Human African trypanosomiasis (sleeping sickness): a pediatric case report

Authors

DOI:

https://doi.org/10.56294/shp2025347

Keywords:

Human African trypanosomiasis, Trypanosoma brucei gambiense, sleeping sickness

Abstract

Human African trypanosomiasis is caused by protozoa of the genus Trypanosoma sp. and is primarily transmitted by the bite of the tsetse fly. This report presents a pediatric case diagnosed with human African trypanosomiasis in low-incidence areas of Central Africa, diagnosed by Cuban collaborators. Case presentation: A 12-year-old patient with a medical history had traveled to an area with active cases of trypanosomiasis within the last 2 years. The patient presented with recurrent fever, general weakness, and drowsiness. Rapid diagnostic tests were positive for salmonellosis and malaria. The patient was treated with antibiotics, with no clinical improvement. The diagnosis was positive for Trypanosoma sp. by thick blood smear and staining. Clinical improvement occurred after nifurtimox-eflornithine combination therapy according to the regional protocol for Trypanosoma brucei gambiense in the second phase of infection. Clinical improvement was seen at 48 hours. Conclusions: Human African trypanosomiasis is a common infection in regions where medical assistance is provided by Cuban medical personnel. The high endemism of other infections with similar symptoms and acquired immunity favors late identification without adequate knowledge and timely clinical-epidemiological analysis. A complementary definition and specific therapeutic measures ensure a good outcome and a better prognosis.

 

References

1. Roche J. Situación actual de la tripanosomiasis humana africana. Enf Emerg [Internet]. 2004 [citado 30 junio 2025];6(2):91-97. Disponible en: https://enfermedadesemergentes.com/articulos/a191/s-6-2-005.pdf

2. Bueno Marí R, Moreno Marí J, Oltra Moscardó MT, Jiménez Peydró R. Artrópodos con interés vectorial en la salud pública en España. Rev Españ Sal Púb [Internet]. 2009 [citado 30 junio 2025];83(2):201-214. Disponible en: https://dialnet.unirioja.es/descarga/articulo/2990626.pdf

3. Franco JR, Cecchi G, Paone M, Diarra A, Grout L, Kadima Ebeja A, et al. The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020. PLoS Negl Trop Dis [Internet]. 2022 [citado 30 junio 2025];16(1): e0010047. Disponible en: https://doi.org/10.1371/journal.pntd.0010047

4. World Health Organization. Neglected tropical diseases. WHO [Internet]. 2025 [citado 30 junio 2025]. Disponible en: https://www.who.int/news-room/questions-and-answers/item/neglected-tropical-diseases

5. World Health Organization. Tripanosomiasis africana humana (enfermedad del sueño). WHO [Internet]. 2023 [citado 30 junio 2025]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/trypanosomiasis-human-african-(sleeping-sickness)

6. Menendez Capote RL. Importancia de la tripanosomiasis africana para Cuba. Rev Cuba Med Tropical [Internet]. 2022 [citado 1 de julio de 2025];74(1):e714. Disponible en: https://revmedtropical.sld.cu/index.php/medtropical/article/view/714

7. Silva-Valido Jorge Alberto, Denis-de Armas Reinaldo, Franco-Bonal Arlene, Khanyile Victor, Mashiane Phuti. Experiencia de la Brigada Médica Cubana “Henry Reeve” en el enfrentamiento a la COVID-19 en Sudáfrica. Rev Inf Cient. [Internet]. 2021 [citado 30 junio 2025] ; 100( 6 ): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1028-99332021000600010&lng=es

8. Marimón Torres N, Martínez Cruz E. Experiencia cubana en Cooperación Sur-Sur. Rev Cub Sal Públ [Internet]. 2011 [citado 30 junio 2025];37(4): 380-393. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662011000400004&lng=es

9. World Health Organization. WHO interim guidelines for the treatment of gambiense human African trypanosomiasis. Geneva: World Health Organization [Internet]. 2019 [citado 30 junio 2025]. Disponible en: https://iris.who.int/bitstream/handle/10665/326178/9789241550567-eng.pdf

10. Menéndez-Capote RL, Bandera-Tirado JF. Tripanosomiasis africana humana. Rev Esp Casos Clin Med Intern [Internet]. 2022 [citado 1 julio 2025];7(3):9-12. Disponible en: https://www.reccmi.com/RECCMI/article/view/708

11. Reyes-Baque JM, Loor-Solórzano MA, Moreira-Loor CS. Malaria: respuesta inmune, sensibilidad y especificidad de las pruebas rápidas. MQRInvestigar [Internet]. 2024 [citado 1 julio 2025];8(1):2617-32. Disponible en: https://www.investigarmqr.org/ojs/index.php/mqr/article/view/1017

12. Kotepui KU, Masangkay FR, De Jesus Milanez G, Kotepui M. Prevalence and outcomes of malaria as co-infection among patients with human African trypanosomiasis: a systematic review and meta-analysis. Sci Rep [Internet]. 2021[citado 30 junio 2025] ;11(1):23777. Disponible en: https://doi.org/10.1038/s41598-021-03295-8

13. Blum J, Schmid C, Burri C. Clinical aspects of 2541 patients with second stage human African trypanosomiasis. Acta Trop. 2006;97(1), 55-64

14. Deeks ED. Fexinidazole: First Global Approval. Drugs. 2019; 79(2): 215-20.

15. Lindner AK, Lejon V, Chappuis F, Seixas J, Kazumba L, Barrett MP et al. New WHO guidelines for treatment of gambiense human African tripanosomiasis including fexinidazole: substantial changes for clinical practice. Lancet Infect Dis [Internet]. 2019 [citado 1 julio 2025]; pii:S1473-3099(19)30612-7

16. Olaf Valverde Mordt O, Tarral A, Strub-Wourgaft N. Development and Introduction of Fexinidazole into the Global Human African Trypanosomiasis Program. Am J Trop Med Hyg. 2022 [citado 1 julio 2025];106(Suppl 5) 61–66. Disponible en: https://doi.org/doi:10.4269/ajtmh.21-1176.

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Published

2025-08-06

How to Cite

1.
Páez Arguelles O, Carrera Gonzalez E, Mojena EP, Auza Santivañez JC, Berty Gutiérrez H, Quisbert Vasquez HT, et al. Human African trypanosomiasis (sleeping sickness): a pediatric case report. South Health and Policy [Internet]. 2025 Aug. 6 [cited 2025 Aug. 19];4:347. Available from: https://shp.ageditor.ar/index.php/shp/article/view/347