Clinical management of East African trypanosomiasis in South Africa: Lessons learned

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
John FreanLucille Blumberg

Abstract

East African trypanosomiasis is an uncommon, potentially lethal disease if not diagnosed and treated in a timely manner. South Africa, as a centre for emergency medical evacuations from much of sub-Saharan Africa, receives a high proportion of these patients, mostly tourists and expatriate residents. The cases of East African trypanosomiasis patients evacuated to South Africa, for whom diagnostic and clinical management advice was provided over the years 2004-2018, were reviewed, using the authors' own records and those of collaborating clinicians. Twenty-one cases were identified. These originated in Zambia, Malawi, Zimbabwe, Tanzania, and Uganda. Nineteen cases (90%) had stage 1 (haemolymphatic) disease; one of these patients had fatal myocarditis. Of the two patients with stage 2 (meningoencephalitic) disease, one died of melarsoprol encephalopathy. Common problems were delayed diagnosis, erroneous assessment of severity, and limited access to treatment. The key to early diagnosis is recognition of the triad of geographic exposure, tsetse fly bites, and trypanosomal chancre, plus good microscopy. Elements for successful management are rapid access to specific drug treatment, skilled intensive care, and good laboratory facili...Continue Reading

Citations

Oct 23, 2020·PLoS Neglected Tropical Diseases·Kyoko HayashidaJunya Yamagishi
Mar 13, 2021·Current Opinion in Neurology·Gagandeep SinghJosemir W Sander
Aug 5, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Vikas Suri, Ashish Bhalla

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