The clinical signs and symptoms of East African trypanosomiasis and West African trypanosomiasis are similar; however, the clinical courses of the two conditions differ considerably. When the tsetse fly bites a person, it may be painful, and a chancre or skin lesion may appear. The patient may first experience a group of nonspecific signs and symptoms such as fever, headache, irritability, fatigue, swollen lymph nodes, muscular aches, and joint pains.
Two Stages of African Trypanosomiasis
As the disease progresses, there may be mental confusion, personality changes, and other neurologic presentations as the infectious parasite invades the patient’s central nervous system. Human African trypanosomiasis, therefore, has two clinical stages. The first is the hemolymphatic phase in which the parasite circulates in the bloodstream, and the second is the neurologic phase in which the central nervous system undergoes invasion by the parasite (World Health Organization, 2012).
Medication is available to treat this medical condition, and its use will lead to a microbiologic cure. However, if the patient does not receive medical therapy, African trypanosomiasis may lead to death. This disease requires hospitalization in most instances, and every person who acquires it has to receive antitrypanosomal drug therapy.
Variation of Disease Progression
East African trypanosomiasis, which is due to infection from Trypanosoma brucei rhodesiense, will generally lead to clinical signs and symptoms one to three weeks after the infective bite of the tsetse fly. Evidence of central nervous system invasion may occur several weeks later in the course of the disease, and without medical treatment, death may ensue after several months.
On the other hand, West African trypanosomiasis, which is the result of Trypanosoma brucei gambiense infection, has a much longer incubation period and slower progression of disease than East African trypanosomiasis. It may take several months to a year before these patients develop clinical signs or symptoms, and death may occur several years later.
Since the worst complications of African trypanosomiasis tend to occur months to years after the initial infection, early diagnosis and management are essential. When the patient presents to the health care facility, the disease may have already been present for quite some time, and implementation of antitrypanosomal medication will yield the best clinical outcome if the physician does it promptly.
Sources
- Centers for Disease Control. (2010). Parasites—African trypanosomiasis (also known as sleeping sickness) Retrieved January 19, 2012.
- World Health Organization. (2012). African trypanosomiasis (sleeping sickness). Fact sheet. Retrieved January 19, 2012.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
Join the Conversation