scholarly journals Towards Point-of-Care Diagnostic and Staging Tools for Human African Trypanosomiaisis

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Enock Matovu ◽  
Anne Juliet Kazibwe ◽  
Claire Mack Mugasa ◽  
Joseph Mathu Ndungu ◽  
Zablon Kithingi Njiru
Keyword(s):  
Diagnostic Tests ◽  
Human African Trypanosomiasis ◽  
Point Of Care ◽  
Body Fluids ◽  
Accurate Diagnosis ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
Recent Advances ◽  
Sub Saharan ◽  
Unacceptable Toxicity

Human African trypanosomiasis is a debilitating disease prevalent in rural sub-Saharan Africa. Control of this disease almost exclusively relies on chemotherapy that should be driven by accurate diagnosis, given the unacceptable toxicity of the few available drugs. Unfortunately, the available diagnostics are characterised by low sensitivities due to the inherent low parasitaemia in natural infections. Demonstration of the trypanosomes in body fluids, which is a prerequisite before treatment, often follows complex algorithms. In this paper, we review the available diagnostics and explore recent advances towards development of novel point-of-care diagnostic tests.

scholarly journals Chemotherapy of Human African Trypanosomiasis

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Cyrus J. Bacchi
Keyword(s):  
Combination Chemotherapy ◽  
Human African Trypanosomiasis ◽  
Economic Loss ◽  
Chemotherapeutic Agents ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
Physical Suffering ◽  
Rural Clinics ◽  
Sub Saharan

Human Africa trypanosomiasis is a centuries-old disease which has disrupted sub-Saharan Africa in both physical suffering and economic loss. This article presents an update of classic chemotherapeutic agents, in use for >50 years and the recent development of promising non-toxic combination chemotherapy suitable for use in rural clinics.

scholarly journals Generation of neuroinflammation in human African trypanosomiasis

2019 ◽  
Vol 6 (6) ◽  
pp. e610 ◽  
Author(s):  
Jean Rodgers ◽  
Israel Steiner ◽  
Peter G. E Kennedy
Keyword(s):  
Human African Trypanosomiasis ◽  
Clinical Symptoms ◽  
Parasite Burden ◽  
Brain Inflammation ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
Peripheral Tissues ◽  
Neuroinflammatory Response ◽  
Proinflammatory Mediators ◽  
Sub Saharan

Human African trypanosomiasis (HAT) is caused by infection due to protozoan parasites of the Trypanosoma genus and is a major fatal disease throughout sub-Saharan Africa. After an early hemolymphatic stage in which the peripheral tissues are infected, the parasites enter the CNS causing a constellation of neurologic features. Although the CNS stage of HAT has been recognized for over a century, the mechanisms generating the neuroinflammatory response are complex and not well understood. Therefore a better understanding of the mechanisms utilized by the parasites to gain access to the CNS compartment is critical to explaining the generation of neuroinflammation. Contrast-enhanced MRI in a murine model of HAT has shown an early and progressive deterioration of blood-CNS barrier function after trypanosome infection that can be reversed following curative treatment. However, further studies are required to clarify the molecules involved in this process. Another important determinant of brain inflammation is the delicate balance of proinflammatory and counterinflammatory mediators. In mouse models of HAT, proinflammatory mediators such as tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and CXCL10 have been shown to be crucial to parasite CNS invasion while administration of interleukin (IL)-10, a counter inflammatory molecule, reduces the CNS parasite burden as well as the severity of the neuroinflammatory response and the clinical symptoms associated with the infection. This review focuses on information, gained from both infected human samples and animal models of HAT, with an emphasis on parasite CNS invasion and the development of neuroinflammation.

Malaria

2021 ◽  
pp. 227-248
Author(s):  
Frank Baiden ◽  
Keziah L. Malm ◽  
Fred Binka
Keyword(s):  
Plasmodium Falciparum ◽  
Pregnant Women ◽  
Neurological Deficit ◽  
Diagnostic Tests ◽  
Point Of Care ◽  
Rapid Diagnostic Tests ◽  
Sub Saharan Africa ◽  
Protozoan Infection ◽  
Life Threatening ◽  
Sub Saharan

Malaria is a subtropical and tropical protozoan infection that accounts for nearly half a million deaths each year. Most deaths occur in sub-Saharan Africa and are caused by Plasmodium falciparum. The least studied of the five Plasmodia species that cause malaria, P. knowlesi, along with P. vivax cause life-threatening disease, mostly in Southeast Asia. Children, pregnant women, and non-immune travellers to endemic countries are most vulnerable to severe malaria. Cerebral malaria and anaemia are complications that results in neurological deficit and death if treatment is delayed or inappropriately administered. Rapid diagnostic tests have emerged as accurate and reliable means to diagnosing malaria at point-of-care.

scholarly journals Human African Trypanosomiasis: Ethnomedical and Biomedical Relationships

2000 ◽  
Vol 14 (1) ◽  
Author(s):  
Justin Brown
Keyword(s):  
Human African Trypanosomiasis ◽  
Explanatory Models ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Trypanosomiasis ◽  
Sub Saharan ◽  
Biomedical Practitioners ◽  
Models Of Disease ◽  
Health Organization ◽  
The Relationship

Human African Trypanosomiasis (HAT) threatens more than 55 million people in sub-Saharan Africa. The focus of this paper is the relationship that exists between ethnomedical and biomedical practitioners regarding treatment of HAT. The relationship has been one of conflict. Biomedical practitioners have attempted to remove ethnomedicine from African society. This practice has been unsuccessful, especially in rural regions. Ethnomedical practitioners have adopted some aspects of biomedicine, but inadequate application and resources limit their efficacy. The biomedical community, including the World Health Organization, has not recognized the resource potential within ethnomedicine. An examination of the areas of conflict reveals differences in the explanatory models of disease causation and treatment methods. There has been some progress toward a cooperative model of healthcare, but most biomedical practitioners disregard ethnomedical techniques as primitive and ineffective. The conclusion of this paper presents a bleak future for the prevention and treatment of HAT in Africa. This future may be avoided with an increased level of cooperation and understanding between the two systems.

scholarly journals APOL1 renal risk variants have contrasting resistance and susceptibility associations with African trypanosomiasis

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Anneli Cooper ◽  
Hamidou Ilboudo ◽  
V Pius Alibu ◽  
Sophie Ravel ◽  
John Enyaru ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Human African Trypanosomiasis ◽  
Disease Risk ◽  
African Ancestry ◽  
Sub Saharan Africa ◽  
African Trypanosomiasis ◽  
African Trypanosomes ◽  
Risk Variants ◽  
Deleterious Alleles ◽  
Sub Saharan

Reduced susceptibility to infectious disease can increase the frequency of otherwise deleterious alleles. In populations of African ancestry, two apolipoprotein-L1 (APOL1) variants with a recessive kidney disease risk, named G1 and G2, occur at high frequency. APOL1 is a trypanolytic protein that confers innate resistance to most African trypanosomes, but not Trypanosoma brucei rhodesiense or T.b. gambiense, which cause human African trypanosomiasis. In this case-control study, we test the prevailing hypothesis that these APOL1 variants reduce trypanosomiasis susceptibility, resulting in their positive selection in sub-Saharan Africa. We demonstrate a five-fold dominant protective association for G2 against T.b. rhodesiense infection. Furthermore, we report unpredicted strong opposing associations with T.b. gambiense disease outcome. G2 associates with faster progression of T.b. gambiense trypanosomiasis, while G1 associates with asymptomatic carriage and undetectable parasitemia. These results implicate both forms of human African trypanosomiasis in the selection and persistence of otherwise detrimental APOL1 kidney disease variants.

scholarly journals Access to affordable medicines and diagnostic tests for asthma and COPD in sub Saharan Africa: the Ugandan perspective

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Davis Kibirige ◽  
Leaticia Kampiire ◽  
David Atuhe ◽  
Raymond Mwebaze ◽  
Winceslaus Katagira ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Parkinson’s disease – a review of pathogenesis, recent advances in management, and challenges of care in sub-Saharan Africa

2021 ◽  
pp. e35
Author(s):  
Akintomiwa I. Makanjuola ◽  
Funmilola T. Taiwo ◽  
Joseph O. Yaria ◽  
Rufus O. Akinyemi ◽  
Adesola Ogunniyi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Options ◽  
Sub Saharan Africa ◽  
Treatment Modalities ◽  
Unequal Distribution ◽  
Low Resource Settings ◽  
Low Resource ◽  
Recent Advances ◽  
Sub Saharan

Parkinson’s disease (PD) remains a common neurodegenerative movement disorder with significant morbidity, which is expected to increase worldwide in the coming decades. Since its initial description, much has been elucidated about its etiology, pathogenesis, and the role of genetic and environmental risk factors. Effective treatments, including surgical therapies, have been discovered. Despite these strides, many questions remain unanswered; PD remains an active research area with ongoing efforts to discover newer treatment modalities and identify neuroprotective strategies. As with many neurological conditions, there is an unequal distribution of health resources, resulting in some management challenges in low resource settings, especially sub-Saharan Africa (SSA). In this communication, we provide an overview of PD etiopathogenesis, including genetics and management strategies, including some recent advances with respect to treatment options and disease modification approaches. Finally, we discuss some challenges of PD management in low-resource settings and highlight efforts to turn the tide.

scholarly journals Strengthening district healthcare in rural Africa: a cross-sectional survey assessing difficulties in pulse oximetry use and handoff practices

2018 ◽  
Vol 6 (1) ◽  
pp. 57
Author(s):  
Herbert G. Masigati ◽  
Grant W. Potter ◽  
Masahiro J. Morikawa ◽  
Rashid S. Mfaume
Keyword(s):  
Pulse Oximetry ◽  
Patient Care ◽  
Point Of Care ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Information Reporting ◽  
Rural Africa ◽  
Sub Saharan ◽  
Developing Settings

Background: Rural hospitals in sub-Saharan Africa suffer from numerous disparities in resources and practices, and subsequently patient care is affected.Methods: In order to assess current practices and opportunities for improvement in pulse oximetry use and patient-care handoffs, a cross-sectional survey was administered to clinicians at a referral level hospital serving a large rural area in Shinyanga, Tanzania.Results: Respondents (n=46) included nurses (50%), medical doctors (48%), and clinical officers (2%). A response rate of 92% was achieved, and 81% of clinicians acknowledged routine difficulties in the use of current devices when obtaining pulse oximetry. Although 83% of respondents reported using a written handoff at shift change, information reporting was inconsistent and rarely included specific management guidance.Conclusions: Further research is needed to elucidate handoff practices in developing settings, but there is a large opportunity for novel point-of-care devices and tools to improve both pulse oximetry use and patient care handoffs in rural Africa.

scholarly journals Improving Accuracy of Malaria Diagnosis in Underserved Rural and Remote Endemic Areas of Sub-Saharan Africa: A Call to Develop Multiplexing Rapid Diagnostic Tests

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Rasheed O. Makanjuola ◽  
Andrew W. Taylor-Robinson
Keyword(s):  
Low Income ◽  
Diagnostic Tests ◽  
Medical Condition ◽  
Hot Spot ◽  
Rapid Diagnostic Tests ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Patient Treatment ◽  
Sub Saharan ◽  
Effective Diagnosis

Clinical infection with malaria, caused by parasites of the genus Plasmodium, is considered a serious medical condition with the potential to become a life-threatening emergency. This is especially relevant to low-income countries in tropical and subtropical regions of the world where high rates of malaria-related morbidity and mortality are recorded. As a means to combat this major global public health threat, rapid and effective diagnosis remains the frontline action to initiate a timely and appropriate medical intervention. From all the approaches to parasite detection, rapid diagnostic tests, so-called RDTs, are the easiest to use and most cost-effective. However, some of the limitations inherent in this methodology could hinder effective patient treatment. A primary drawback is that the vast majority of commercially available RDTs detect only one of the five species of human malaria, P. falciparum. While this is the main cause of infection in many areas, it excludes the possibility of infection with another parasite (P. vivax, P. ovale, P. malariae, and P. knowlesi) or of mixed infections containing different species. Hence, a diagnosis of non-P. falciparum malaria is missed. In turn, in resource-constrained settings where optimal microscopy is not available, a misdiagnosis of bacterial infection based on signs and symptoms alone often results in an inappropriate prescription of antibiotics. Here, we discuss how effective diagnosis of malaria and indiscriminate use of antibiotics in sub-Saharan Africa, a hot spot for P. falciparum transmission, may both be addressed by the development of innovative multiplexing RDTs that detect two or more species of Plasmodium.

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