Human African trypanosomiasis

• Published in: The Lancet (British edition) 2010-01, Vol.375 (9709), p.148-159
• Main Authors: Brun, Reto, Prof, Blum, Johannes, MD, Chappuis, Francois, MD, Burri, Christian, PhD
• Format: Article
• Language: English
• Subjects: Africa - epidemiology; Animals; Biological and medical sciences; Biomedical Research; Communicable Disease Control - methods; Drugs; Eflornithine - therapeutic use; Endemic Diseases - prevention & control; General aspects; Glossina; Health services; Human protozoal diseases; Humans; Incidence; Infectious diseases; Insect Bites and Stings - prevention & control; Insect Vectors; Insects; Internal Medicine; Medical diagnosis; Medical sciences; Melarsoprol - therapeutic use; Parasites; Parasitic diseases; Pentamidine - therapeutic use; Protozoal diseases; Rural areas; Suramin - therapeutic use; Tropical diseases; Trypanocidal Agents - therapeutic use; Trypanosoma brucei; Trypanosoma brucei gambiense; Trypanosoma brucei gambiense - immunology; Trypanosoma brucei gambiense - pathogenicity; Trypanosomiasis; Trypanosomiasis, African - diagnosis; Trypanosomiasis, African - epidemiology; Trypanosomiasis, African - therapy; Trypanosomiasis, African - transmission; Tsetse Flies - parasitology; Variant Surface Glycoproteins, Trypanosoma - immunology; Vector-borne diseases
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(09)60829-1

Summary Human African trypanosomiasis (sleeping sickness) occurs in sub-Saharan Africa. It is caused by the protozoan parasite Trypanosoma brucei , transmitted by tsetse flies. Almost all cases are due to Trypanosoma brucei gambiense , which is indigenous to west and central Africa. Prevalence is strongly dependent on control measures, which are often neglected during periods of political instability, thus leading to resurgence. With fewer than 12 000 cases of this disabling and fatal disease reported per year, trypanosomiasis belongs to the most neglected tropical diseases. The clinical presentation is complex, and diagnosis and treatment difficult. The available drugs are old, complicated to administer, and can cause severe adverse reactions. New diagnostic methods and safe and effective drugs are urgently needed. Vector control, to reduce the number of flies in existing foci, needs to be organised on a pan-African basis. WHO has stated that if national control programmes, international organisations, research institutes, and philanthropic partners engage in concerted action, elimination of this disease might even be possible.