Trypanosomiasis — Uganda (General Adult population)
T. Rhodesiense — Clinical Features
Incubation is 2-3 weeks. Early stage (haemolymphatic stage): headache not responding to common analgesics, fever, generalised lymphadenopathy, joint pains. Late stage (meningoencephalitis stage): after some weeks, neurological and psychiatric symptoms like apathy, day sleepiness, paralysis, seizures. If not treated: cachexia, lethargy, coma and death within 3-6 months.
T. gambiense — Clinical Features
Similar to the rhodesiense but less acute and with slower progression. Incubation can last several years.
Differential diagnosis
Malaria, meningitis, TB, HIV/AIDS.
Investigations
Blood: Slides for trypanosomes. CSF: For trypanosomes, lymphocyte count. Aspirate from chancre/lymph node: for trypanosomes.
Disease Staging (CSF Findings) — Early (first) stage
CSF is normal. Lymphocytes <5 cells/mm3. Total protein <37 mg/dl (by dye-binding protein assay) or < 25 mg/dl (by Double Standard & Centrifuge Metod). Absence of trypanosomes (by Double Standard and Centrifuge Method).
Disease Staging (CSF Findings) — Late (second) stage
Lymphocytes > 5 cell/ mm3 And/or Presence of trypanosomes.
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