Are you aware of Trypanosomiasis, the sleeping sickness found in Africa?

Have you ever heard of a strange, slightly dangerous disease that occurs in parts of Africa? Doctors call it trypanosomiasis. Some people also call it "African sleeping sickness" because it makes you feel increasingly sleepy. It's actually a serious infection caused by a parasite. Let's talk about it all in detail today.

What is this Trypanosomiasis?

Simply put, trypanosomiasis is a very serious parasitic infection. It can spread to different parts of our body. Let's see where it affects:

• For your skin
• For your blood
• To your lymph nodes
• Your brain and the fluid that surrounds your brain and spinal cord , called cerebrospinal fluid.

This disease is spread by the bite of a special type of fly found in Equatorial Africa . These flies are called tsetse flies . These tsetse flies are large, yellowish-brown or dark brown blood-sucking flies. Think about it, these flies can be about 0.2 to 0.6 inches (that’s about 6 to 16 millimeters) long. Equatorial Africa is the part of Africa that runs along the equator, below the Sahara Desert. Symptoms can appear within a few weeks or months after infection.

The important thing is that trypanosomiasis is a curable disease . However, if not treated properly, it can even lead to death .

This disease is called by several other names:

• African sleeping sickness
• African trypanosomiasis
• Human African trypanosomiasis (HAT)

Why is this called "African sleeping sickness"?

Many people call this disease trypanosomiasis "African sleeping sickness" for two reasons. One is that the parasites that cause it are transmitted by tsetse flies in Equatorial Africa. Another is that one of the main symptoms of this disease is that it can affect your sleep . That means you can feel sleepy all the time.

How common is this disease?

Trypanosomiasis used to be a very common disease. According to the World Health Organization (WHO), there were about 30,000 cases in the late 1990s and early 2000s. However, due to control measures taken over the past 20 years, the number of cases has decreased significantly .As of 2020, fewer than 700 cases of trypanosomiasis have been reported.

What are the symptoms of Trypanosomiasis?

The symptoms of this disease can appear one after another. See if these are familiar to you (since this disease is not actually present in our country, it is important to be aware of these):

• A swollen, discolored (red, purple, or brown) lump may develop at the site of the bite. This can be painful.
• A fever that comes and goes (recurrent fever) .
• The body is getting cold (Chills) .
• Headache .
• Muscle pain .
• Joint pain .
• Skin rash .
• A decrease in red blood cells in the blood, that is , anemia .
• Swelling of the face and/or lymph nodes .
• Difficulty staying awake, frequent drowsiness .
• Inability to concentrate, a state of unconsciousness (Confusion) .
• Difficulty walking or talking .

If not treated properly , trypanosomiasis can cause seizures , coma, and even death .

What causes trypanosomiasis?

This disease is caused by two types of single-celled microscopic parasites called protozoa .

• Trypanosoma brucei gambiense . This parasite is responsible for more than 90% of cases of trypanosomiasis.
• Trypanosoma brucei rhodesiense . This parasite is responsible for less than 10% of cases.

How do people get this disease?

Trypanosomiasis is transmitted to humans by the bite of infected tsetse flies . Tsetse flies acquire these parasites from infected animals (such as cattle, sheep, goats, pigs, horses, and camels) or from other people who have the disease.

Is Trypanosomiasis a contagious disease?

Trypanosomiasis is most often caused by the bite of an infected tsetse fly. However, if you are pregnant, you can pass the disease to your baby .

Another thing is that there is a very small chance that this disease can be transmitted through blood transfusion . But it is very rare. Because healthcare providers take many precautions to make blood donation safe.

Who is most affected by this disease?

Tsetse flies are diurnal flies that are active during the day.A type of fly. They live in wooded areas or savannahs (a combination of forest and desert) in Equatorial Africa. So, if you spend time in these areas, you are more likely to develop trypanosomiasis.

How is Trypanosomiasis diagnosed?

A doctor can diagnose trypanosomiasis by taking your medical history, asking about your symptoms and recent travel history, and performing a physical examination.

After that, the doctor may order several special tests to confirm the diagnosis.

What are the diagnostic tests?

These tests help diagnose trypanosomiasis:

• Blood tests : In this, the doctor takes a small sample of blood from a vein in your arm using a thin needle. It is then examined under a microscope to see if there are parasites.
• Lymph node fluid test : The doctor uses a needle to take some fluid from a swollen lymph node and check it for parasites.
• Spinal tap / Lumbar puncture : In this, the doctor inserts a needle between two vertebrae in your lower back (lumbar region) and removes a small amount of cerebrospinal fluid . It is checked for parasites, high white blood cell count, and other signs of infection.

Can trypanosomiasis be cured?

Yes, if diagnosed early and treated properly, trypanosomiasis can be completely cured. Treatment depends on the type of protozoa that has infected you, and whether the infection has spread to other parts of your body, especially the brain.

• If the trypanosomiasis infection has not spread to your brain or cerebrospinal fluid , your doctor may prescribe medications such as:
• You have Suramin, a parasite called Trypanosoma brucei rhodesiense.
• If you have `(Trypanosoma brucei gambiense)`, take Fexinidazole or Pentamidine .
• If the trypanosomiasis infection has affected your brain or cerebrospinal fluid , your doctor may prescribe medications such as:
• You have Melarsoprol, which is called `(Trypanosoma brucei rhodesiense)`.
• If you have `(Trypanosoma brucei gambiense)`, you should take Fexinidazole , Eflornithine , Nifurtimox orMelarsoprol.

Sometimes, corticosteroids may be prescribed to reduce swelling and joint and muscle pain.

This medicine can be given to you either as a pill (with water) or as a liquid given into a vein (intravenously). The most important thing is to take the full course of medicine prescribed by your doctor, even if you start to feel better. Otherwise, the trypanosomiasis may come back, making it more difficult to treat.

What happens after treatment? How do I check if I am still recovering?

There is no definitive test that can confirm that you are no longer infected with trypanosomiasis. Therefore, doctors will monitor you for about two years after treatment to see if symptoms return. If you develop symptoms again, they may do blood and cerebrospinal fluid tests to check for parasites.

How quickly will I recover after treatment?

Your doctor is the best person to answer this. Depending on the severity of your infection, he or she can estimate how long it will take for you to start feeling better after treatment.

What happens if I have trypanosomiasis?

If diagnosed early and treated properly, the chances of recovery from trypanosomiasis are very good. Most people recover if they receive treatment within two to three weeks of infection.

However, if not treated properly, many people die from trypanosomiasis. Treatment is possible even after the parasite has affected the brain and cerebrospinal fluid. However, the chances of saving lives are low.

What are the chances of surviving sleeping sickness?

With proper treatment, more than 95% of people with trypanosomiasis survive.

What is the outlook for trypanosomiasis?

Over the past 20 years, efforts to reduce the number of cases of trypanosomiasis have been very successful. The World Health Organization (WHO) has set a goal of eliminating trypanosomiasis as a public health problem by 2030. They hope to achieve this goal by:

• Provide more funding for research.
• Developing better testing methods.
• Providing treatment quickly.
• Limiting contact between tsetse flies and humans.

Can Trypanosomiasis be prevented?

Yes, you can do these things to protect yourself from being bitten by tsetse flies (especially if you are traveling to areas where this disease is prevalent):

• Try not to travel to infected areas.
• Wear thick clothing , long pants, and long sleeves, as tsetse flies can bite through even thin clothing.
• Wear neutral-colored clothing. Tsetse flies are attracted to dark and bright colors. Choose clothes in colors like white, gray, cream, brown, or beige.
• Avoid hanging around bushes and shrubs during the day. Although tsetse flies are active during the day, they sometimes seek shade among bushes during the hottest part of the day.
• Install screens on windows and doors.
• Stay indoors during the times when tsetse flies are most active.
• Apply sprays or chemicals to clothing, tents, and net covers that repel tsetse flies.
• Sleep in a tent with a thin mesh, or use protective netting when you sleep. Make sure to zip your tent completely shut.
• Before getting into cars or trucks, check inside for tsetse flies. They are attracted to movement and the dust stirred up by vehicles.

Is there a vaccine for Trypanosomiasis?

No, there is currently no vaccine or other medicine that can prevent trypanosomiasis.

How do I take care of myself if I have trypanosomiasis?

If you start feeling unwell after travelling to an area where trypanosomiasis is common, it is important to see a doctor immediately . Even if you don't remember being bitten by a tsetse fly, tell your doctor if you have been in an area where you were at risk. Follow their treatment plan exactly to make a full recovery.

Also, getting plenty of rest and drinking plenty of fluids will help you recover quickly.

When should I see a doctor?

If you have spent time in areas where you are at risk of being bitten by tsetse flies and develop symptoms of trypanosomiasis, see a doctor immediately.

After treatment, you will need to see your doctor for regular checkups - usually every six months for two years. If you have signs of infection again, your doctor will take blood and cerebrospinal fluid samples.

When should I go to an Emergency Treatment Unit (ETU) ?

If you have these severe symptoms, go to the nearest Emergency Room (ER), or call 911 (or your local emergency number):

• A fever over 103 degrees Fahrenheit (40 degrees Celsius).
• Confusion or disorientation.
• Seizures .

What questions should you ask the doctor?

When you see your doctor, you can ask questions like these:

• How exactly did I get trypanosomiasis?
• If I don't have trypanosomiasis, what other condition could I have?
• How serious is my condition?
• What tests do you perform to diagnose trypanosomiasis?
• What treatments do you recommend?
• Are there any side effects to the treatments you recommend?
• When will I start feeling better?
• What else can I do to speed up my recovery?
• Should I be concerned about new or worsening symptoms?
• When should I see the doctor for further tests?

Can I get trypanosomiasis more than once?

Yes, you can get trypanosomiasis more than once. Successful treatment for trypanosomiasis does not give you immunity from getting it again.

What is the difference between African Trypanosomiasis and American Trypanosomiasis?

American Trypanosomiasis is another name for Chagas disease . It is another type of parasitic infection. It is caused by a parasite called Trypanosoma cruzi . The Trypanosoma cruzi parasite is most commonly spread by the bite of infected Triatomine bugs (also known as "kissing bugs").

Take-Home Message

Okay, so let's recap the most important things we've talked about about trypanosomiasis:

• This is a parasitic infection transmitted by the bite of tsetse flies and found in some parts of Africa.
• If detected and treated early, it can be cured , or it can be fatal .
• Symptoms may include fever, body aches, swollen lymph nodes, and subsequent extreme drowsiness and confusion.
• If you are traveling to areas where this disease is prevalent, it is very important to take steps to protect yourself from flies .
• If symptoms appear after returning from such a trip, seek medical advice immediately .

I hope this information is useful to you. Stay healthy!

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