Trypanosoma Brucei Research Paper

Abstract

Trypanosoma brucei, the parasite, is not very common in the United States but is very common in Africa. Trypanosoma brucei is a disease that kills many people throughout Africa. Though we may not have it here it still affects people, in this paper we are going to look at the different ways T. brucei will infect people, the life cycle, the pathophysiology, the epidemiology, the signs and symptoms of the host, and last the different medicines that cure T. brucei. Trypanosoma brucei is a very serious illness and we will look how T. brucei turns into the West African trypanosomiasis and different ways to prevent getting infected by the parasite. The Africa sleeping sickness is another major thing I will be talking about, and the different

aspects of the disease, I will also talk about how the disease is caused, and how it could be transmitted between other people, and even embryos.

Keywords: Trypanosoma brucei, T. brucei, West African trypanosomiasis, The Africa sleeping sickness.
Trypanosoma brucei
Trypanosoma brucei is not very common here in the United States. Not many people know about it here, but in Africa it is a very popular parasitic disease. This disease at one point was the number one mortality, which was higher than HIV (Odero, 2015, Para 5). Africa sleeping sickness is such a crazed disease, and is transmitted so easy, all it takes is for a tsetse fly with the parasite to bite you and the parasite to get in your system and you can get affected. With this parasite there are two types of this parasitic disease which are, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense. There is a lot of confusion between these two, because they have such similar features, but they do have some different one as well.
Life cycle
The life cycle of Trypanosoma brucei is very unique. In the life cycle there are 8 different steps that the parasite goes through. The first four stages are in the human, and the last four stages are the tsetse fly stages. The tsetse fly is how the human in all reality gets the parasite. The first step is a tsetse fly gets a blood meal, which carries Trypanosoma brucei in it. Second step is the parasite then enters into the bloodstream trypomastigotes; then the parasite is carried in other parts of the body and other systems. The third stage is replication, the trypomastigotes is then replicated in body fluids such as blood or lymph. In the fourth stage, trypomastigotes start to invade blood, till eventually it’s in the whole blood stream. Starting now in the fifth stage it starts over on how the tsetse fly gets the disease. In the fifth stage the tsetse fly takes a blood meal from the human when it bites the human. The sixth stage the blood stream trypomastigotes transform into a procylic trypomastigotes in tsetse fly’s gut. Replication in tsetse fly is now started by binary fission. The procylic trypomastigotes then leaves the gut in stage seven and change into epimastigotes. In the final stage the epimastigotes multiply in the tsetse fly salivary glands (Biology of T. brucei, 2015, para 1). Then the cycle eventually starts over when a tsetse fly bites again and the human goes through the life cycle of the parasite again.
Pathophysiology
When a person is bit and infected with Trypanosoma brucei there are many changes that happen in the body. After it goes through the life cycle the parasite will continue to mature and continue to replicate. Since it starts replicating in the blood and lymph like we talked about before it starts to cause malaise, which is a sign of parasitic disease, intermittent fever, rash, and wasting. Then eventually after having T. brucei for a long period, the parasitic invasion reached the central nervous system, causing behavioral and neurological changes. Other pathophysiology may include changes in the hematologic, lymphatic, and cardiac systems. This is the reaction of immune-mediate reaction against the invaded red blood cells. A hypersensitivity may react in the skin causing problems, which may include facial edema. High levels in the spleen or lymph nodes may lead to fibrosis but rarely in to spleen failure. If not treated in time T. brucei may cause death (Odero, 2015, Para 3).
Epidemiology. Though African trypanosomiasis is not common in the United States, there are still cases that are reported that were imported from Africa. Infections in travelers are very rare and is less than 1 case a year among US travelers. Most of these infections are from East Africa game parks. There may not be any cases in the US, but in 36 countries of sub-Saharan Africa it threatens millions of people (Odero, 2015, Para 5). There are two types of this parasitic disease as mentioned before, Trypanosoma brucei gambiense, which are found in 24 countries of the sub-Saharan Africa, and Trypanosoma brucei rhodesiense, which is found in 12 of the countries (Trypanosomiasis, 2016, para 3). In 1998, there was a panel of experts convened by the World Health Organization that discovered 40,000 case of African trypanosomiasis was reported and 300,000 were untreated therefore was un-diagnosed. African trypanosomiasis was considered the first or even second greatest cause of mortality in Africa, even ahead of HIV infection. This disease can happen to anyone, it does not matter if your young, old, white, black, women, or man. This disease can happen to anyone. The only thing is that when kids get it they have more severe problems, such as causing psychomotor retardation and seizure disorders (Odero, 2015, Para 5).
Major Epidemics. Though we may not have this epidemic here in the United States, there have been quite a few in Africa. The latest epidemic was in 1970 and lasted about 25 years until 1995. The earliest epidemic was one between 1896 and 1906, and that was mostly in Uganda and Congo Basin (Trypanosomiasis, 2016, para 8). In the earliest epidemic there were about half a million people who were estimated to be infected. T. b. gambiense was the causative agent that they thought was the parasite but later Koerer et al proved that in fact it was T. b. rhodesiense. At that point in time there was no diagnostic features which led anyone to think that it was in fact T. b. rhodesiense (Hide, 1999, Para 8). In 1920 there was epidemic that was in many African countries. This epidemic was on its way to be bad, but mobile teams which carried screenings, test many people at risk and got them the help they needed. By the mid-1960s the disease was under control with less than 5 thousand case. This was the last case until the most recent one in 1970, there is not much information on the 1970 epidemic, but we do know that there was more than four thousand people that was infected with the disease in Uganda. (Trypanosomiasis, 2016, para 9).
Transmission. Though we know that you can get Trypanosoma brucei by getting bit from tsetse fly, but there are other ways this can be transmitted. One way other than the tsetse fly you can get it is mother to child infection. This is transferred through the placenta and afect the fetus, and can cause harm or even death to the fetus. Another way is mechanical transmission through other blood sucking insects such as mosquito. One way that has been documented is sexual transmission. If two people were to have sexual intercourse the other may get the parasitic disease, which is kind of like an STD (Trypanosomiasis, 2016, para 21).
Signs and Symptoms. This parasitic disease signs and symptoms can be very severe or even cause death. At the site that you are bitten, there will be a red sore that is called a chancre. Your body will start to try and stop the infection in the first 48 hours, most of the time your body will not be able to stop it. The body then starts to become feverish, you get severe body aches and headaches, irritability, fatigue, swollen lymph nodes, and joint aches. These are the common signs and symptoms of the African sleeping sickness. Some other symptoms may include skin rash, progressive confusion, personality changes, and other neurological problems once the parasite reaches the central nervous system. If left and not treated, the symptoms will become worse, and eventually death will occur within a few months (Biology of T. brucei, 2015, para 5).
Diagnoses.

The way this disease is diagnosed is through the laboratory methods. The diagnosis is found on by looking at fluid or tissues by microscopy. T. b. rhodesiense is much more intense than T. b. gambiense, therefore you can find T. b. rhodesiense faster and easier, because its takes over more of the body than T. b. gambiense does. You can find T. b. rhodesiense in the blood, lymph node fluid or fluid, or a biopsy of chancre. As for T. b. gambiense you cannot find it in the blood easily, therefor is harder to diagnose. After diagnosis all patients with African sleeping sickness must have their cerebrospinal fluid examined to make sure there CNS is not in any danger because of the parasitic

disease.
Medicine and cures.

There are a few treatments for the Africa sleeping sickness, which can get rid of the parasitic disease. One of the treatment is Antitrypanosomal is indicated for all persons diagnosed with African trypanosomiasis. The parasitic disease comes in stages, and with different stages come different treatment. In the first and second stage of the disease Pentamidline, will be fused into the body 2 hours, this is with T. b. gambiense. With T. b. rhodesiense the cure in the first couple stages, you would be injected Suramin/. The only thing with these medicines are they have a lot of adverse reactions such as injection of site pain, diarrhea, nausea, and vomiting. The third stage of both is treated with Eflorithine, which is given in four daily infusions for fourteen days. The adverse effects are much more intense, which include bone marrow suppression, gastrointestinal symptoms, and seizures. For pregnant people you have to be careful, because you can hurt the fetus in embryo if you take a lot of Eflorithine. Doctors will often use this as a last resort because it may cause a lot or harm or even death to it (Resources for Health Professionals, 2013, para

2).
Conclusion. Now we have talked about different aspects of Trypanosoma brucei and the different ways it harms us. The way the disease can harm people is so senseless, and it could happen to anyone. African sleeping sickness takes so many lives, and the statistics that we discussed are crazy and it is scary to think that people actually have this disease. This disease is easily transmitted through people, and it causes so many problems. We also discussed the life cycle of Trypanosoma brucei and the pathophysiology, and the epidemiology, and we can clearly see that this disease is a scary disease to carry if not treated. Though Africa may be one of the only country that this is in, the Africa Sleeping sickness is like the plague, it will be calm with no victims, but all of a sudden it takes so many people, and in some places in Africa they do not have the luxury of going to the doctor so they have to try and fight it off with the little resources they do have, and just hope for the best. This disease is a serious issue and needs to be handled immediately, because it does not discriminate, it will take many lives.