Trypanosoma brucei

by Christian Jay N. Bacanto

Trypanosoma brucei
-Is a unicellular parasite causing African
sleeping sickness(African trypanosomiasis), a
fatal tropical disease, in cattle and humans.
“Trypanosoma brucei are transmitted by the
bite of insect vectors belonging to the genus
glossina (tsetse flies) and display a life cycle
strategy that is equally spread between human
and insect hosts (Brun, Blum, Chappuis, &
Burri, 2010).”
From: Advances in Pharmacology, 2014
(Bloodstream form,
phase-contrast picture. Black
bar indicates 10 µm.)
What is African trypanosomiasis?

Two types of African Trypanosomiasis

1. East African trypanosomiasis is caused by
the parasite Trypanosoma brucei
rhodesiense.
2. West African trypanosomiasis is caused
by the parasite Trypanosoma brucei
gambiense.
-Both types of African trypanosomiasis are
transmitted by the tsetse fly which is found
only in rural Africa.
Sleeping sickness is characterized by two stages of illness:

In the first stage, infected persons typically experience: fever,

headache, muscle and joint pain, and inflammation of the
lymph nodes.

The second stage, which develops within several weeks (T. brucei
rhodesiense) or within one to two years (T. brucei gambiense), is
marked by involvement of the brain and spinal cord, accompanied
by personality changes, sleep disturbances, and profound lethargy,
frequently ending in death when left untreated.
Life Cycle
Morphology
The parasite forms trypomastigotes in
vertebrate hosts and epimastigotes in
the insect vector. The trypomastigotes
(with posterior kinetoplast and long
undulating membrane) are pleomorphic
in size ranging from 16-42µm in length
by 1-3µm in width. They occur as
elongate slender dividing forms (with
long free flagellum) or stumpy non-
dividing infective (metacyclic) forms
(with no free flagellum). The
epimastigotes (with anterior kinetoplast
and short undulating membrane) are
also variable in size ranging from 10-
35µm in length by 1-3µm in width.
Pathology

Both forms of sleeping sickness are transmitted by the bite of

the tsetse fly (Glossina species).

-Tsetse flies inhabit rural areas, living in the woodlands and

thickets that dot the East African savannah.

-In central and West Africa, they live in the forests and
vegetation along streams. Tsetse flies bite during daylight
hours.

-Both male and female flies can transmit the infection, but
even in areas where the disease is endemic only a very small
percentage of flies are infected. Close up of a tsetse fly taking a blood
meal. Tsetse flies can transmit T.
-Occasionally, a pregnant woman can pass the infection to her brucei.
unborn baby (T. b. gambiense). In theory, the infection can
also be transmitted by blood transfusion, sexual contact,
organ transplantation and accidental laboratory exposure, but
such cases are rare and poorly documented.
Epidemiology & Risk Factors
T. b. rhodesiense (East African sleeping sickness)
-is found in focal areas of eastern and southeastern Africa.
Since 2015, less than 100 cases have been reported annually
to WHO.
-Domestic and wild animals are the main reservoir of
infection. Cattle have been implicated in the spread of the
disease to new areas and in local outbreaks.
-Infection of international travelers is rare, but it occasionally
occurs and most cases of sleeping sickness imported into the
U.S. have been in travelers who were on safari in East Africa.

T. b. gambiense (West African sleeping sickness)

-is found predominantly in central Africa and in limited areas
of West Africa and accounts for most sleeping sickness in
Africa.
-the disease is reasonably well-controlled at present, with less Distribution of human African
than 2000 cases reported in 2017–2018. trypanosomiasis. The black line
-humans are the most important reservoir of infection, divides the areas where
although the parasite can sometimes be found in domestic Trypanosoma brucei gambiense and
animals (e.g., pigs, dogs, goats). T. b. rhodesiense occur.
Treatment
Drugs used in the treatment of first stage:
 Pentamidine
 Suramin
Drugs used in the treatment of second stage:
 Melarsoprol
 Eflornithine 
 Nifurtimox 
Drugs used in the treatment of both
stages:
Fexinidazole 
Prevention & Control

•Wear long-sleeved shirts and pants of medium-weight material in

neutral colors that blend with the background environment. Tsetse flies
are attracted to bright or dark colors, and they can bite through
lightweight clothing.

•Inspect vehicles before entering. The flies are attracted to the motion
and dust from moving vehicles.

•Avoid bushes. The tsetse fly is less active during the hottest part of the
day but will bite if disturbed.

•Use insect repellent. Permethrin-impregnated clothing and insect

repellent have not been proved to be particularly effective against tsetse
flies, but they will prevent other insect bites that can cause illness.