-9 086.5-086
MeSH D014352

Trypanosomiasis or trypanosomosis is the name of several diseases in vertebrates caused by parasitic protozoan trypanosomes of the genus Trypanosoma. Approximately 500,000 men, women and children in 36 countries of sub-Saharan Africa suffer from human African trypanosomiasis which is caused by either Trypanosoma brucei gambiense or Trypanosoma brucei rhodesiense. The other human form of trypanosomiasis, called Chagas disease, causes 21,000 deaths per year [1] mainly in Latin America.

Contents

Human trypanosomiases

See main article: Human trypanosomiasis

Diagnosis

Diagnosing African trypanosomiasis requires the documentation of T.brucei in blood smears, lymph node aspirates, or CSF.[2] Presentation of the disease outside the endemic areas, especially in Western Europe, may present a diagnostic problem to the treating physician[3]

Treatment

American trypanosomiasis is currently treated with a variety of antifungal agents, including benznidazole and nifurtimox. Melarsoprol is another drug which is used for the treatment of T. b. gambiensie.

Epidemiology

Disability-adjusted life year for trypanosomiasis per 100,000 inhabitants.
  no data
  less than 10
  10-25
  25-50
  50-75
  75-100
  100-150
  150-200
  200-250
  250-300
  300-400
  400-500
  more than 500

Animal trypanosomiases

Chagas endemic zones (in red)
  • Nagana, or Animal African trypanosomiasis, also called 'Souma' or 'Soumaya' in Sudan.
  • Surra
  • Mal de caderas (of central South America)
  • Murrina de caderas (of Panama; Derrengadera de caderas)
  • Dourine
  • Cachexial fevers (various)
  • Gambian horse sickness (of central Africa)
  • Baleri (of Sudan)
  • Kaodzera (Rhodesian trypanosomiasis)
  • Tahaga (a disease of camels in Algeria)
  • Galziekte, galzietzke (bilious fever of cattle; gall sickness of South Africa)
  • Peste-boba (of Venezuela; Derrengadera)

Some species of cattle such as the African buffalo, N'dama and Keteku appear trypanotolerant and do not suffer from clinical disease. Calves are more resistant than adults.

Clinical signs and diagnosis

Cattle may show enlarged lymph nodes and internal organs. Haemolytic anaemia is a characteristic sign. Systemic disease and reproductive failure are common, and cattle appear to waste away.

Horses with dourine show signs of ventral and genital oedema and urticaria.

Infected dogs and cats may show severe systemic signs.

Diagnosis relies on recognition of the flagellate on a blood smear. Motile organisms may be visible in the buffy coat when a blood sample is spun down. Serological testing is also common.

Treatment and prevention

Diminazene, homidium, isometadium, suramin and melarsomine can all be used to treat infections. Resistance is increasing in endemic areas and recurrent treatments may be necessary.

The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread.

Fly control is another option but is difficult to implement.

Bibliography

  • Thomas (1905). Report on Trypanosomes. London. 
  • Manson, Patrick, Sir, G.C.M.G. (1914). Tropical diseases (5th ed.). London. 
  • Daniels, C. W. (1914). Tropical Medicine and Hygiene. New York. 
  • Miles, Michael W.; Ian Maudlin; Holmes, Peter (2004). The Trypanosomiases. Wallingford, UK: CABI Publishing. ISBN 0-85199-475-X. 

References

  1. ^ Maya JD, Cassels BK, Iturriaga-Vásquez P, et al. (2007). "Mode of action of natural and synthetic drugs against Trypanosoma cruzi and their interaction with the mammalian host". Comp. Biochem. Physiol., Part a Mol. Integr. Physiol. 146 (4): 601–20. doi:10.1016/j.cbpa.2006.03.004. PMID 16626984. http://linkinghub.elsevier.com/retrieve/pii/S1095-6433(06)00173-5. 
  2. ^ Pepin J (2007). "Combination therapy for sleeping sickness: a wake-up call". J. Infect. Dis. 195 (3): 311–3. doi:10.1086/510540. PMID 17205466. 
  3. ^ Vingerhoets LMA, Bauer MP, Hamminga AE, Verweij JJ, Visser LG (2011). "Treatment and follow-up using microscopy and polymerase chain reaction in East African sleeping sickness: a case report". Grand Rounds 11: 12–15. doi:10.1102/1470-5206.2011.0003. http://www.grandrounds-e-med.com/articles/gr110003.htm.