African Trypanosomiasis Flashcards

1
Q

What is the vector for Human African Trypanosomiasis?

A

Tsetse fly

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2
Q

What are the organisms that causes African Trypanosomiasis and which is more common?

A

Trypanosoma brucei gambiense-98%

Trypanosoma brucei rhodesiense

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3
Q

Which species of tsetse flies transmit gambiense and where are they usually found?

A

Glossina papalis found in riverine forrest areas

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4
Q

Which species of tsetse flies transmit rhodiesense and where are they found?

A

Glossina mortisans in savannah woodland areas

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5
Q

Does trypanosoma brucei have an intracellular life cycle?

A

No

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6
Q

How can human African trypanosomiasis be transmitted?

A

Tsetse fly bite
Vertical transmission
Needle stick
Raw infected meat

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7
Q

What are the signs and symptoms of early stage African trypanosomiasis and how long does it last ?

A

Intermittent fevers
Anaemia
Flu like symptoms
Sometimes hepatosplenomegaly

Painless chancre
Winterbottoms sign

Gambiense 3yrs
Rhodesiense weeks to months

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8
Q

Why do you get intermittent fevers in African trypanosomiasis?

A

Waves in parasitaemia due to variable surface glycoproteins

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9
Q

What are the symptoms of stage 2 African trypanosomiasis?

A
Meningism
Sleep/wake reversal
Psychosis 
Depression
Coma
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10
Q

How do you diagnose African trypanosomiasis?

A

Card agglutination trypanosome test for gambiense
RDTs

Blood film
CSF sample for WCC and parasites

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11
Q

How to treat Trypanosoma brucei gambiense?

A

Stage 1- pentamidine for 1 week

Stage 2- nifurtimox-eflornithine

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12
Q

How to treat trypanosoma brucei rhodiesense?

A

Stage 1- IV Suramin

Stage 2- IV melarsoprol

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13
Q

What are the side effects of pentamidine?

A

Nephrotoxicity
Hypotension
Hypoglycaemia

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14
Q

What are the side effects of suramin?

A

Fever
Nausea
Anaphylaxis
Proteinuria

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15
Q

What are the side effects of melarsoprol?

A

Reactive encephalopathy 5% mortality

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16
Q

What’s the follow up for African trypanosomiasis?

A

Bloods and LP every 6 months for 2 years

17
Q

What control mechanisms are in place for African trypanosomiasis?

A

Active surveillance: teams go around the countryside and do mass CATT testing (gambiense)
Vector control: blue flags with insecticide and release sterile males
Free medications negotiated by WHO

18
Q

How do you identify a tsetse fly?

A

Folded wings when resting

Hatchet cell on wing