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Trypanosomiasis or trypanosomosis is the name of several diseases in vertebrates caused by parasitic protozoan trypanosomes of the genus Trypanosoma. Approximately 500,000 men, women, and children in 36 countries of sub-Saharan Africa suffer from human African trypanosomiasis which is caused by either Trypanosoma brucei gambiense or Trypanosoma brucei rhodesiense. The other human form of trypanosomiasis, called Chagas disease, causes 21,000 deaths per year ^[1] (mainly in Latin America).

Human trypanosomiases

See main article: Human trypanosomiasis

Human African trypanosomiasis, transmitted by the tsetse fly infected with Trypanosoma brucei, see African trypanosomiasis (sleeping sickness)
Human American trypanosomiasis, transmitted by the assassin bug infected with Trypanosoma cruzi, see Chagas disease

Diagnosis

Diagnosing African trypanosomiasis requires the documentation of T.brucei in blood smears, lymph node aspirates, or CSF.^[2] Presentation of the disease outside the endemic areas, especially in Western Europe, may present a diagnostic problem to the treating physician.^[3]

Treatment

American trypanosomiasis is currently treated with a variety of antifungal agents, including benznidazole and nifurtimox. Melarsoprol is another drug which is used for the treatment of T. b. gambiensie.

Epidemiology

Disability-adjusted life year for trypanosomiasis per 100,000 inhabitants.

no data

less than 10

10-25

25-50

50-75

75-100

100-150

150-200

200-250

250-300

300-400

400-500

more than 500

Animal trypanosomiases

Chagas endemic zones (in red)

Nagana, or Animal African trypanosomiasis, also called 'Souma' or 'Soumaya' in Sudan.
Surra
Mal de caderas (of central South America)
Murrina de caderas (of Panama; Derrengadera de caderas)
Dourine
Cachexial fevers (various)
Gambian horse sickness (of central Africa)
Baleri (of Sudan)
Kaodzera (Rhodesian trypanosomiasis)
Tahaga (a disease of camels in Algeria)
Galziekte, galzietzke (bilious fever of cattle; gall sickness of South Africa)
Peste-boba (of Venezuela; Derrengadera)

Some species of cattle such as the African buffalo, N'dama, and Keteku appear trypanotolerant and do not suffer from clinical disease. Calves are more resistant than adults.

Clinical signs and diagnosis

Cattle may show enlarged lymph nodes and internal organs. Haemolytic anaemia is a characteristic sign. Systemic disease and reproductive failure are common, and cattle appear to waste away.

Horses with dourine show signs of ventral and genital edema and urticaria.

Infected dogs and cats may show severe systemic signs.

Diagnosis relies on recognition of the flagellate on a blood smear. Motile organisms may be visible in the buffy coat when a blood sample is spun down. Serological testing is also common.

Treatment and prevention

Diminazene, homidium, isometadium, suramin, and melarsomine can all be used to treat infections. Resistance is increasing in endemic areas and recurrent treatments may be necessary.

The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread.

Fly control is another option but is difficult to implement.

Bibliography

Thomas (1905). Report on Trypanosomes. London.
Manson, Patrick, Sir, G.C.M.G. (1914). Tropical diseases (5th ed.). London.
Daniels, C. W. (1914). Tropical Medicine and Hygiene. New York.
Miles, Michael W.; Ian Maudlin; Holmes, Peter (2004). The Trypanosomiases. Wallingford, UK: CABI Publishing. ISBN 0-85199-475-X.

References

^ Maya JD, Cassels BK, Iturriaga-Vásquez P, et al. (2007). "Mode of action of natural and synthetic drugs against Trypanosoma cruzi and their interaction with the mammalian host". Comp. Biochem. Physiol., Part a Mol. Integr. Physiol. 146 (4): 601–20. doi:10.1016/j.cbpa.2006.03.004. PMID 16626984. http://linkinghub.elsevier.com/retrieve/pii/S1095-6433(06)00173-5.
^ Pepin J (2007). "Combination therapy for sleeping sickness: a wake-up call". J. Infect. Dis. 195 (3): 311–3. doi:10.1086/510540. PMID 17205466.
^ Vingerhoets LMA, Bauer MP, Hamminga AE, Verweij JJ, Visser LG (2011). "Treatment and follow-up using microscopy and polymerase chain reaction in East African sleeping sickness: a case report". Grand Rounds 11: 12–15. doi:10.1102/1470-5206.2011.0003. http://www.grandrounds-e-med.com/articles/gr110003.htm.

Animal Trypanosomosis reviewed and published by Wikivet, accessed 08/10/2011.

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UpToDate Contents

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1. アフリカ・トリパノソーマ症の疫学、病因、および予防 epidemiology pathogenesis and prevention of african trypanosomiasis
2. アフリカ・トリパノソーマ症の臨床症状、診断、および治療 clinical manifestations diagnosis and treatment of african trypanosomiasis
3. シャーガス病の病理および病因 pathology and pathogenesis of chagas disease
4. シャーガス心臓病の臨床症状および診断 clinical manifestations and diagnosis of chagas heart disease
5. サハラ以南アフリカへの旅行によって感染する可能性のある疾患 diseases potentially acquired by travel to sub saharan africa

English Journal

Evaluating 5-nitrofurans as trypanocidal agents.

Bot C, Hall BS, Alvarez G, Di Maio R, González M, Cerecetto H, Wilkinson SR.SourceQueen Mary Pre-Clinical Drug Discovery Group, School of Biological and Chemical Sciences, Queen Mary University of London, London, United Kingdom.
Antimicrobial agents and chemotherapy.Antimicrob Agents Chemother.2013 Apr;57(4):1638-47. doi: 10.1128/AAC.02046-12. Epub 2013 Jan 18.
The nitroheterocycle nifurtimox, as part of a nifurtimox-eflornithine combination therapy, represents one of a limited number of treatments targeting Trypanosoma brucei, the causative agent of human African trypanosomiasis. The mode of action of this prodrug involves an initial activation reaction c
PMID 23335745

Mechanisms of complement lectin pathway activation and resistance by trypanosomatid parasites.

Cestari I, Evans-Osses I, Schlapbach LJ, de Messias-Reason I, Ramirez MI.SourceSeattle Biomedical Research Institute, Seattle, WA 98109, USA.
Molecular immunology.Mol Immunol.2013 Apr;53(4):328-34. doi: 10.1016/j.molimm.2012.08.015. Epub 2012 Oct 9.
Studies in the past decade have demonstrated a crucial role for the complement lectin pathway in host defence against protozoan microbes. Recognition of pathogen surface molecules by mannan-binding lectin and ficolins revealed new mechanisms of innate immune defence and a diversity of parasite strat
PMID 23063472

PCR based diagnosis of trypanosomiasis exploring invariant surface glycoprotein (ISG) 75 gene.

Rudramurthy GR, Sengupta PP, Balamurugan V, Prabhudas K, Rahman H.SourceProject Directorate on Animal Disease Monitoring and Surveillance, Hebbal, Bengaluru 560024, Karnataka, India.
Veterinary parasitology.Vet Parasitol.2013 Mar 31;193(1-3):47-58. doi: 10.1016/j.vetpar.2012.11.045. Epub 2012 Dec 11.
The invariant surface glycoprotein (ISG-75) gene of Trypanosoma evansi buffalo isolate from Karnataka state in India was sequenced and analyzed to elucidate its relationship with other isolates/species. The sequenced ISG-75 gene was also explored to device a polymerase chain reaction (PCR) strategy
PMID 23305969

Japanese Journal

アフリカ睡眠病治療薬の候補化合物と標的タンパク質との複合体構造

志波智生,高橋元,原田繁春 [他],斎本博之,城戸康年,稲岡ダニエル健,北潔
日本結晶学会誌 55(4), 254-259, 2013
… We determined the first crystal structures of the trypanosomal alternative oxidase in the absence and presence of ascofuranone and its derivatives, which are drug candidates for African trypanosomiasis. …
NAID 130003373914

The use of Loop-mediated Isothermal Amplification (LAMP) to detect the re-emerging Human African Trypanosomiasis (HAT) in the Luangwa and Zambezi valleys

Namangala Boniface,Hachaambwa Lottie,Kajino Kiichi,Mweene Aaron S.,Hayashida Kyouko,Simuunza Martin,Simukoko Humphrey,Choongo Kennedy,Chansa Pamela,Lakhi Shabir,Moonga Ladslav,Chota Amos,Ndebe Joseph,Nsakashalo-Senkwe Mutale,Chizema Elizabeth,Kasonka Lackson,Sugimoto Chihiro
Parasites & Vectors 5, 282, 2012-12-04
Background: Loop-mediated isothermal amplification (LAMP) is a novel strategy which amplifies DNA with high sensitivity and rapidity under isothermal conditions. In the present study, the performance …
NAID 120005183188