African Trypanosomiasis
African trypanosomiasis is a native parasitic ailment of Africa. It is spread by a fly specie known as tsetse fly that can only be found in Africa. This disease is also called sleeping sicknes or African lethargy; and is named in two types depending on the area where they were located (East African trypanosomiasis and West African trypanosomiasis). African trypanosomiasis is caused by the parasite Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense that are transmitted to the hosts by the tsetse fly.
Manifestations
Signs and symptoms of African Trypanosomiasis appear differently depending on the stages of the disease process:
- Hemolymphatic phase (this is the phase where the parasite attacks both the circulatory and the lymphatic system)
- Fever
- Body rash
- Joint pains
- Itchiness
- Irritability
- Muscle pains
- Headache
- Swollen lymph glands
- Weight loss
- Neurological phase (this is the phase where the parasite attacks the central nervous system)
- Confusion
- Sleep cycle disruption
- Personality changes
- Seizures
- Speech difficulties
- Mobility problems (walking)
- Abnormally sleeping at longer periods of time (daytime) and insomnia at night
Pathophysiology
Since tsetse flies can only be found in Africa, most probably, African natives are at risk onto getting this disease (can also affect travellers and foreigners). The infected tsetse fly bites its host and leaves a painful sore or chancre. This bite is the entry point of the parasite to invade the systems and its cells. Organ transplants and blood component transfusions coming from infected individuals may also pass the parasite to others. In even rare cases, if the host is pregnant, then most probably the fetus might get infected as well, for the Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense can cross placental barriers.
Diagnosis
- Blood examination
- Spinal fluid examination
- Serological tests
- micro-CATT
- whole blood-CATT
- whole blood-LATEX
Prevention
Prevention starts by avoiding tsetse fly, protective clothing made of thick material should be worn (long sleeved shirts and long pants). Colors do attract insects and as to the fly-vector, it is drawn to both bright and dark colors, so it is recommended to use bland colored clothing. Put up screened rooms and bed nets to prevent fly attacks. Promoting sanitation in the surroundings will be of great help, avoid bushes and shrubs (tsetse flies rest in this habitat) as well.
Management
Care of individuals with this disease focuses on the management of presenting symptoms such as fever and malaise while strictly monitoring the neurologic status. The specific drug and management course depends on the type of infection and the disease stage and should be started as soon as possible. For T.b. gambiense, Pentamidine is the recommended the infection. On the other hand, Suramin is the drug of choice for T.b. rhodesiense.
Byron Webb Romero, RN, MSN
Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.
