TRYPANOSOMIASIS, AFRICAN - ZAMBIA: (LUSAKA)
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Date: Tue 22 Apr 2014
Source: The Global Dispatch [edited]
http://www.theglobaldispatch.com/zambia ... nce-14762/
An outbreak of the deadly parasitic disease, African sleeping sickness, or African trypanosomiasis, has been reported in Rufunsa District in Lusaka Province, according to Member of Parliament Kenneth Chipungu.
The Times of Zambia reports 8 cases had been recorded at Mupanshya Hospital. Mr Chipungu said the outbreak was due to an increase in tsetse flies mainly in the areas that border the Game Management Areas (GMAs) owing to the constant interaction with wild animals. Chipungu also noted an increase in malaria cases in the area.
Often a fatal disease with 15 000-20 000 cases reported annually, more than 60 million people are at risk in more than 30 African countries. One of the true tropical diseases, African sleeping sickness is endemic only in sub-Saharan Africa, bounded by 15 deg North and South latitudes. Two varieties of African sleeping sickness exist: one primarily in East Africa caused by the parasite _Trypanosoma brucei rhodesiense_. _T. b. rhodesiense_ produces an acute infection that will usually cause severe illness and death in weeks to months.
The other species is _Trypanosoma brucei gambiense_. This parasite is found in West and Central Africa. However, the 2 species are showing some geographic overlap. This infection progresses more slowly and may require months to years for disease to appear.
Both types of sleeping sickness are caused by the bite of a tsetse fly. These vicious little bugs depend on blood meals for their nutrients. It gets the blood from mammals, including humans. The tsetse fly has a very painful bite, and a traveler will certainly remember getting bitten. When taking a blood meal, the fly injects the parasite into the skin. From here the parasite is carried to the lymphatic system and eventually the bloodstream. It goes through stages in the body and eventually ends up in the spinal fluid.
According to the US Centers for Disease Control and Prevention [CDC], treatment should be started as soon as possible and is based on the infected person's symptoms and laboratory results. The drug regimen depends on the infecting species and the stage of infection. Pentamidine isethionate and suramin (under an Investigational New Drug Protocol from the CDC Drug Service) are the drugs of choice to treat the hemolymphatic stages of West and East African trypanosomiasis, respectively. Melarsoprol is the drug of choice for late disease with central nervous system involvement (infections by _T. b. gambiense_ or _T. b. rhodiense_). There is no vaccine for African trypanosomes. Prevention is by preventing tsetse fly bites.
[Byline: Robert Herriman]
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[WHO reports that "Countries such as, Angola, Cameroon, Congo, Cote d'Ivoire, Equatorial Guinea, Gabon, Ghana, Guinea, Kenya, Malawi, Nigeria, Uganda, United Republic of Tanzania, Zambia and Zimbabwe are reporting fewer than 100 new cases per year" (Trypanosomiasis, human African (sleeping sickness) fact sheet,
http://www.who.int/mediacentre/factsheets/fs259/en/).
A review of tsetse fly distribution in Zimbabwe and Zambia from 1992 shows that the area around Lusaka is considered free from tsetse (
http://www.fao.org/docrep/004/t0599e/T0599E12.htm). A recent estimate of the distribution of suitable areas for tsetse flies can be found at PAAT (Program Against African Trypanosomiasis,
http://www.fao.org/ag/againfo/programme ... outhafrica). - Mod.EP
A HealthMap/ProMED-mail map can be accessed at:
http://healthmap.org/promed/p/2939.]