Trypanosomiasis

Question 1

What are neglected tropical diseases (NTDs)?

Answer 1

Heterogeneous groups of tropical infections common in low-income countries with limited access to clean water, sanitation, and healthcare.

NTDs are caused by helminth, bacteria, virus, and protozoa, leading to chronic, disfiguring, and disabling conditions.

Question 2

How many people are estimated to be affected by NTDs?

Answer 2

More than 1 billion people, including over 500 million children.

Approximately 500,000 deaths occur yearly due to NTDs.

Question 3

What are the two forms of human African trypanosomiasis (sleeping sickness)?

Answer 3

1. Trypanosoma brucei gambiense
2. Trypanosoma brucei rhodesiense

Question 4

What is the primary vector for human African trypanosomiasis?

Answer 4

Tsetse fly (Glossina genus)

The tsetse fly acquires the infection from humans or animals harboring the parasites.

Question 5

What percentage of reported cases of sleeping sickness is caused by Trypanosoma brucei gambiense?

Answer 5

Over 98% of reported cases.

Question 6

What is the first stage of human African trypanosomiasis called?

Answer 6

Haemolymphatic stage.

This stage involves multiplication of trypanosomes in subcutaneous tissues, blood, and lymph.

Question 7

What symptoms are associated with the first stage of sleeping sickness?

Answer 7

Fever, headaches, joint pains, and itching.

Question 8

What is the second stage of human African trypanosomiasis known as?

Answer 8

Meningoencephalic stage.

This stage involves the infection of the central nervous system.

Question 9

What are the common symptoms of the second stage of sleeping sickness?

Answer 9

Changes in behavior, confusion, sensory disturbances, poor coordination, and sleep cycle disturbance (somnolence).

Question 10

What is the treatment for the first stage of T.b. gambiense sleeping sickness?

Answer 10

Pentamidine.

Administered intravenously or by deep intramuscular injection.

Question 11

What is a significant side effect of Pentamidine?

Answer 11

Kidney damage, hepatic impairment, blood dyscrasias, and hypoglycemia.

Question 12

What is the treatment for the first stage of T.b. rhodesiense sleeping sickness?

Answer 12

Suramin.

Given by slow intravenous injection.

Question 13

What are some side effects of Suramin?

Answer 13

Optic atrophy, adrenal insufficiency, skin rashes, hemolytic anemia, and agranulocytosis.

Question 14

What is the combination therapy used for the second stage T.b. gambiense?

Answer 14

Nifurtimox-eflornithine combination therapy (NECT).

Also includes fexinidazole for patients over 6 years old weighing more than 20 kg.

Question 15

What is Melarsoprol used for?

Answer 15

Treatment of both gambiense and rhodesiense infections in the second stage.

It is derived from arsenic and has many undesirable side effects.

Question 16

What is a major risk associated with Melarsoprol?

Answer 16

Reactive encephalopathy (encephalopathic syndrome), which can be fatal.

Question 17

What is the new oral treatment for gambiense human African trypanosomiasis introduced in 2019?

Answer 17

Fexinidazole.

Indicated as first line for first stage and non-severe second stage.

Question 18

True or False: The distribution of sleeping sickness is uniform across affected countries.

Answer 18

False.

70% of reported cases occur in the Democratic Republic of the Congo (DRC).

Question 19

Fill in the blank: The disease is transmitted through the bite of an infected _______.

Answer 19

tsetse fly.

Question 20

What is the role of animals in the transmission of Trypanosomiasis?

Answer 20

Animals can act as reservoirs for the human pathogenic parasites, especially T.b. rhodesiense.

Domestic and wild animals can be infected and transmit the disease.