🦠 African Trypanosomiasis (Sleeping Sickness) – Overview
African trypanosomiasis, also known as sleeping sickness, is a parasitic disease caused by Trypanosoma brucei and transmitted to humans by the bite of the tsetse fly (Glossina species). It is fatal if untreated and is mostly found in rural parts of sub-Saharan Africa.
🧬 Causes
Caused by two subspecies of Trypanosoma brucei:
| Subspecies | Disease Type | Location |
|---|---|---|
| T. b. gambiense | Chronic form (weeks to years) | West and Central Africa |
| T. b. rhodesiense | Acute form (days to weeks) | East and Southern Africa |
🪰 Transmission
- Spread through the bite of an infected tsetse fly
- The parasite enters the blood and invades the central nervous system in later stages
- No human-to-human transmission except through:
- Mother to child (congenital)
- Blood transfusions
- Organ transplants
⚠️ Symptoms
1️⃣ Early Stage (Hemolymphatic Stage)
- Fever
- Headache
- Muscle and joint pain
- Itching
- Swollen lymph nodes (especially at the back of the neck – “Winterbottom’s sign”)
2️⃣ Late Stage (Neurological or CNS Stage)
- Confusion, personality changes
- Daytime sleepiness and nighttime insomnia
- Difficulty walking or talking
- Seizures (in children)
- Coma and death if untreated
🧪 Diagnosis
- Blood smear to detect parasites (early stage)
- Lymph node aspirate (especially in T. b. gambiense)
- Lumbar puncture (spinal tap) to detect CNS involvement
- Serologic tests (like CATT) for T. b. gambiense
💊 Treatment
Treatment depends on the stage and type:
| Drug | Used For | Notes |
|---|---|---|
| Pentamidine | Early-stage T. b. gambiense | Well-tolerated |
| Suramin | Early-stage T. b. rhodesiense | Intravenous |
| Nifurtimox-eflornithine combination therapy (NECT) | Late-stage T. b. gambiense | WHO-recommended |
| Melarsoprol | Late-stage T. b. rhodesiense | Toxic; reserved for severe cases |
🛡️ Prevention
- Avoid tsetse-infested areas (especially during the day)
- Wear long sleeves and neutral-colored clothing
- Use insect repellent
- Screen and treat infected populations (key to controlling T. b. gambiense)
- Vector control (tsetse fly traps, spraying)
🌍 Geographic Distribution
- T. b. gambiense accounts for over 95% of cases
- WHO reports a significant decline in cases in recent years due to control programs
- Endemic in 36 African countries
✅ Key Facts
- Fatal if untreated, especially the rhodesiense form
- Curable with proper diagnosis and treatment
- Prevention and early detection are critical