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Trypanosomiasis
Causative agent: Trypanosoma
cruzi
Background information
Described
in 1909 by Carlos
Chagas
16- 18 million people estimated to be
infected
100 million people at risk of
becoming infected
Historical Background - 2
Carlos Chagas
Distribution of
Chagas,
Disease:Trypanosoma
cruzi
Geographical Distribution
Brazil,
Morphology 2 - Trypomastigote
Morphology 3- 2. Amastigotes
Amastigotes in tissue
Morphology 4- Amastigote
Epidemiology -I
Chagas disease is a typical ZOONOTIC
disease
Transmission occurs when metacyclic
trypomastigotes are rubbed into the
puncture wound made by the insect/or
abrasion of the skin
Congenital transmission
Blood transfusion (contaminated blood
products)
Organ transplant from an infected donor
Epidemiology II Transmission
Laboratory accident
Contaminative
Eating infected bug
Children between a few months and two
years affected
Triatoma prefer to bite at junction of mucus
and cutaneous surface (painless bite
KISSING Bug
Incidence in vectors 40 -50% but current
control initiatives have reduced incidence to
low level. Bugs live in walls of mud and
thatch
Epidemiology -III
Reduviid Bugs
Destructive effects of
Amastigotes in Cardiac muscle
Amastigotes
Amastigotes of T. Cruzi in
Tissue
Amastigotes
Diagnosis
Clinical Diagnosis
History of living in bug infested house
Presence of Chagoma, Romanas sign
Cardiac or Gastrointestinal symptoms
Laboratory Diagnosis
Early stages: Trypomastigotes in blood
film
Diagnosis - II
Methods:
Treatment
Symptom relief only
1. Nifurtimox- 5mg/kg/day in 4 divided
doses- increase by 2mg/kg/day every 2
weeks until a dosage of 15- 17 mg
/kg/day
2. Primaquine phosphate -26.3 mg ( 15mg
base/day) for 7 -10 days
3. Benzinidazole 5 -7 mg/kg/day (30 -120
days)
4. Allopurinol
Prevention
Vaccine with Trypanosoma rangeli
produced positive results in Animal models
DNA vaccine for immunotherapy of acute
and chronic Chagas disease is being
tested
0.5g/L of gentian violet kills T. cruzi
Antifungal agent amphotericin B has been
proposed as a second line treatment but
high cost and relatively high toxicity of the
drug have limited its use
Management of Clinical
Manifestations
Pacemakers
Trypanosoma cruzi
Control/Prevention
References