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Clinical Infectious Diseases : An... Jun 2000
Topics: Female; Humans; Hypoglycemia; Middle Aged; Trypanosomiasis, African
PubMed: 10880327
DOI: 10.1086/313833 -
Trends in Parasitology Aug 2016Animal African trypanosomiasis (AAT), caused by Trypanosoma congolense and Trypanosoma vivax, remains one of the most important livestock diseases in sub-Saharan Africa,... (Review)
Review
Animal African trypanosomiasis (AAT), caused by Trypanosoma congolense and Trypanosoma vivax, remains one of the most important livestock diseases in sub-Saharan Africa, particularly affecting cattle. Despite this, our detailed knowledge largely stems from the human pathogen Trypanosoma brucei and mouse experimental models. In the postgenomic era, the genotypic and phenotypic differences between the AAT-relevant species of parasite or host and their model organism counterparts are increasingly apparent. Here, we outline the timeliness and advantages of increasing the research focus on both the clinically relevant parasite and host species, given that improved tools and resources for both have been developed in recent years. We propose that this shift of emphasis will improve our ability to efficiently develop tools to combat AAT.
Topics: Africa South of the Sahara; Animals; Host-Parasite Interactions; Research; Trypanosoma; Trypanosomiasis, African
PubMed: 27167665
DOI: 10.1016/j.pt.2016.04.012 -
Journal of Travel Medicine 2012Human African trypanosomiasis (HAT) can affect travelers to sub-Saharan Africa, as well as migrants from disease endemic countries (DECs), posing diagnosis challenges to... (Review)
Review
BACKGROUND
Human African trypanosomiasis (HAT) can affect travelers to sub-Saharan Africa, as well as migrants from disease endemic countries (DECs), posing diagnosis challenges to travel health services in non-disease endemic countries (non-DECs).
METHODS
Cases reported in journals have been collected through a bibliographic research and complemented by cases reported to the World Health Organization (WHO) during the process to obtain anti-trypanosome drugs. These drugs are distributed to DECs solely by WHO. Drugs are also provided to non-DECs when an HAT case is diagnosed. However, in non-DEC pentamidine can also be purchased in the market due to its indication to treat Pneumocystis and Leishmania infections. Any request for drugs from non-DECs should be accompanied by epidemiological and clinical data on the patient.
RESULTS
During the period 2000 to 2010, 94 cases of HAT were reported in 19 non-DECs. Seventy-two percent of them corresponded to the Rhodesiense form, whereas 28% corresponded to the Gambiense. Cases of Rhodesiense HAT were mainly diagnosed in tourists after short visits to DECs, usually within a few days of return. The majority of them were in first stage. Initial misdiagnosis with malaria or tick-borne diseases was frequent. Cases of Gambiense HAT were usually diagnosed several months after initial examination and subsequent to a variety of misdiagnoses. The majority were in second stage. Patients affected were expatriates living in DECs for extended periods and refugees or economic migrants from DECs.
CONCLUSIONS
The risk of HAT in travelers and migrants, albeit low, cannot be overlooked. In non-DECs, rarity, nonspecific symptoms, and lack of knowledge and awareness in health staff make diagnosis difficult. Misdiagnosis is frequent, thus leading to invasive diagnosis methods, unnecessary treatments, and increased risk of fatality. Centralized distribution of drugs for HAT by WHO enables an HAT surveillance system for non-DECs to be maintained. This system provides valuable information on disease transmission and complements data collected in DECs.
Topics: Africa; Animals; Endemic Diseases; Female; Humans; Male; Middle Aged; Trypanosoma; Trypanosomiasis, African; Young Adult
PubMed: 22221811
DOI: 10.1111/j.1708-8305.2011.00576.x -
PLoS Neglected Tropical Diseases Nov 2022Sleeping sickness, or human African trypanosomiasis (HAT), is transmitted by tsetse flies in endemic foci in sub-Saharan Africa. Because of international travel and...
BACKGROUND
Sleeping sickness, or human African trypanosomiasis (HAT), is transmitted by tsetse flies in endemic foci in sub-Saharan Africa. Because of international travel and population movements, cases are also occasionally diagnosed in non-endemic countries.
METHODOLOGY/PRINCIPAL FINDINGS
Antitrypanosomal medicines to treat the disease are available gratis through the World Health Organization (WHO) thanks to a public-private partnership, and exclusive distribution of the majority of them enables WHO to gather information on all exported cases. Data collected by WHO are complemented by case reports and scientific publications. During 2011-2020, 49 cases of HAT were diagnosed in 16 non-endemic countries across five continents: 35 cases were caused by Trypanosoma brucei rhodesiense, mainly in tourists visiting wildlife areas in eastern and southern Africa, and 14 cases were due to T. b. gambiense, mainly in African migrants originating from or visiting endemic areas in western and central Africa.
CONCLUSIONS/SIGNIFICANCE
HAT diagnosis in non-endemic countries is rare and can be challenging, but alertness and surveillance must be maintained to contribute to WHO's elimination goals. Early detection is particularly important as it considerably improves the prognosis.
Topics: Animals; Humans; Trypanosomiasis, African; Trypanosoma brucei rhodesiense; Tsetse Flies; Black People; Africa, Southern; Trypanosoma brucei gambiense
PubMed: 36342910
DOI: 10.1371/journal.pntd.0010885 -
Journal of Neuroimmunology Jun 2009Trypanosomes have been recognised as human pathogens for over a century. Human African trypanosomiasis is endemic in an area sustaining 60 million people and is fatal... (Review)
Review
Trypanosomes have been recognised as human pathogens for over a century. Human African trypanosomiasis is endemic in an area sustaining 60 million people and is fatal without chemotherapeutic intervention. Available trypanocidal drugs require parenteral administration and are associated with adverse reactions including the development of a severe post-treatment reactive encephalopathy (PTRE). Following infection the parasites proliferate in the systemic compartment before invading the CNS where a cascade of events results in neuroinflammation. This review summarises the clinical manifestations of the infection and chemotherapeutic regimens as well as the current research findings and hypotheses regarding the neuropathogenesis of the disease.
Topics: Animals; Central Nervous System Protozoal Infections; Humans; Trypanocidal Agents; Trypanosomiasis, African
PubMed: 19269696
DOI: 10.1016/j.jneuroim.2009.02.007 -
PLoS Neglected Tropical Diseases May 2024
Topics: Humans; Trypanosomiasis, African; Disease Eradication; Animals; Africa; Neglected Diseases
PubMed: 38691551
DOI: 10.1371/journal.pntd.0012091 -
Brain Pathology (Zurich, Switzerland) Jan 1997African (sleeping sickness) and American (Chagas' disease) trypanosomiasis, caused by protozoa of the family Trypanosomatidae, are diseases that are endemic in parts of... (Review)
Review
African (sleeping sickness) and American (Chagas' disease) trypanosomiasis, caused by protozoa of the family Trypanosomatidae, are diseases that are endemic in parts of Africa and Latin America, respectively. Physicians in developed countries may occasionally see cases because of extensive travel and immigration from endemic countries. Although neurological involvement is common in both, its incidence and clinical presentation differ considerably. African trypanosomiasis, caused by subspecies of Trypanosoma brucei (T b rhodesiense, T b gambiense), is transmitted by the tsetse fly and causes meningoencephalitis, in which somnolence is a prominent feature. Parasites may reach the brain parenchyma through the choroid plexus or the Virchow Robin spaces. American trypanosomiasis, caused by Trypanosoma cruzi is transmitted by reduviid bugs. While lesions in the central nervous system are not prominent, except in the reactivated forms which occur in immunodeficient patients, the peripheral nerve, mainly the autonomic nervous system, is frequently involved, leading to the cardiomegaly and the digestive megaviscera. Congenital infections may also occur. In this paper we give an account of the epidemiology, clinical presentation and pathological features of these two protozoal infections based on human and experimental studies of both the central and peripheral nervous system.
Topics: Animals; Central Nervous System Diseases; Chagas Disease; Endemic Diseases; Humans; Infant, Newborn; Peripheral Nervous System Diseases; Recurrence; Trypanosomiasis, African; Zoonoses
PubMed: 9034568
DOI: 10.1111/j.1750-3639.1997.tb01077.x -
Trends in Parasitology Sep 2006In West and Central Africa, the protozoan parasite Trypanosoma brucei (T. b.) gambiense causes a chronic form of Human African trypanosomiasis (HAT) that might last... (Review)
Review
In West and Central Africa, the protozoan parasite Trypanosoma brucei (T. b.) gambiense causes a chronic form of Human African trypanosomiasis (HAT) that might last several years, whereas T. b. rhodesiense refers to an acute form in East Africa that lasts weeks to months. Without treatment, both forms can cause death. Diagnosis relies on detecting parasites in blood, lymph or cerebrospinal fluid. HAT was no longer considered a public health problem in the 1960s, but it returned to alarming levels in the 1990s. After intensifying case detection and treatment, WHO recently declared the situation is under control. However, research based on host and trypanosome interactions should be encouraged to help develop innovative tools for HAT diagnosis and treatment to prevent re-emergence.
Topics: Africa; Animals; Endemic Diseases; Genetic Variation; Host-Parasite Interactions; Humans; Immunity, Innate; Trypanosoma brucei gambiense; Trypanosoma brucei rhodesiense; Trypanosomiasis, African
PubMed: 16837245
DOI: 10.1016/j.pt.2006.06.011 -
Expert Review of Anti-infective Therapy Nov 2014Treatment of second-stage gambiense human African trypanosomiasis relied on toxic arsenic-based derivatives for over 50 years. The availability and subsequent use of... (Review)
Review
Treatment of second-stage gambiense human African trypanosomiasis relied on toxic arsenic-based derivatives for over 50 years. The availability and subsequent use of eflornithine, initially in monotherapy and more recently in combination with nifurtimox (NECT), has drastically improved the prognosis of treated patients. However, NECT logistic and nursing requirements remain obstacles to its deployment and use in peripheral health structures in rural sub-Saharan Africa. Two oral compounds, fexinidazole and SCYX-7158, are currently in clinical development. The main scope of this article is to discuss the potential impact of new oral therapies to improve diagnosis-treatment algorithms and patients' access to treatment, and to contribute to reach the objectives of the recently launched gambiense human African trypanosomiasis elimination program.
Topics: Animals; Disease Progression; Drug Therapy, Combination; Humans; Trypanocidal Agents; Trypanosoma brucei gambiense; Trypanosomiasis, African
PubMed: 25204360
DOI: 10.1586/14787210.2014.959496 -
Infectious Disease Clinics of North... Jun 2012Human African trypanosomiasis (sleeping sickness) is caused by the unicellular parasite Trypanosoma brucei and transmitted by tsetse flies. It occurs exclusively in...
Human African trypanosomiasis (sleeping sickness) is caused by the unicellular parasite Trypanosoma brucei and transmitted by tsetse flies. It occurs exclusively in sub-Saharan Africa, usually in rural areas affected by civil conflicts and neglected health systems. Reported cases are fewer than 10,000/year, which classifies it as one of the most neglected tropical diseases. Because sleeping sickness is fatal if not treated, it has to be included in the differential diagnosis of every febrile traveler returning from a game park in East Africa. Elimination of the disease is considered feasible provided better tools for diagnosis and treatment can be made available.
Topics: Africa South of the Sahara; Antiprotozoal Agents; Drug Therapy, Combination; Humans; Travel; Trypanosomiasis, African
PubMed: 22632638
DOI: 10.1016/j.idc.2012.03.003