infectious diseases
African Trypanosomiasis
Introduction
Human African trypanosomiasis is infection with protozoa of the speciesTrypanosoma brucei, transmitted by the bite of a tsetse fly. Symptoms include characteristic skin lesions, intermittent fever, headache, rigors, transient edema, generalized lymphadenopathy, and often fatal meningoencephalitis. Diagnosis is by identification of the organism in blood, lymph node aspirate, or cerebrospinal fluid or sometimes by serologic tests. Treatment is withfexinidazole, suramin,pentamidine, melarsoprol, oreflornithine, depending on the infecting subspecies, clinical stage, and drug availability. Human African trypanosomiasis is caused byTrypanosoma brucei gambiensein West and Central Africa and byT. brucei rhodesiensein East Africa; both species are endemic in Uganda.Trypanosoma brucei gambienseaccounts for 98% of all cases of African trypanosomiasis, andT. brucei rhodesienseaccounts for 2%. African trypanosomiasis has been targeted for eradication by the World Health Organization (WHO) and, as a result of control efforts, there has been a dramatic decrease (> 95%) in the number of reported cases worldwide. In 2021, approximately 800 combined cases were reported to the WHO, with over 90% caused byT. b. gambiense(seeWHO: Human African trypanosomiasis). On average, 1 case is diagnosed in the US each year, always in travelers returning to the US from endemic regions. The organisms are transmitted by tsetse flies and can be transmitted prenatally from mother to fetus. Rarely, the infection is transmitted through blood transfusions; theoretically, it could be transmitted through organ transplantation. , is endemic in South and Central America and causes Chagas Disease (American trypanosomiasis). 