1. Trypanosomiasis Trypanosoma brucei (African trypanosomes)
sleeping sickness
Trypanosoma cruzi (American trypanosomes)
Chagas’ disease
S. and Central America

2. transmission
A bite from an infected tsetse fly causes African trypanosomiasis .
Blood transfusions are a rare cause of parasitic transmission.
In rare cases, accidental transmission in the laboratory has been implicated.

3. Morphology
1- trypanosmes is an elongated , spindle-shape cell with a single nucleus near the middle of parasite.
2- it has kinetoplast.
3- it has undulating membrane.
4- possess a slender-single flagella at the anterior end.
5- flagellum serve as organ of attachment and locomotion.
6- there are four stages in life cycle :-

4. A –trypomastigote:- postnuclear kinetoplast , flagellum start from anterior end with undulating
membrane , found in vertebrate and insects .
B –epimastigote:- kinetoplast anterior to nucleus flagellum emerging from the body and continuing
to the anterior end with short undulating membrane.
C –promastigote:- kinetoplast at the anterior end. Flagellum emerging from anterior end of the body . there is no undulating membrane.
D–amastigote:- spherical or oval in shape without undulating membrane . flagellum not extend from outside the membrane , start from the kinetoplast .

5. Trypomastigote
Epimastigote
Promastigote
Amastigote
FORM

6. Kinetoplast
Nucleus

7. A trypomastigote of Trypanosoma brucei sp

8. There are two Types of HAT
Trypanosoma brucei rhodesiense 
Acute -- can cause death in weeks or months
Trypanosomoa brucei gambiense
Chronic --lasts years

9. Disease Course and Symptoms
invasion of blood characterized by irregular fever and headache (acute stage)
T. gambiense can be self-limiting or progressing to a more serious disease (chronic)
includes invasion of lymphatics and CNS

10. parasites crossing blood-brain barrier(BBB) result in CNS involvement and nervous impairment
described as meningoencephalitis
increased apathy and fatigue
confusion and somnolence
motor changes including tics, slurred speech, incoordination
convulsions, coma, death

11. 100% Fatal if left untreated
cardiac failure or from the infection itself

12. Life cycle
Trypanosomes are parasites with a 2-host life cycle: mammalian and arthropod.
The life cycle starts when the trypanosomes are ingested during a blood meal by the tsetse fly .
The trypanosomes multiply over a period of 2-3 weeks in the fly midgut; then, the trypanosomes migrate to the salivary gland, where they develop into epimastigotes.
The metacyclic trypomastigotes infect humans.

14. Trypanosoma cruzi and Chagas Disease
Transmitted by triatomine bugs
Inefficient transmission (parasite in feces of bug)
Associated with infestation of houses with triatomines (rural poverty)
Urban transmission associated with blood transfusions
Leading cause of cardiac disease in South and central America

15. Clinical Course of Chagas
Acute Phase
active infection (1-4 months)
most are asymptomatic (children most likely to be symptomatic)
Indeterminate Phase
10-30 years of latency
seropositive with no detectable parasitemia
Chronic Phase
10-30% of infected exhibit cardiomyopathy
conductions defects
congestive heart failure

16. Diagnosis Direct microscopy Blood smear Lymph node aspirate
Clinical Features
travel or residence in endemic area
irregular fever and enlarged lymph nodes
behavioral changes/mental symptoms
Laboratory Diagnosis
Direct microscopy
Blood smear
Lymph node aspirate
demonstration of trypanosomes in blood, lymph node aspirates, cerebral spinal fluid

18. Animal inoculation Serology Culture
Antigen detection tests based on enzyme-linked immunosorbent assay (ELISA) technology have been developed.
Culture
of CSF, blood, bone marrow aspirate, or tissue specimens can be performed in liquid media.
Other tests developed like polymerase chain reaction (PCR)
Animal inoculation

19. Treatment Early stage - most recover Late stage - upto 5% relapse
Suramin
Melasporol
Pentamidine
Late stage - upto 5% relapse
Only Melasporol

20. Destruction of animal reservoir
Control
Destruction of animal reservoir
Vector Control
Diagnosis & treatment