Trypanosoma brucie gambiense

1
Trypanosoma brucie gambiense

• Trisha Patel

From the beginning of Arab and European
influence in the hinterland of tropical Africa,
trypanosomiasis of man and animals has curbed the
realization of human ambitions and the
mobilization of the continents vast resources.
--Herbert S. Gasser
2
WEST AFRICAN SLEEPING SICKNESS

• Found in western and central Africa
• Transmitted human to human via tsetse fly vector
• Slow onset of symptoms
• Two stages
• First stage- Before crossing the blood-brain
  barrier
• Second stage- After crossing the blood-brain
  barrier and entering the Central Nervous System

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DISCOVERY

• The first documented case of Trypanasoma brucei
  was in 1902 by R.M. Forde. In The Journal of
  Tropical Medicine, Forde records his account of a
  42 year-old European male colonialist who came to
  him in May 1901 in Gambia Colony. The patient
  complained about having a fever and malaise.
  Forde presumed the gentleman to have malaria and
  therefore gave him anti-malarial medication.
  After days the condition had remained the same.
  A blood sample from the patient was taken and it
  showed no malarial parasites. Later, Dutton,
  another physician from the Liverpool School of
  Tropical Medicine, identified the parasite within
  the patients blood as Trypanasoma brucei. Due
  to the location of the parasite within the
  patient, it is assume that the species was of
  T.b. gambiense.

4
TIMELINE

• 14th Century First described case in Mali
• 1896- 1906 First major recorded endemic
• 1902 R.M. Forde Dutton identified one
• causative agent of the sleeping disease
• 1903 Castellani working in Uganda observed
• the parasite in the cerebrospinal fluid
• of one of his patients
• 1903 Sir David Bruce recognized Tsetse fly as
  vector
• 1906 Ayres Kopke introduced Atoxyl, an arsenic
  compound, as a treatment
• 1920 Second major recorded endemic (first noted
  by Jamrot, a colonel for the French army)
• 1970- now Third major recorded endemic
• 1984 The World Health Organization (WHO)
  launched a program to control trypanosomiasis

Sir David Bruce
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MAJOR ENDEMICS

• Three Major Endemics
• 1896 through 1906 (mostly in Uganda and the Congo
  Basin)
• 1920 (several African countries)
• - Contained due to screening of millions of
  people at risk
• - The disease has practically disappeared from
  1960-1965
• - Surveillance was relaxed causing a relapse
• 1970-now
• - With the help of the World Health
  Organization, national control
  programs, and nongovernmental organizations
  efforts to control the spread have been
  implemented

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PREVELANCE
Thirty-six countries in equatorial Africa could
be affected, including 22 of the world's most
underdeveloped countries. In the United States,
31 cases of trypanosomiasis have been reported
mostly Eastern Sleeping Sickness. In 1998,
almost 40,000 cases were reported but about
300,000-500,000 went undiagnosed In the Congo,
more people die from sleeping sickness than from
AIDS. Fifty-five to 60 million people in
equatorial Africa that are exposed to the risk of
a bite from the tsetse fly. The number of cases
have decreased. From 1998 to now, reported cases
feel from 37,991 to 17,616. It costs about a
thousand dollars to treat a victim of the
parasite. Recently, in the Democratic Republic
of Congo, Angola and Southern Sudan, prevalence
has reached 50. This is greater than those
infected with HIV/AIDS in these areas.
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PREVANECE CONTINUED
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SPREAD

• Transmitted by Tsetse fly
• War
• A pregnant women pass it to her fetus (rare)
• Through a blood transfusion (rare)
• Homosexual males (very rare)
• The migration of people

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ENVIRONMENTAL CHANGES

• Glossina papalis tsetse fly - lives near
  vegetation associated with drainage lines,
  rivers, and other permanent bodies of water
• Removal of waterways are ineffective since
• They are also habitats for other insects and
  animals
• They are a source of water for people
• Vegetation around these areas need water
• Sanitation of waterways will not effect the
  spread of the organism.

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TREATMENT

• First stage treatments
• Pentamidine
• Discovered in around 1941
• Highly effective
• Few side-effects usually tolerable
• Second stage treatments
• Melarsoprol
• Discovered in 1949
• Arsenic base
• Many side-effects including enchephalopathy,
  myocarditis, renal damage, peripheral neuropathy,
  etc.
• Fatal (3-10)
• Eflornithine
• Also known as the resurrection drug
• Registered in 1990
• Less toxic than melarsoprol
• Regime is strict and difficult to apply
• Costly

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PREVENTION

• Wear khaki or olive colored clothing
• Wear thick clothing
• Use insect repellant
• Use bed netting when sleeping
• Inspect vehicles for tsetse flies before entering
  
• Do not ride in the back of jeeps, pickup trucks
  or other open vehicles
• Avoid bushes (tsetse fly is less active during
  the hottest time of the day and rests in
  bushesit will bite if disturbed)
• Avoid thick shrubbery and trees by rivers and
  waterholes
• Test blood during transfusions

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SOURCES

• African Trypanosomiasis. African Sleeping
  Sickness. 22 May, 2001. 13 November, 2006.
  lthttp//www.stanford.edu/class/humbio103/ParaSites
  2001/trypanosomiasis/trypano.htmgt.
• Background to Trypanosoma brucei gambeinse
  genome project. 13 November, 2006.
  lthttp//www.bio.bris.ac.uk/research/molpar/TBG.pdf
  search'Trypanosoma20brucei20gambiense202020
  Discoverygt.
• Behind the Frieze. Sir David Bruce. London
  School of Hygiene and Tropical Medicine. 1
  August, 2005. 16 November, 2006.
  lthttp//www.lshtm.ac.uk/library/archives/bruce.htm
  lgt.
• Google Image Search. 19 November, 2006.
  lthttp//images.google.com/imghp?ieUTF-8oeUTF-8
  hlentabwiqgt.
• Reanalyzing the 19001920 Sleeping Sickness
  Epidemic in Uganda. Center of Disease Control.
  12 April, 2004. 16 November, 2006.
  lthttp//www.cdc.gov/ncidod/EID/vol10no4/02-0626.ht
  mgt.
• Sleeping Sickness. Wikimedia Foundation, Inc.
  15 November, 2006. 16 November, 2006.
  lthttp//en.wikipedia.org/wiki/Sleeping_sicknessTr
  eatmentgt.
• Trypanosomiasis. Microbiology _at_ Leicester. 19
  October, 2004. 13 November, 2006.
• lthttp//www-micro.msb.le.ac.uk/224/Trypano.htmlgt.
  
• Trypanosomiasis/Sleeping Sickness. Medindia
  Health Network Pvt Ltd. 13 November, 2006. 13
  November, 2006. lthttp//www.medindia.net/patients
  /patientinfo/trypanosomiasis_Clinical.htmgt.