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African trypanosomiasis

(Sleeping Sickness)

ANDREA BRADY
BIOL 062

Epidemics have
killed hundreds of
thousands since
1900.

http://www.microbiologybytes.com/introduction/Trypa
no.html

http://www.doctorswithoutborders.org/images/news/sleeping/344
76.jpg

Tens of thousands continue to die each year

WHO estimated that in 2001, there

were 48,000 deaths caused by sleeping


sickness.

www.dcp2.org/pubs/DCP/23/Section/3154

Tens of thousands continue to die each year

WHO estimated that in 2001, there

were 48,000 deaths caused by sleeping


sickness.

Currently, it is estimated the number of

deaths per year has increased to 50,000


or as high as 100,000.
http://www.dcp2.org/pubs/DCP/23/Section/3154

As many as 500,000

are currently infected.


http://www.kfwh.org/information.asp

Most cases
are found in
Sub-Saharan
Africa.

Chart from World Bank, 2006

http://www.dcp2.org/pubs/DCP/23/Table/23.1

How can an infectious disease be


contained to such a specific region of the
world?

How can an infectious disease be


contained to such a specific region of the
world?
Lets take a closer look at how the disease
is spread

Disease Transfer

The disease is caused

by two parasites of the


Trypanosoma Genus
and brucei Species.

http://en.wikipedia.org/wiki/Sleeping_sickness

http://farm3.static.flickr.com/2110/1760532740_20189a8cdc.jpg

Disease Transfer

The disease is caused

by two parasites of the


Trypanosoma Genus
and brucei Species.
More commonly

called Trypanosomes
http://www.who.int/mediacentre/factsheets/fs259/en/

http://farm3.static.flickr.com/2110/1760532740_20189a8cdc.jpg

Trypanosomes

are protozoans.

http://www.who.int/mediacentre/factsheets/fs259/en/

http://jcs.biologists.org/content/vol115/issue12/images/medium/jo
ces11512cvf.gif

Trypanosomes

are protozoans.

(unicellular eukaryotes)
(single flagellum)

http://www.who.int/mediacentre/factsheets/fs259/en/

http://jcs.biologists.org/content/vol115/issue12/images/medium/jo
ces11512cvf.gif

http://www.modares.ac.ir/elearning/Dalimi/P
roto/images/Lectures/fig77_1.JPG

Disease Transfer

The trypanosomes are

mainly transferred by
the tsetse fly, which is
found primarily in SubSaharan Africa.

the tsetse fly


The tsetse fly

http://www.microbiologybytes.com/introduction/Trypano.html

http://library.truman.edu/test/carol/Tsetse_fly.gif

Areas
Infested
by the
Tsetse Fly

http://www.fao.org/ag/icons/map.gif

Distribution
Map for
African
Sleeping
Sickness

http://www.medicalecology.org/diseases/af
rican_trypano/clip_image002.jpg

Areas Infested by tsetse fly

Distribution of the disease

Trypanosoma brucei:
Two different parasites

African Sleeping Sickness is

caused by two different


parasites.

http://www.microbiologybytes.com/introduction/Trypano.html

Trypanosoma brucei:
Two different parasites

African Sleeping Sickness is

caused by two different


parasites.
Trypanosoma brucei gambiense
Trypanosoma brucei rhodesiense

http://www.microbiologybytes.com/introduction/Trypano.html

Trypanosoma brucei:
Two different parasites
Trypanosoma brucei

gambiense
Accounts for 90% of

reported cases of African


Sleeping Sickness.
Causes the chronic form of
the disease
Prevalent mostly in West
and Central Africa.

http://www.microbiologybytes.com/introduction/Tr
ypano.html

http://www.dmacc.cc.ia.us/instructors/Image11.gif

Trypanosoma brucei:
Two different parasites
Trypanosoma brucei

rhodesiense
Accounts for 10% of

reported cases of African


Sleeping Sickness.
Causes the acute form of
the disease.
Prevalent mostly in
Eastern and Southern
Africa.

http://www.microbiologybytes.com/introduction/Tr
ypano.html

http://www.uoguelph.ca/~pwoo/fig6.jpg

Method of Infection

Begins with the bite of the tsetse fly

http://www.who.int/mediacentre/factsheets/fs259/en/

http://www.mimg.ucla.edu/faculty/Hill/fig2.jpg

Method of Infection

The bite will become

red and swollen.

http://www.who.int/mediacentre/factsheets/fs259/en/

http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg

Method of Infection

The bite will become

red and swollen.


From here, the
infection will enter the
bloodstream.

http://www.who.int/mediacentre/factsheets/fs259/en/

http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg

Method of Infection

The bite will become

red and swollen.


The infection will
enter the bloodstream.
Long asymptomatic
phase.

http://www.who.int/mediacentre/factsheets/fs259/en/

http://io.uwinnipeg.ca/~simmons/16cm05/1116/28-11-TrypanosomaLM.jpg

The disease has three distinct stages.

The disease has three distinct stages.

Asymptomatic Phase

http://www.who.int/mediacentre/factsheets/fs259/en/

The disease has three distinct stages.

Asymptomatic Phase
First Stage
(haemolymphatic phase)

http://www.who.int/mediacentre/factsheets/fs259/en/

The disease has three distinct stages.

Asymptomatic Phase
First Stage
(haemolymphatic phase)
Second Stage (neurological phase)

http://www.who.int/mediacentre/factsheets/fs259/en/

First Stage

The pathogens

will spread
throughout the
blood and the
lymph.
http://www.who.int/mediacentre/factsheets/fs259/en/

http://www.pnas.org/content/100/3/F1.medium.gif

First Stage
Symptoms

Fever
Headache
Sweating
Joint Pain
Itching
Swollen Lymph Nodes

www.who.int/mediacentre/factsheets/fs259/en

http://upload.wikimedia.org/wikipedia/commons/thumb/8/88/Wi
nterbottom%27s_sign.jpg/200px-Winterbottom%27s_sign.jpg

Second Stage
Eventually, the disease will manage to cross

the blood-brain barrier.

Second Stage
Eventually, the disease will manage to cross

the blood-brain barrier.


This will cause an infection of the Central

Nervous System

www.who.int/mediacentre/factsheets/fs259/en

Second Stage

Symptoms
Confusion
Sensory Disturbances
Poor Coordination
Disturbances of Sleep
Cycles

www.who.int/mediacentre/factsheets/fs259/en

http://www.msf.org.uk/UploadedImages/e64ac496-41d9-4b8b8cac-423baecb957f.jpg

If not treated, the

disease is fatal.

www.who.int/mediacentre/factsheets/fs259/en

Diagnosis and Treatment

Treatment varies

depending on the
stage of the
disease.

www.who.int/mediacentre/factsheets/fs259/en

http://www.sawitfirst.co.uk/media/pill_clockbig.gif

Diagnosis and Treatment

The disease is easier and more effective

to treat the earlier it is diagnosed.

http://www.who.int/mediacentre/factsheets/fs259/en/

Diagnosis and Treatment

The disease is easier and more effective

to treat the earlier it is diagnosed.


Much harder after the pathogens have
crossed the blood-brain barrier.

http://www.who.int/mediacentre/factsheets/fs259/en/

Diagnosis and Treatment

Four drugs are

available for
treatment

http://www.pet-comfort-products.com/images/colorful-pills01.gif

Diagnosis and Treatment

Four drugs are

available for
treatment
Two available for firststage treatment
Two available for
second-stage treatment

www.who.int/mediacentre/factsheets/fs259/en

www.pet-comfort-products.com/images/colorful-pills-01.gif

Diagnosis and Treatment

The two drugs available for second-

stage treatment are significantly more


dangerous.

http://www.who.int/mediacentre/factsheets/fs259/en/

Diagnosis and Treatment

So, in summary, treatment during

the first-stage is

Diagnosis and Treatment

So, in summary,

treatment during
the first-stage
is
More

effective

http://images.thescientist.com/content/figures/images/yr2002/may13/iv.jpg

Diagnosis and Treatment

So, in summary,

treatment during
the first-stage
is
More

effective

Safer

http://images.thescientist.com/content/figures/images/yr2002/may13/iv.jpg

Diagnosis and Treatment

Therefore,

early diagnosis
is imperative

http://www.who.int/mediacentre/factsheets/fs259/en/

http://www.bayerscheringpharma.de/html/images/upload/gesells
chaftliches_engagement/aerztin_patient_205.jpg

Like with malaria, if

we could reduce the


number of people with
the disease, we could
reduce transmissions
and eventually
eradicate the disease.

http://www.ecdl.com/countries/images/map_africa.gif

Organizations like

WHO have began


efforts to eliminate
the risk of this
disease

http://www.who.int/mediacentre/factsheets/fs259/en/

http://www.who.int/mediacentre/factsheets/fs259/en/

Organizations like

WHO have began


efforts to eliminate
the risk of this
disease
HAT programme

http://www.who.int/mediacentre/factsheets/fs259/en/

http://www.who.int/mediacentre/factsheets/fs259/en/

Due to lack of funds and turmoil, there

are an estimated 7 nations currently at


epidemic level for the disease.

http://www.kfwh.org/information.asp

Like many other infectious diseases in

third world countries, much change is


needed in world health policies before
we can effectively eradicate African
Sleeping Sickness.

THE END.