Human African trypanosomiasis in endemic populations and travellers

Human African trypanosomiasis in non-endemic countries

“…2 In Gambiense HAT the main risk groups are migrants or long-term travellers. 3 A detailed review of non-endemic cases of HAT over the last 20 years was performed by Migchelsen SJ et al in 2011. 4 …”

“…This variability in presentation depends on multiple factors; including the specifi c parasite strain and the background of the host affected (travellers or migrants). 3 …”

Loop-Mediated Isothermal Amplification for Detection of the 5.8S Ribosomal Ribonucleic Acid Internal Transcribed Spacer 2 Gene Found in Trypanosoma brucei gambiense

“…Causing substantial morbidity throughout sub-Saharan Africa, death by HAT is likely if a patient is untreated. [1][2][3] The trypanosomes replicate at the tsetse fly bite site before disseminating from the skin through the hemolymphatic system to the spleen, liver, lymph nodes, skin, eyes, endocrine system, and the heart (stage 1).…”

“…For treatment of stage 2 neurologic HAT, toxic BBB-permeable trypanocidal drugs are used. [1][2][3] Melarsoprol, effective for stage 2 T. b. gambiense and T. b. rhodesiense HAT, can cause a lethal severe posttreatment reactive encephalopathy brain inflammation. Less toxic eflornithine is active only against gambiense HAT and resistance to both drugs is increasing.…”

“…Although parasite detection in the blood by wet blood film examination is frequently successful in T. b. rhodesiense infections because of the high levels of parasitemia, this method is insensitive in T. b. gambiense infections that constitute 90-95% of all HAT cases. [1][2][3] Because of the often-silent neurological involvement, stage determination still relies on lumbar puncture to examine cerebrospinal fluid (CSF) for trypanosomes and/or changes suggestive of chronic meningoencephalitis. Single or double centrifugation of CSF is required to concentrate parasites for microscopic detection.…”