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Rockefeller F. Cooper II, PhD. StudentWalden University
Ph 8165-2Instructor: Dr. Stephen Arnold
FALL, 2009
The Government of Liberia: Ministry of Health: Public Health Officials Healthcare Givers Monrovia City Hall Corp
What is trypanosomiasis?
What causes it and how is it transmitted?
Who is at risk?
What are the symptoms?
How do we prevent it?
How do we control it?
How do we treat it?
Understanding the etiology and geography.
Introduction
African Trypanosomiasis
Etiology of African Trypanosomiasis
Geographical Distribution
Mode of Transmission
Symptoms Human African Trypanosomiasis African Animal Trypanosomiasis
Prevention A-B-C Method
Control use of insecticide traps and screens
Treatment References
Trypanosomiasis is commonly known as “sleeping sickness”(Dias, 1999).
In cattle and other domestic animals, the disease is referred to as Nagana (Dias,1999).
Approximately, 66 million people are victims (Dias,1999).
Reference: Dias, J.C.P (1999). The evolution of Chagas disease (American
Trypanosomiasis) control after 90 years since Carlos Chagas discovery. Memorias do Instituto Oswaldo Cruz. 1, 103-121.
Acute and chronic phase.
Origin was unknown as caravanners noticed prevailing symptoms of the disease (Dias,1999).
The disease infiltrated the western, eastern and southern parts
of Africa
Colonial masters organized campaigns to prevent and control trypanosomiasis.
This effort turned out to be successful due to the use
pentamidine, and agronol prevention (Dias,1999).
Reference: Dias, J.C.P (1999). The evolution of Chagas disease (American
Trypanosomiasis) control after 90 years since Carlos Chagas discovery. Memorias do Instituto Oswaldo Cruz. 1, 103-121.
Trypanosomiasis was suppressed but reemerged after African countries started to obtain their independence. as they could not maintained the financial burden of suppressing the disease (Dias,1999).
Trypanosomiasis causes economical instability due to death infliction on cattle as a result of anemia, loss of condition and emaciation.
Disease is caused by: Trypanosoma congolense, Trypanosoma vivax and Trypanosoma brucei
brucei. (Grove, 1990).
References: Dias, J.C.P (1999). The evolution of Chagas disease (American
Trypanosomiasis) control after 90 years since Carlos Chagas discovery. Memorias do Instituto Oswaldo Cruz. 1, 103-121.
Grove, A.T. (1990). The Changing Geography of Africa. Oxford, England: Oxford University Press.
(2008,Dec 5). African Trypanosomiasis. Retrieved October 7, 2009, from CDC Web site: http://www.dpd.cdc.gov/dpdx/html/TrypanosomiasisAfrican.htm
African Trypanosomiasis: Tsetse flies are between latitude 15 0 North and 20 0 South.
Central and West Africa serves as host to the Trypanosoma brucei gambiense, which is the most common causal agent of the disease.
In East and Southern Africa, there is the Trypanosoma brucei Rhodesiense.
Reference: Legros, D (2002).Treatment for human African Trypanosomiasis-present situation
and needs for research and development. The Lancelet Infectious Diseases. 2, 437-440.
Dias, J.C.P (1999). The evolution of Chagas disease (American Trypanosomiasis) control after 90 years since Carlos Chagas discovery. Memorias do Instituto Oswaldo Cruz. 1, 103-121.
Human African Trypanosomiasis: Glossina are the vectors
African Animal Trypanosomiasis: The vectors are Glossina palpalis, Glossina fusca and Glossina morsitans Other vectors are of the genus Tabanus, Haematopota, Chrysops, Liperosia and
Stomoxys
References:
Carlier, Yves (2004). Chagas Disease. Retrieved October 10, 2009, from the chagaspace group Web site: http://chagaspace.org/eng/chagas/index.htm
Legros, D (2002).Treatment for human African Trypanosomiasis-present situation and needs for research and development. The Lancelet Infectious Diseases. 2, 437-440.
Human African Trypanosomiasis:
Chancre develops from bite.
Other manifestations are: fever rash severe headache severe fatigue painful muscles and joints Edema around eyes and hand Winterbottom’s sign weight loss
Reference: Moore, A (2004). Human
African Trypanosomiasis: a reemerging public health threat. Washington, D.C: ASM Press.
African Animal Trypanosomiasis:
Infertility
Abortion
Anemia
Weight loss
Intermittent fever
Reference: Grove, A.T. (1990). The
Changing Geography of Africa. Oxford, England: Oxford University Press.
A-B-C Method: Awareness of Risk Bite Avoidance
Chemoprophylaxis
References: Carlier, Yves (2004). Chagas Disease. Retrieved October 10,
2009, from the chagaspace group Web site: http://chagaspace.org/eng/chagas/index.htm
Legros, D (2002).Treatment for human African Trypanosomiasis-present situation and needs for research and development. The Lancelet Infectious Diseases. 2, 437-440.
Insecticide
Traps and Screen
References:
(2004, Oct 19). Trypanosomiasis. Retrieved April 10, 2009, from Public Health Agency of Canada Web site: http://www-micro.msb.le.ac.uk/224/Trypano.html
Moore, A (2004). Human African Trypanosomiasis: a reemerging public health threat. Washington, D.C: ASM Press.
DrugsDrugs SpeciesSpecies PhasePhase DosageDosage RouteRoute Common side Common side
effectseffects Pentamidine Pentamidine isethionate isethionate T. gambienseT. gambiense acuteacute 7-10 doses of 7-10 doses of
4mg/kg per day4mg/kg per day IMIM DiarrheaDiarrhea
DizzinessDizziness
HeadacheHeadache
Upset stomachUpset stomach
NauseaNausea
Suramin sodium Suramin sodium T. gambienseT. gambiense
T. rhodisiense T. rhodisiense
acuteacute 5mg/kg on the 1st day, 5mg/kg on the 1st day, 10 on the 3rd and 20 on 10 on the 3rd and 20 on the 5th,11th, 23rd and the 5th,11th, 23rd and 30th 30th
IVIV Renal failureRenal failure
Anaphylactic shocksAnaphylactic shocks
Signs of neurotoxicitySigns of neurotoxicity
Severe cutaneous Severe cutaneous
reactionsreactions Melasoprol Melasoprol T. gambienseT. gambiense
T. rhodisienseT. rhodisiense chronicchronic 3-4 series of 3-4 3-4 series of 3-4
injections per day injections per day IVIV Reactive encephalopathic Reactive encephalopathic
syndromesyndrome
Elfornithine Elfornithine T. gambienseT. gambiense chronicchronic 400mg/kg per day in 4 400mg/kg per day in 4
daily infusions for 1-2 daily infusions for 1-2 wks. wks.
IVIV DiarrheaDiarrhea
PancytopeniaPancytopenia
ConvulsionConvulsion
HallucinationHallucination
Nifurtimox Nifurtimox T. gambienseT. gambiense
T. cruziT. cruzi chronicchronic 400mg/kg per day in 4 400mg/kg per day in 4
daily infusions for 1-2 daily infusions for 1-2 wks. wks.
OralOral AnorexiaAnorexia
Neurological problems Neurological problems
The nickname for trypanosomiasis is “sleeping sickness”.
It is an infectious disease that can be transmitted by the tsetse fly.
Two phases are involved.
Infection is specie specific with regards to the geography.
Transmission of the disease into humans and animals are not of the same species as symptoms vastly differs as well.
Prevention using the “ABC Method” as well as traps, screen and insecticide.
Different types of drugs.
"American Trypanosomiasis of Chagas Disease." Public Health Agency of Canada. 13 June 2001. Public Health Agency of Canada. Retrieved October 10, 2009, from http://www.phac-aspc.gc.ca/tmp-pmv/info/am_trypan_e.html.
Carlier, Yves (2004). Chagas Disease. Retrieved October 10, 2009, from the chagaspace group Web site: http://chagaspace.org/eng/chagas/index.htm
Dias, J.C.P (1999). The evolution of Chagas disease (American trypanosomiasis) control after 90 years since Carlos Chagas discovery. Memorias do Instituto Oswaldo Cruz. 1, 103-121.
Dias, J.C.P (1992). Epidemiology of Chagas disease. Retrieved October 5, 2006, from Foreign Animal Diseases Web site:
http://www.dbbm.fiocruz.br/tropical/chagas/chapter4.html
Grove, A.T. (1990). The Changing Geography of Africa. Oxford, England: Oxford University Press.
Legros, D (2002).Treatment for human African trypanosomiasis-present
situation and needs for research and development. The Lancelet Infectious Diseases. 2, 437-440.
Mare, C.J. (1998). Foreign animal diseases. Retrieved October 10, 2009, from The Gray Book Web site: http://www.vet.uga.edu/VPP/gray_book/FAD/index.htm
Mare, C.J. (1998). In foreign animal diseases. Richmond, VA: United States Animal Health Association.
Moore, A (2004). Human African Trypanosomiasis: a reemerging public health threat. Washington, D.C: ASM Press.
Stich, A (2002).Human African Trypanosomiasis. BMJ. 325, 203-06.
Trail, J.C.M (1985). Productivity of Boran cattle maintained by chemoprophylaxis under Trypanosomiasis risk. Retrieved October 10, 2009, from Economic trade-offs between milk and meat production Web site: http://www.fao.org/wairdocs/ILRI/x5527E/x5527e00.HTM
(2004, Oct 19). Trypanosomiasis. Retrieved October 10, 2009, from Public Health Agency of Canada Web site: http://www-micro.msb.le.ac.uk/224/Trypano.html
(2006, Feb 8). West African Trypanosomiasis. Retrieved October 8, 2009, from Division of parasitic Diseases Web site: http://www.cdc.gov/NCIDOD/dpd/parasites/trypanosomiasis/factsht_ea_trypanosomiasis.htm
Cooper, Rockefeller (2007). Prevention and Control of Selective Tropical Diseases. Baltimore, MD: Publish America
(2008,June 8). West African Trypanosomiasis. Retrieved October 10, 2009, from CDC Web site: http://www.cdc.gov/ncidod/dpd/parasites/trypanosomiasis/factsht_wa_trypanosomiasis.htm
(2009). Trypanosomiasis, Africa. Retrieved October 7, 2009, from World Health Organization Web site: http://www.who.int/topics/trypanosomiasis_african/en/
Kioy, D., & Jannin , N (2004). Human African Trypanosomiasis. Nature Reviews Microbiology. 2, 186-187.