Abstract

Introduction: Trypanosoma brucei rhodesiense has been known to be responsible for transmission of Human African Trypanosomiasis (HAT) in Zambia for decades, affecting predominantly rural districts and communities. Despite a decline in cases of T.b. rhodesiense HAT in the country over the years, sporadic cases are still being reported in some rural areas. Despite years of dealing with the disease challenges are still being experienced on diagnosis. This article on a HAT case highlights challenges in the diagnosis of T.b. rhodesiense. Case history: A 27 year old black African male developed malaria-like symptoms and signs, followed by palpable swellings in the neck and skin rash. The patient was initially diagnosed of malaria and treated with artemether lumefantrine, according to national guidelines. The patient later developed central nervous system (CNS) manifestations and was diagnosed as bacterial meningo-enchephalitis and put on several antibiotics. Thirty five days (35) after admission Trypanosoma brucei rhodesiense parasites were confirmed in the spinal fluid with fatal outcome despite commencing the patient with definitive treatment. Conclusions: The diagnosis of Trypanosoma brucei rhodesiense continues to experience challenges resulting into delayed treatment. Improved capacities to diagnose treat, and map the disease are vital elements to effective control in endemic areas.

Keywords: Trypanosoma brucei rhodesiense; Human african trypanosomiasis (HAT); Diagnosis; Central nervous system; Zambia