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  Trypanosoma brucei rhodesiense

Trypanosoma brucei rhodesiense:

T. brucei rhodesiense is widespread in east and central Africa and common in the Savanna woodlands. Gambian trypanosomiasis is limited to humans however Rhodesian trypanosomiasis is a zoonosis with the wild antelope of the Savanna performing as reservoir host.

Life cycle and transmission:

Lifecycle and transmission is similar as that for T. brucei gambiense.

Clinical features:

Gambian trypanosomiasis is a slow death for the infected human. On other hand, T. brucei rhodesiense kills its untreated sufferer in weeks or months. It generates a fulminating parasitemia and quickly invades the central nervous system.

Parasitologic diagnosis:

T. brucei rhodesiense is generally present in microscopically detectable quantities at all phases of infection except very early phase.

Diagnosis can be prepared by wet or stained thick blood film examination.

IgM is prominent during the later phases of infection.

Treatment and prevention:

Suramin is the drug of selection for treating the early blood or lymphatic phase of the disease. Alternatives for treating the early phase are pentamidine isothionate and DFMO (i.e., deflornithine, DL-α- difluoromethylornithine). Melarsoprol is the drug of choice whenever CNS participation is suspected.

The most efficient control measures comprise an integrated approach to reduction of the human reservoir of infection and the utilization of insecticide and fly traps. Persons visiting regions where the infection is endemic must wear protective clothing (i.e., long sleeved shirts and long trousers). Other measures comprise reduction in vegetation around human settlements and the utilization of insect repellents, bed netting and screens.

 

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