The authors declare that they have no competing interests.
All the authors participated in the discussion of the two cases and contributed to the drafting of the manuscript. All authors read and approved the final manuscript.
Trypanosoma brucei rhodesiense typically causes acute and severe human African trypanosomiasis in Zambia and other countries in Eastern and Southern Africa. Although a few atypical cases of chronic and mild forms of this disease were reported in Zambia more than 40 years ago, no such cases have been diagnosed over the last four decades.
For the first case, a 19-year-old Black African woman from the Eastern Province of Zambia presented with symptoms and signs of an atypical chronic and mild form of the disease for a period of 2 years. For the second case, a 16-year-old Black African boy from the Northern Province presented with symptoms and signs of a typical acute and severe form of the disease for 3 weeks.
Two strains of T. b. rhodesiense with varying degrees of virulence still do exist in Zambia. This has implications for control strategies at the national level.
van den Bossche P: The control of Glossina morsitans morsitans (Diptera: Glossinidae) in a settled area in Petauke District (Eastern Province, Zambia) using odour-baited targets. Onderstepoort J Vet Res. 1997, 64: 251-257. PubMed
Buyst H: The epidemiology, clinical features, and treatment, and history of sleeping sickness in the Northern edge of Luangwa fly belt. Med J Zambia. 1974, 8: 2-12.
MacLean L, Chisi JE, Odiit M, Wendy C, Gibson WC, Ferris V, Picozzi K, Sternberg JM: Severity of human African trypanosomiasis in East Africa is associated with geographic location, parasite genotype, and host inflammatory cytokine response profile. Infect Immun. 2004, 72: 7040-7044. 10.1128/IAI.72.12.7040-7044.2004. CrossRefPubMedPubMedCentral
- Clinical presentation of human African trypanosomiasis in Zambia is linked to the existence of strains of Trypanosoma brucei rhodesiense with varied virulence: two case reports
- BioMed Central