African Sleeping Sickness

What Is African Sleeping Sickness?

African sleeping sickness is also called trypanosomiasis. It is a parasitic disease that affects humans due to infection from protozoan parasites, which belong to genus Trypanosoma. Tsetse fly obtains this parasite from infected animals or humans and transmits the infection to other people. 3

African Sleeping Sickness Picture 1

Causes

The parasite can also be transmitted to humans through the following ways:

  • Protozoan parasites can be transferred by other insects that suck blood.
  • You can also get the infections from contaminated needle used by a health officer.
  • The parasite from an infected mother can cross the placenta and infect the fetus.

Sub Saharan Africa is an inhabitant of tsetse flies although only particular species cause this disease. For unknown reasons, some areas in Africa have tsetse flies but do not have this disease. Trypanosomiasis is more prevalent in rural populations in Africa especially those who do fishing, agriculture, hunting or animal husbandry. This disease can start in one village and spread to the whole region. In those affected areas, the disease will vary in intensity from one place to another.

Types

African sleeping sickness can take two types, but this depends on which parasite is causing the disease. These types include:

Trypanosoma brucei gambiense

This type of infection occurs mostly in central and west central Africa. This disease is responsible for most of the chronic infections. Signs and symptoms appear after some time; an individual can show signs and symptoms of this disease after several years of infection. When the symptoms appear, they are mostly in advanced phase and damage especially to the nervous system is already done.

Trypanosoma brucei rhodesiense

This type of trypanosomiasis infection is more prevalent in eastern and southern Africa. Currently, it accounts for few acute infections cases.

Start of symptoms varies after infection among individuals. In some people the signs can show after some weeks while in other they may manifest after some months. This infection spreads rapidly in an infected person and can reach your nervous system and damage it.

These two types of African sleeping sickness can occur both in a country. For example only Uganda experiences these two forms of the disease, although in different areas in the country.

Distribution of African Sleeping Sickness

The occurrence of African sleeping disease differs from one country to another and also in various parts of the country. In Democratic Republic of Congo, more than 70% of this disease was reported in the last ten years. In addition DRC has over many new infections of this disease yearly. While countries such as Tanzania, Angola, Cameroon, South Sudan, Gabon etc are reporting few cases of this disease.

Symptoms

Symptoms depend on the stage of the disease. In the haemo-lymphatic stage, protozoan parasites enter your body through a bite from tsetse fly and reproduces in your body. In this stage, an infected person can have high body temperatures, headaches and pain in the joints.

In neurological or meningo-encephalic, the parasite has reached your nervous system where it causes infection. This stage is where common signs and symptoms are noticed. An infected individual can be confused and also have difficult in coordinating things. This person can have trouble in sleeping properly which can affect his/her daily chores.

Diagnosis

African sleeping sickness can be diagnosed using the following:

Serological tests

These tests are done to identify presence of antibodies in your blood. A doctor takes a sample of your blood and analyzes it in laboratory for antibodies. This test can help the doctor know if you have a parasitic infection.

The serological tests can either be normal or abnormal. When testing shows absence of antibodies in your blood, it implies that you don’t have an infection and your blood is normal.

When testing shows presence of antibodies in your blood, it means that you have been exposed to antigens such as parasites that cause infection.

Blood smear test

This test is conducted to check for problems in your blood cells. Red blood cells, white blood cells and platelets are used in this test. The test looks at the shape and number of these blood cells in your body to help your doctor diagnose blood problems.

Your doctor can take a sample of your blood and analyses it for the appearance and shape of blood cells. A blood smear test can show your blood cells to be normal in appearance and size or have different shape and number.

For abnormal smear results, it will depend on which of your blood cells are affected. In most cases parasitic infection affect your white blood cells. Your doctor will be able to determine if it is a protozoan parasite causing the infection.

Treatment

The form of treatment depends on whether the disease is in haemo-lymphatic and neurological or meningo-encephalic stage. Also for effective management of this disease, early diagnosis of the disease is vital to help in curing it. Once you have received treatment, your doctor will do follow-up for 2 years in order to completely eliminate the parasites.

The following medicines can be used to treat sleeping sickness.When the disease is in haemo-lymphatic stage, your doctor can prescribe the following drugs:

Pentamidine

This drug is used to treat the initial phase of Trypanosoma brucei gambiense.

Suramin

This drug is used to cure Trypanosoma brucei rhodesiense in its initial stages. However this drug triggers undesirable effects in patients such as allergic reaction and urinary tract infections

In neurological or meningo-encephalic stage, the following drugs can be recommended to treat the symptoms of this disease:

Melarsoprol

This drug is obtained from arsenic and is used to treat infections from both Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense. This drug can cause many side effects to the patient but the most common complication is encephalopathic syndrome. This syndrome is very fatal and can lead to death.

In addition, resistance to melarsoprol is also reported in several studies especially in central Africa countries.

Eflornithine

This drug is effective in treating Trypanosoma brucei gambiense infections. However this drug is difficult to apply to patients in the second stage of sleeping sickness infections.

African sleeping sickness can become fatal if left untreated. The best option to manage this disease is patients to go for early diagnosis. Early screening will help detect the parasite and treat in before it reaches your nervous system.

Reference List

  1. African sleeping sickness. http://www.who.int/mediacentre/factsheets/fs259/en/
  2. http://emedicine.medscape.com/article/228613-overview
  3. https://www.cdc.gov/parasites/sleepingsickness/
  4. https://travel.gc.ca/travelling/health-safety/diseases/trypanosomiasis
  5. http://www.healthline.com/health/blood-smear#results5
  6. Serologic Testing. http://www.healthline.com/health/serology#results5

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