Smith D H, Bailey J W
Liverpool School of Tropical Medicine, U.K.
Ann Trop Med Parasitol. 1997 Oct;91(7):851-6. doi: 10.1080/00034989760617.
The spectrum of clinical manifestations of trypanosomiasis in south-eastern Uganda is extremely wide. Isoenzyme characterization of trypanosome strains isolated in this area during recent epidemics of sleeping sickness has shown that particular clinical features of the disease can be related to the zymodeme of the causative parasite. For example, B17, part of the 'busoga' group of isolates and a zymodeme identified from central areas of Busoga during outbreaks of sleeping sickness, is associated with severe early features and a high frequency of presentation with a chancre. Isolates belonging to the 'zambezi' group, most of which came from areas close to the lake shores or close to the River Nile, were more heterogenous and were associated with significantly different clinical features: a more chronic, prolonged illness; more frequent presentation with meningo-encephalitis, and less frequent chancres. The clinical spectrum of infection associated with the parasites currently in circulation indicates that the previous endemicity and the early epidemics could be explained on the basis of existing zymodemes.
乌干达东南部锥虫病的临床表现范围极为广泛。在近期昏睡病流行期间于该地区分离出的锥虫菌株的同工酶特征表明，该疾病的特定临床特征可能与致病寄生虫的酶型有关。例如，B17是“布索加”分离株组的一部分，是在布索加中部昏睡病暴发期间鉴定出的一种酶型，它与严重的早期症状以及出现溃疡的高频率相关。属于“赞比西河”组的分离株，其中大多数来自靠近湖岸或尼罗河的地区，更为多样化，且与明显不同的临床特征相关：病程更慢性、持续时间更长；脑膜脑炎的出现频率更高，溃疡的出现频率更低。与目前正在传播的寄生虫相关的感染临床谱表明，先前的地方病情况和早期疫情可以根据现有的酶型来解释。
