Parkinson-like movements might arise due to non-specific movement disorders and speech disorders.Psychiatric/behavioural symptoms
Individuals may exhibit psychiatric symptoms which may sometimes dominate the clinical diagnosis and may include aggressiveness, apathy, irritability, psychotic reactions and hallucinations, anxiety, emotional lability, confusion, mania, attention deficit, and delirium. Advanced/late disease and outcomes
Without treatment, the disease is invariably fatal, with progressive mental deterioration leading to coma, systemic organ failure, and death. An untreated infection with T. b. rhodesiense will cause death within months whereas an untreated infection with T. b. gambiense will cause death after several years. Damage caused in the neurological phase is irreversible. Cause
Trypanosoma brucei gambiense accounts for the majority of African trypanosomiasis cases, with humans as the main reservoir needed for the transmission, while Trypanosoma brucei rhodesiense is mainly zoonotic, with the occasional human infection. African trypanosomiasis is dependent on the interaction of the parasite (trypanosome) with the tsetse flies (vector), as well as the host (human for Trypanosoma brucei gambiense, and animals for Trypanosoma brucei rhodesiense). The risk of contracting African trypanosomiasis is dependent on coming in contact with an infected tsetse fly. Trypanosoma brucei
There are two subspecies of the parasite that are responsible for starting the disease in humans. Trypanosoma brucei gambiense causes the diseases in west and central Africa, whereas Trypanosoma brucei rhodesiense has a limited geographical range and is responsible for causing the disease in east and southern Africa.
diarrhoea and jaundice) with lymphadenopathy developing only rarely.Trypanosomal chancre
Systemic disease is sometimes presaged by a trypanosomal chancre developing at the site of the infectious fly bite within 2 days of infection. The chancre is most commonly observed in T. b. rhodesiense infection, and only rarely in T. b. gambiense (however, in T. b. gambiense infection, chancres are more common in persons from non-endemic areas). Hemolymphatic phase
Incubation period is 1–3 weeks for T. b. rhodesiense, and longer (but less precisely characterised) in T. b. gambiense infection. The first/initial stage, known as the hemolymphatic phase, is characterized by non-specific, generalised symptoms like: fever (intermittent), headaches (severe), joint pains, itching, weakness, malaise, fatigue, weight loss, lymphadenopathy, and hepatosplenomegaly.Diagnosis may be delayed due to the vagueness of initial symptoms. The disease may also be mistaken for malaria (which may in fact occur as a co-infection).Intermittent fever
Fever is intermittent, with attacks lasting from a day to a week, separated by intervals of a few days to a month or longer. Episodes of fever become less frequent over the course of the disease.Lymphadenopathy
Invasion of the circulatory and lymphatic systems by the parasite is associated with severe swelling of lymph nodes, often to tremendous sizes. Posterior cervical lymph nodes are most commonly affected, however, axillary, inguinal, and epitrochlear lymph node involvement may also occur. Winterbottoms sign, the tell-tale swollen lymph nodes along the back of the neck, may appear.