Prevalence and Types of Coinfections in Sleeping Sickness Patients in Kenya (2000/2009)

J M Kagira,S M Karori,J Njenga,N Maina,J M Ngotho,S M Karanja

doi:10.1155/2011/248914

Abstract

The occurrence of coinfections in human African trypanosomiasis (HAT) patients was investigated using a retrospective data of hospital records at the National Sleeping Sickness Referral Hospital in Alupe, Kenya. A total of 31 patients, 19 males and 12 females, were diagnosed with HAT between the years 2000 and 2009. The observed co-infections included malaria (100%), helminthosis (64.5%), typhoid (22.5%), urinary tract infections (16.1%), HIV (12.9%), and tuberculosis (3.2%). The species of helminthes observed included Ancylostoma duodenale (38.7%), Ascaris lumbricoides (45.7%), Strongyloides stercoralis (9.7%), and Taenia spp. (3.2%). The patients were also infected with Entamoeba spp. (32.3%) and Trichomonas hominis (22.6%) protozoan parasites. The main clinical signs observed at the point of admission included headache (74.2%), fever (48.4%), sleep disorders (45.2%), and general body pain (41.9%). The HAT patients were treated with suramin (early stage, 9/31) and melarsoprol (late stage, 22/31). In conclusion, the study has shown that HAT patients have multiple co-infections which may influence the disease pathogenesis and complicate management of HAT.

Highlights

Human African trypanosomiasis (HAT) is endemic in subSaharan Africa, and at least 60 million people are at risk [1]
Prior to 1990, most HAT cases originated from Lambwe Valley in Nyanza Province, whereas, from 1990 to 2009, the majority of cases came from new focus in Busia, Teso, and Bungoma districts in Western Province [2]
The investigators showed that malaria and human immunodeficiency virus (HIV) coinfections did not have any significant implication on the clinical presentation and treatment outcomes of T.b. rhodesiense infections

Summary

Introduction

Human African trypanosomiasis (HAT) is endemic in subSaharan Africa, and at least 60 million people are at risk [1]. In Kenya, the disease is caused by Trypanosoma brucei rhodesiense and occurs in the western part of the country. HAT occurs in areas which are endemic of other tropical diseases, the main one being malaria. This is because these diseases are vector transmitted, and the vectors (tsetse flies and mosquitoes) share the same habitat. In East Africa, T.b. rhodesiense is characterized by a wide spectrum of clinical signs [4]. For first-stage infections, the main clinical signs and symptoms are not specific and include fever, headache, body pains, loss of appetite, and enlarged lymph nodes. The investigators showed that malaria and HIV coinfections did not have any significant implication on the clinical presentation and treatment outcomes of T.b. rhodesiense infections.

Methods

Results

Conclusion