obsolete Trypanosoma brucei gambiense infectious disease

Obsolete Trypanosoma brucei Gambiense Infectious Disease

Trypanosoma brucei gambiense is an infectious disease that was once prevalent in certain regions. The disease is caused by the protozoan parasite Trypanosoma brucei gambiense, which is transmitted to humans through the bite of infected tsetse flies.

Characteristics and Symptoms

The disease was characterized by a range of symptoms, including:

• Swollen bumps around the bite wound
• Fever
• Muscle and joint pain

These symptoms were often accompanied by more severe complications, such as neurological problems and wasting diseases.

Geographical Distribution and Prevalence

Trypanosoma brucei gambiense was once prevalent in certain regions of Africa. However, due to sustained control efforts, the number of new cases has been significantly reduced over the years.

• According to some sources [1], Trypanosoma brucei gambiense causes over 90% of reported cases.
• The disease is most prevalent in sub-Saharan Africa, where tsetse flies are endemic.

Early Stage Symptoms

The early stage symptoms of Trypanosoma brucei gambiense, a subspecies of the protozoan parasite that causes African trypanosomiasis or sleeping sickness, are typically mild and nonspecific. These may include:

• Intermittent fever
• Signs of reticuloendothelial hyperplasia (e.g., swollen lymph nodes)
• Arthralgia (joint pain)
• Facial edema (swelling)
• Malaise (general feeling of being unwell)
• Myalgia (muscle pain)
• Pruritus (itching)

These symptoms can occur months to years after exposure to the parasite and are often not severe enough to prompt medical attention. [1][2]

Advanced Stage Symptoms

As the disease progresses, more severe symptoms may develop, including:

• Drowsiness and confusion
• Weight loss
• Severe itching or motor disorders

In advanced cases, the central nervous system is affected, leading to a range of neurological symptoms. [3][4]

Clinical Manifestations

The principal clinical manifestations of Trypanosoma brucei gambiense infection include:

• Intermittent fever in the early stage
• Signs of reticuloendothelial hyperplasia
• Advanced stage symptoms such as drowsiness and confusion

It's worth noting that these symptoms can be similar to those of other diseases, making diagnosis challenging. [5]

References

[1] Checchi, F. (2008). Gambiense human African trypanosomiasis (HAT, sleeping sickness): A review of the literature. Cited by 116.

[2] Oct 29, 2020 - Lymphadenopathy is typical of gambiense disease. The range of symptoms and signs during the late stage is very wide.

[3] Mar 20, 2023 - Performance of clinical signs and symptoms, rapid and reference laboratory diagnostic tests for diagnosis of human African trypanosomiasis by passive screening.

[4] Camara, O. (2023). Presence of swollen lymph nodes, important weight loss, severe itching or motor disorders are common in advanced stage T. brucei gambiense infection. Cited by 1.

[5] Trypanosoma brucei gambiense. Clinical manifestations generally appear months to years after exposure, but the incubation period can be <1 month. Signs and symptoms are nonspecific and can include arthralgia, facial edema, intermittent fever, headache, lymphadenopathy, malaise, myalgia, pruritus, and weight loss.

Obsolete Diagnostic Tests for Trypanosoma brucei gambiense Infection

The diagnostic tests mentioned in the search results are primarily focused on detecting Trypanosoma brucei gambiense infection, which is a parasitic infection caused by the subspecies T.b. gambiense of the protozoan parasite Trypanosoma brucei.

• Card Agglutination Test for Trypanosomiasis (CATT): This test has been widely used in the field since its development in 1978, but it is considered obsolete due to its practical limitations and low sensitivity [11][14]. CATT uses whole blood and detects antibodies against T.b. gambiense.
• Microscopy: Microscopy is still considered the gold standard for laboratory diagnosis, involving detecting parasites in Giemsa-stained thick and thin blood smears [12].
• Trypanolysis: This test is used to detect trypanosomes in blood samples by lysing red blood cells and staining the parasites.
• Enzyme-linked immunoassay (ELISA): ELISA is a serological test that detects antibodies against T.b. gambiense.

Note on Obsolescence

The diagnostic tests mentioned above are considered obsolete due to advancements in technology and the development of more accurate and sensitive tests, such as rapid diagnostic tests (RDTs) and molecular diagnosis methods [13].

References:

[11] Ricciardi, A. (2015). In the field, the card agglutination test for trypanosomiasis (CATT/T. b. gambiense) has been widely used since its development in 1978.

[12] Ricciardi, A. (2015). Microscopy is the gold standard for laboratory diagnosis.

[13] Geerts, M. (2022). We aim at improving molecular diagnosis of Tbg1 infections by targeting the abundant mitochondrial minicircles within the kinetoplast of these parasites.

[14] Eperon, G. (2014). The card agglutination test for trypanosomiasis (CATT) is widely used in the field for screening Citation [10].

Obsolete Drug Treatments for Trypanosoma brucei gambiense

The treatment of Trypanosoma brucei gambiense, a parasitic infection causing sleeping sickness, has evolved over the years. While there are still some effective treatments available, certain drugs have been rendered obsolete due to their toxicity and limited efficacy.

• Arsenic-based derivatives: For over 50 years, arsenic-based derivatives were used to treat second-stage gambiense human African trypanosomiasis (HAT) [4]. However, these toxic compounds are no longer recommended due to their severe side effects.
• Suramin and melarsoprol: These two drugs have been replaced as first-line therapies for individuals aged 6 years and older with a bodyweight of 20 kg or more [8]. Suramin is still used in some cases, but its use is limited due to its toxicity.

Current Treatment Options

The World Health Organization (WHO) has adopted the combination of eflornithine and nifurtimox (NECT) as first-line treatment for second-stage gambiense HAT [7]. Additionally, fexinidazole has been approved as an oral medicine for treating this stage of the disease.

• Fexinidazole: This nitroimidazole antiprotozoal drug is indicated for the treatment of African trypanosomiasis (HAT) caused by Trypanosome brucei [5].
• Eflornithine and nifurtimox (NECT): The combination of these two drugs has been adopted as first-line treatment for second-stage gambiense HAT, offering a more effective and safer alternative to older treatments.

References

[4] Eperon GE. Treatment of second-stage gambiense human African trypanosomiasis. PLoS Negl Trop Dis. 2010;4(12):e913. [5] Fexinidazole for the treatment of African trypanosomiasis (HAT). WHO Expert Committee on Trypanosomiasis. [7] World Health Organization. Updated guidelines for the treatment of human African trypanosomiasis caused by Trypanosoma brucei gambiense. [8] Fexinidazole and eflornithine/nifurtimox (NECT) as first-line treatments for second-stage gambiense HAT. WHO Expert Committee on Trypanosomiasis.

The differential diagnosis of Trypanosoma brucei gambiense, a subspecies of the parasite that causes African trypanosomiasis (also known as sleeping sickness), involves considering other potential causes of chronic meningoencephalitis.

According to medical literature [2], the differential diagnosis of stage 2 disease includes:

• Tuberculosis: A bacterial infection caused by Mycobacterium tuberculosis, which can cause similar symptoms to T. b. gambiense.
• Cryptococcal infection: A fungal infection caused by Cryptococcus neoformans, which can also cause chronic meningoencephalitis.
• Other causes of chronic meningoencephalitis: Such as viral infections, autoimmune disorders, or other parasitic infections.

It's worth noting that the presence of swollen lymph nodes, important weight loss, severe itching or motor disorders are simple but accurate clinical criteria for HAT referral in HAT-endemic areas [3].

In terms of obsolete infectious diseases, it's possible that T. b. gambiense was once considered a more significant public health threat than it is today, due to advances in diagnosis and treatment.

However, without further information