Establishment of a partly DFMO-sensitive primate model of Trypanosoma rhodesiense sleeping sickness

Abstract

Human African Trypanosomiasis (HAT) caused by Tb. rhodesiense occurs mainly in Eastern and Central Africa (Manson-Bahr and Bell, 1989). Unlike the West African form caused by Tb. gambiense that manifests as a chronic disease, the East African type is an acute complex of syndromes lasting less than a year. It has a three-phase course; first as the haemo-stage when parasites are in blood circulation with no central nervous system (CNS) invasion, then the second phase which is a transitional one when the parasites are present in the cerebrospinal fluid (CSF) with no CNS parenchymal infection and, thirdly the late stage, also called the meningoencephalitic phase, when the CNS parenchyma is invaded by parasites. For the management of the haemo-phase of the disease, suramin is the drug of choice for Tb. rhodesiense and Tb. gambiense infections whereas pentamidine may also be used in early Tb. gambiense infections. The late stage form is dependent on melarsoprol (Gutteridge, 1985). Treatment with melarsoprol is often associated with a potentially fatal and unpredictable encephalopathy in 5-10% of patients.