The Flipside of Eradicating a Disease; Human African Trypanosomiasis in a Woman in Rural Democratic Republic of Congo: A Case Report

Abstract

Human African Trypanosomiasis (HAT) is a neglected disease caused by the protozoan parasites Trypanosoma brucei and transmitted by tsetse flies that progresses in two phases. Symptoms in the first phase include fever, headaches, pruritus, lymphadenopathy, and in certain cases, hepatoand splenomegaly. Neurological disorders such as sleep disorder, aggressive behavior, logorrhea, psychotic reactions, and mood changes are signs of the second stage of the disease. Diagnosis follows complex algorithms, including serological testing and microscopy. Our case report illustrates the course of events of a 41-year old woman with sleep disorder, among other neurological symptoms, whose diagnosis was made seven months after the onset of symptoms. The patient had consulted two different hospitals in Kinshasa and was on the verge of being discharged from a third due to negative laboratory test results. This case report highlights the challenges that may arise when a disease is on the verge of eradication.

Gambiense Human African Trypanosomiasis Sequelae after Treatment: A Follow-Up Study 12 Years after Treatment

“…Secondly, after an initial cure, some patients could have had a relapse or a reinfection with HAT with an oligosymptomatic presentation and trypanosomes below the detection level in the blood. Even if HAT infections are rare events, mainly in the last decade [25], the study design does not allow the exclusion of such reinfection or relapse.…”

The complex health seeking pathway of a human African trypanosomiasis patient in Côte d’Ivoire underlines the need of setting up passive surveillance systems

“…Equally important, public awareness on HAT should be raised, at the local level in the areas at risk but also at national level, including information on the possibility to be screened in primary health centres. Difficulties in passive case detection of HAT in the context of a significant drop in prevalence have also been observed in DR Congo [ 53 ]. In this country, the most affected by HAT [ 2 ], a national HAT commemoration day has been created [ 54 ], a sensitization initiative that could be extended to all endemic countries.…”

Sleeping Sickness at the Crossroads

“…The efforts to maximise output and optimize innovation by the WHO has intensified since, and several stakeholders and expert groups have been created and convened [46]. Since 2012, the spectacular decrease of the case number has continued: some 2,164 cases were reported in 2016, far fewer than the targeted 2016 milestone of 4000 cases, and 660 in 2018 [47,48].…”