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1 HT Présentation

Human trypanosomiasis, also known as sleeping sickness, is caused by two subspecies of the protozoan parasite Trypanosoma and transmitted by tsetse flies found only in Africa. It has two stages - an early lymphatic-blood phase with symptoms like fever and joint pain, and a later meningoencephalitic phase with neurological symptoms. It is diagnosed through tests of blood, lymph nodes, and cerebrospinal fluid for parasites or antibodies. Treatment involves trypanocidal drugs like pentamidine or melarsoprol, along with vector control and screening of at-risk populations. Though cases have declined in recent years, it remains a re-emerging threat in central

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37 views15 pages

1 HT Présentation

Human trypanosomiasis, also known as sleeping sickness, is caused by two subspecies of the protozoan parasite Trypanosoma and transmitted by tsetse flies found only in Africa. It has two stages - an early lymphatic-blood phase with symptoms like fever and joint pain, and a later meningoencephalitic phase with neurological symptoms. It is diagnosed through tests of blood, lymph nodes, and cerebrospinal fluid for parasites or antibodies. Treatment involves trypanocidal drugs like pentamidine or melarsoprol, along with vector control and screening of at-risk populations. Though cases have declined in recent years, it remains a re-emerging threat in central

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ngombanaomi79
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HUMAN

TRYPANOSOMIASIS
Sleeping sickness
PLAN

Introduction
• Definition
• Epidemiology
• Signs-Symptom
• symptomatology
• Diagnostics
• Treatments

Conclusion
Introduction

Tropical diseases include all those that occur solely or mainly in tropical regions.
Trypanosomiasis is one of these tropical diseases, transmitted by flies found only in Africa
(tsetse flies), which means that it is a strictly African disease.
Definition

Sleeping sickness or human trypanosomiasis (HT) is a vector-borne,


parasitic disease of the blood. It is caused by the presence and development
in the human body of flagellate protozoa of the Trypanosoma genus. In
West and Central Africa (98% of cases), it is caused by the parasite
Trypanosoma brucei (T. b.) gambiense; in East Africa, T. b. rhodesiense
(2% of cases) is responsible.
Epidemiology

After relentless control efforts, the occurrence of


trypanosomiasis reached its lowest level ever,
dropping below 2,000 cases in 2017 and 1,000 The incidence of human African
cases in 2018, to remain below this threshold trypanosomiasis varies greatly from country to
ever since (data from 2022). The population at country and region to region. Looking back over
risk of contracting the disease is estimated at 55 the last five years :
million for the period 2016-2020, of which only
3 million are at moderate to high risk.
Epidemiology

DRC reported 61% of cases (average of 522 cases/year).Angola, Central African Republic, Chad,
Congo, Gabon, Guinea, Malawi and South Sudan reported between 10 and 100 new cases, while
Cameroon, Côte d'Ivoire, Equatorial Guinea, Ethiopia, Tanzania, Uganda and Zambia reported
between 1 and 10 new cases.Burkina Faso, Ghana, Kenya, Nigeria and Zimbabwe have reported
sporadic cases over the past decade.Countries such as Benin, Botswana, Burundi, Eswatini,
Gambia, Guinea Bissau, Liberia, Mali, Mozambique, Namibia, Niger, Rwanda, Senegal, Sierra
Leone and Togo have not reported any new cases for over 10 years. Transmission of human African
trypanosomiasis appears to have ceased in some of these countries, but this has not yet been fully
assessed.
Distribution of trypanosomiasis in africa
Signs-Symptom

Headless boil or trypanoma


Satellite lymphadenopathy and fever
Headache
Back pain, arthralgia
Pruritus
Digestive disorders: diarrhea, vomiting
Symptomatology

 THA with T.b. gambiense


Appearance of an inoculation chancre with satellite adenopathies, following
the bite, signals the start of silent incubation lasting from a few days (5 to 20
days) to several years.
The disease takes two interrelated forms:
• The first or lymphatic-blood phase, corresponding to multiplication in
subcutaneous tissues and dissemination (spread) of the parasites
(trypanosome) in the lymphatic-blood system: irregular fever,
arthralgias, hepatosplenomegaly (enlarged liver and spleen), skin signs
(facial edema, pruritus).
Symptomatology

• The second or meningoencephalitic phase is


the phase of invasion of the central nervous system: signs
of the first phase diminish or disappear, and neurological
signs gradually appear, depending on the case: sensory
disorders (profound hyperesthesia), psychiatric disorders
(apathy, excitation), sleep disorders (progressing towards
alteration of the sleep-wake rhythm), motor disorders
(paralysis, convulsions, tics) and neuroendocrine disorders
(amenorrhea, impotence).
• If left untreated: cachexia, somnolence, coma, death.
Symptomatology

 THA with T.b. rhodesiense

• The initial phase is identical, with a shorter incubation period (< 3


weeks) and a more rapid evolution.
• In the generalized phase, the infectious syndrome is more severe,
and is rapidly complicated by myocarditis (inflammation of the
myocardium), which is fatal in 3 to 6 months, sometimes before
signs of cerebral damage appear.
Diagnostics

 Serological diagnosis  Parasitological diagnosis


- Antibody testing consists of testing for trypanosomes
- In lymph nodes (lymph node punctures)
- Antigen testing
- In blood (fresh blood smear, mini ion
- Inflammatory sign exchange column, in vitro culture,
xenodiagnosis)
- In cerebrospinal fluid (CSF)
(white blood cell numbering + trypanosome
testing)
Treatment:

 Goals
Eliminate the parasite from the body
Prevent complications.

 Means
Trypanocidal drugs
Pentamidine (Lomidine, Pentacarinat)
Melarsoprol Arsobal)

 Preventive treatment
Vector control
Use of insecticides, covering clothing
Pyramid traps impregnated with insecticides
Screening and treatment of patients
Re-emerging disease particularly
in Central Africa.
Fearsome condition, difficult to
treat, requiring periodic checks of
exposed populations to be
maintained.
CONCLUSION
Most effective weapon: active
surveillance.
THANKS FOR THE
ATTENTION !

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