African Trypanosomiasis

African trypanosomiasis (sleeping sickness) is transmitted by tsetse fly; sub-Saharan Africa, up to 80% prevalence in some foci. Early fever/rash/edema/lymphadenopathy; later meningoencephalitis. East African = rapid; West African = chronic sleeping sickness/coma/death.

Common Symptoms

Hyperesthesia; diarrhea; ataxia; ascites; amenorrhea; convulsion; fatigue; bradykinesia

Causes and Pathogenesis

T. brucei: gambiense (West African), rhodesiense (East African), brucei (nagana in animals). Extracellular flagellate; central nucleus + posterior kinetoplast; undulating membrane. Life cycle: tsetse fly (Glossina) ingests trypomastigotes → midgut division → proventriculus/esophagus → salivary glands epimastigotes → infective metacyclics (12-30 days, lifelong fly infectivity). Human: bite → local division → blood. Long slender in blood; short stumpy in tissue. Antigenic variation → immune evasion despite high IgM. Stage I = hemolymphatic; Stage II = meningoencephalitis. Pathology: lymph node/spleen enlargement; later lymphoid depletion; petechial/epicardial hemorrhage; myocarditis; lymphoplasmacytic meningeal infiltrate → panencephalitis → basal ganglia/midbrain/diencephalon/demyelination → subcortical atrophy; liver hemorrhage/focal necrosis.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Suramin early; pentamidine/melarsoprol; organic arsenicals for CNS disease. Mass screening/treatment of asymptomatic carriers; treat patients; manage livestock; tsetse traps (scent-baited) every 6 months.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.