The Kinetoplastid Infections: Human African Trypanosomiasis (Sleeping
Sickness), Chagas Disease, and the Leishmaniases

doi:10.1128/9781555818753.ch7

Chapter 7 : The Kinetoplastid Infections: Human African Trypanosomiasis (Sleeping Sickness), Chagas Disease, and the Leishmaniases

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Affiliations: 1: National School of Tropical Medicine, Baylor College of Medicine Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine DevelopmentJames A. Baker III Institute, Rice University, Houston, Texas

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Abstract:

The kinetoplastid infections are transmitted by insect vectors, and the three major kinetoplastid infections of humans, human African trypanosomiasis (HAT), Chagas disease, and leishmaniasis, kill approximately 70,000 people annually, making them among the most lethal neglected tropical diseases (NTDs). HAT, also known as sleeping sickness, is caused by two different species of trypanosomes. Trypanosoma brucei gambiense is the cause in West Africa, while T. b. rhodesiense occurs in East Africa. It results from the bite of tsetses of the genus Glossina. Control of West African HAT relies largely on case detection and treatment as well as vector control, while fighting East African HAT relies on control in animal reservoirs and vector control. Chagas disease, also known as American trypanosomiasis, is caused by T. cruzi, which has the ability to invade host cells and replicate as amastigotes. The infection is transmitted by kissing bugs, primarily of the genus Triatoma. Control of Chagas disease in the Southern Cone has been highly effective through indoor spraying that targets the vector, T. infestans. Leishmaniasis is transmitted by the bite of a sandfly. Cutaneous leishmaniasis (CL) is a disfiguring, pizza-like lesion, which often self-heals but can leave a scar. The scar is often deeply stigmatizing for women in developing countries. Visceral leishmaniasis (VL), or kala-azar, produces a febrile wasting syndrome with signs and symptoms that resemble leukemia. Drugs containing antimony are still widely used for the treatment of CL and VL, but are toxic and difficult to administer.

Citation: Hotez P. 2013. The Kinetoplastid Infections: Human African Trypanosomiasis (Sleeping Sickness), Chagas Disease, and the Leishmaniases, p 115-148. In Forgotten People Forgotten Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555818753.ch7

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Infectious Diseases: 0.63813686
Infectious Pathogens: 0.6355944
Trypanosoma brucei gambiense: 0.51704544
Parasitic Diseases: 0.5139377

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Figures

The Kinetoplastid Infections: Human African Trypanosomiasis (Sleeping Sickness), Chagas Disease, and the Leishmaniases

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Figure 7.1

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Figure 7.1

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Figure 7.2

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Figure 7.2

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Figure 7.3

Photomicrograph of stained trypanosomes in the bloodstream. (Image from Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.3

Photomicrograph of stained trypanosomes in the bloodstream. (Image from Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.4

Life cycle of human trypanosomes and HAT. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.4

Life cycle of human trypanosomes and HAT. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.5

Reproduction of J. E. Dutton’s original watercolor drawing of T. b. gambiense from the blood of an infected patient. (Image from the archives of the University of Liverpool, courtesy of David H. Molyneux.)

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Figure 7.5

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Figure 7.6

Distribution of cases of T. cruzi infection, based on official estimates and status of vector transmission, worldwide, 2006–2009. (See http://gamapserver.who.int/mapLibrary/Files/Maps/Global_chagas_2009.png [© 2010 WHO].)

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Figure 7.6

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Figure 7.7

Triatomine bug, Rhodnius prolixus. (Courtesy of Erwin Huebner, University of Manitoba, Winnipeg, Canada.)

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Figure 7.7

Triatomine bug, Rhodnius prolixus. (Courtesy of Erwin Huebner, University of Manitoba, Winnipeg, Canada.)

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Figure 7.8

Life cycle of T. cruzi and Chagas disease. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.8

Life cycle of T. cruzi and Chagas disease. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.9

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Figure 7.9

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Figure 7.10

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Figure 7.10

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Figure 7.11

Life cycle of human leishmaniasis infection. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.11

Life cycle of human leishmaniasis infection. (From Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.12

The “pizza-like” lesion of CL. (Image from Public Health Image Library, CDC [http://phil.cdc.gov].)

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Figure 7.12

The “pizza-like” lesion of CL. (Image from Public Health Image Library, CDC [http://phil.cdc.gov].)

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Tables

The Kinetoplastid Infections: Human African Trypanosomiasis (Sleeping Sickness), Chagas Disease, and the Leishmaniases

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Table 7.1

The major species of HAT and animal trypanosomiasis

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Table 7.1

The major species of HAT and animal trypanosomiasis

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Table 7.2

Simplified summary of the human leishmaniases a

a Based on information from Alvar et al., 2006a .

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Table 7.2

Simplified summary of the human leishmaniases a

a Based on information from Alvar et al., 2006a .