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Special Populations > Neglected Tropical Diseases - SP > Flashcards

Neglected Tropical Diseases - SP Flashcards

1
Q

Buruli ulcer

A
  • Chronic debilitating skin and soft tissue infection
  • Can lead to permanent disfigurement and disability
  • Caused by Mycobacterium ulcerans bacterium (same family as leprosy and tuberculosis)
  • Can be found in animals: Koalas, Possums, Horses, Dogs, Alpacas, Cats
  • No vaccine
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2
Q

Buruli ulcer: Epidemiology

A
  • Tropical and sub-tropical climates
  • Found in at least 33 countries
  • 5000-6000 cases annually
  • Most cases in rural communities in sub-Saharan Africa
  • Usually found in communities near rivers, swamps and wetlands
  • Nearly half of people affected in Africa are children under 15
  • Mode of transmission unknown
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3
Q

Buruli ulcer: Signs and Symptoms

A
  • Usually starts as painless nodule
  • Painless plaque
  • Diffuse painless edema of legs, arms, or face
  • Local immunosuppressive properties of mycolactone toxin enable painless progression
  • Without treatment (or during treatment) ulceration occurs
  • Occasionally bone is affected causing gross deformity
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4
Q

Buruli ulcer: Diagnosis

A
  • No field test available
  • IS2404 polylmerase chain reaction (PRC) is main method of confirmation
  • Highest sensitivity
  • Results can be available within 48 hours

-Usually clinical diagnosis if lab not available

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5
Q

Buruli ulcer: Treatment

A

-Rifampicin 10 mg/kg once daily and streptomycin 15mg/kg once daily (standard treatment)

Complementary treatment

  • Wound care
  • Surgery – debridement and skin grafting
  • Interventions to minimize or prevent disability
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6
Q

Human African Trypanosomiasis, (sleeping sickness)

A
  • Vector-born parasitic disease
  • Protozoa belonging to the Trypanosoma genus
  • Transmitted to humans by tsetse fly bites infected from humans or from animals harboring the human pathogenic parasites
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7
Q

Human AfricanTrypanosomiasis, (sleeping sickness): Modes of transmission

A
  • Bite of infected tsetse fly
  • Mother-to-child infection: trypanosomes can cross placenta and infect the fetus
  • Accidental infections in laboratories due to pricks from contaminated needles
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8
Q

Human AfricanTrypanosomiasis, (sleeping sickness): Stages of disease

A
  • Stage 1 – trypanosomes multiple in subcutaneous tissues, blood and lymph (haemolymphatic phase)
  • Stage 2 – parasites cross blood-brain barrier to infect nervous system (neurological phase)
  • Fatal without treatment
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9
Q

Human AfricanTrypanosomiasis, (sleeping sickness): Symptoms

A

Stage 1

  • Bouts of fever
  • Headaches
  • Joint pains
  • itching

Stage 2

  • Changes in behavior
  • Confusion
  • Sensory disturbances and poor concentration
  • Disturbance of sleep cycle
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10
Q

Human AfricanTrypanosomiasis, (sleeping sickness): Diagnosis

A
  • Serologic testing
  • Clinical signs (generally swollen cervical glands)
  • Diagnosing whether the parasite is present
  • Staging to determine the stage of disease progression through examination of cerebro-spinal fluid
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11
Q

Human AfricanTrypanosomiasis, (sleeping sickness): treatment

A
  • Diagnosis must be made as early as possible and before the neurological stage
  • Type of treatment depends on stage of disease
  • Drugs used in the first stage are of lower toxicity and easier administer.
  • The earlier the disease is identified, the better the prospect of a cure
  • Treatment success in the second stage depends on a drug that can cross the blood-brain barrier to reach the parasite.
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12
Q

Leprosy

A
  • Caused by slow-growing bacillus, -Mycobacterium leprae
  • Transmitted via droplets from the nose and mouth of untreated patients with severe disease
  • Not highly infectious
  • If left untreated can cause nerve damage leading to muscle weakness and atrophy, and permanent disability
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13
Q

Leprosy: tx

A
  • treated with 6-12 month course of multidrug therapy
  • Treatment is highly effective
  • Few side-effects and low relapse rates
  • No known drug resistance
  • Most effective way of preventing disability and further transmission is early diagnosis and treatment
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14
Q

Leprosy: Epidemiology

A
  • 2012 – 107 countries or territories on leprosy

- 224,385 new cases reported during 2011

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15
Q

Lymphatic filariasis

A
  • Infection with the filarial worms, Wuchereria bancrofti, Brugia malayi or B. timori
  • Transmitted to humans through bite of infected mosquito and develop into adult worms in the lymphatic vessels
  • Cause severe damage and swelling (lymphedema)
  • Elephantiasis – painful disfiguring swelling of the legs and genital organs in late-stage disease
  • Usually acquired in childhood, with visible manifestations later in life
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16
Q

Lymphatic filariasis: Clinical manifestations

A

Lymphedema of limbs

  • Genital disease (hydrocele, chylocele, swelling of scrotum and penis)
  • Recurrent attacks with fever are extremely painful
  • Vast majority are asymptomatic
  • Virtually all have subclinical lymphatic damage
  • As many as 40% have kidney damage with proteinuria and hematuria
17
Q

Lymphatic filariasis: Treatment

A
  • Treatable condition, but chronic disease not curable by anti-filarial drugs
  • Annual treatment of all at risk individuals with anti-filarial drug combinations recommended to prevent new infection and disease
18
Q

Trachoma

A
  • Result of eye infection with Chlamydia trachomatis
  • Infection spread from person to person through contact with eye discharge
  • Infection often begins during infancy or childhood and can become chronic
  • If left untreated the infection causes the eyelid to turn inward which causes the eyelashes to rub the eyeball resulting I intense pain and scarring
  • Ultimately leads to irreversible blindness, typically between 30 and 40 years of age
19
Q

Trachoma: Epidemiology

A

Affects ~ 21.4 million people
~ 2.2 million visually impaired
-1.2 million blind
-Responsible for 3% of the world’s blindness
-Continues to be hyperendemic in many of the poorest and most remote poor rural areas of Africa, Asia, Central and South America, Australia and the Middle East
-In endemic areas active disease most common in pre-school children with prevalence rates as high as 60-90%
-Women more at risk of developing blinding complications than men

20
Q

Trachoma: Risk factors & interventions

A

RF’s: Water shortage, Flies, Poor hygiene conditions, Crowded households

  • Improved sanitation
  • Reduction of fly breeding sites and increased facial cleanliness with clean water among children at risk of disease
  • Simple surgical procedure to reverse the inturned eyelashes
  • Antibiotic treatment: tetracycline eye ointment or azithromycin

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