African trypanosomiasis is a parasitic infection endemic to Africa, where it has been documented since at least the 14th century in both humans and animals. There are two forms of the disease, West African trypanosomiasis and East African trypanosomiasis. Outside of Africa, this disease is occasionally observed in people who have traveled to Africa, which is one reason why it is important to disclose travel history to a doctor; someone who presents with the symptoms of African trypanosomiasis will not be tested for the disease if the doctor doesn't know that the patient has been to Africa.
This infection is caused by protozoans in the Trypanosoma genus. The organisms are carried by the tsetse fly, which infects people when it bites them. Sometimes African trypanosomiasis can be transmitted from mother to child as well. The fly bite usually becomes swollen and mildly inflamed. Symptoms set in within weeks and if not treated the patient will die in months or years of neurological complications or organ failure.
Early signs of African trypanosomiasis include headaches, joint pain, restlessness, fever, and irritability. The patient's lymph nodes will start to swell, and the patient will develop problems with the kidneys, heart, and endocrine system. Anemia will start to set in as well, which often causes fatigue. Finally, the disease enters the neurological stage, with the patient experiencing confusion and other neurological symptoms. The dazed state observed in patients with this disease explains the alternate name “sleeping sickness.”
Drugs are available to treat patients with African trypanosomiasis. The earlier the disease is caught, the better the prognosis for the patient, as rapid treatment can prevent long term damage. The drug regimen used varies depending on the subspecies of organism responsible for the infection, the patient's location, and how responsive the disease is to treatment. Drug resistant cases of African trypanosomiasis have been documented in some areas, complicating treatment considerably.
Prevention of African trypanosomiasis involves avoiding the tsetse fly. Sleeping under fly nets is advised, as is using bug repellent sprays which will reduce contact with flies. Tsetse fly control measures are practiced throughout Sub-Saharan Africa with the goal of limiting human African trypanosomiasis cases and addressing the devastating impact this disease can have on livestock. Travelers to Africa should comply with posted warnings and notices about tsetse flies and other health threats and they should seek treatment if they develop medical problems during their travels. Treatment for aggressive forms of this disease cannot wait until a traveler returns home.
