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Parasite Immunology Aug 2011
Topics: Animals; Genetic Variation; Humans; Livestock; Trypanocidal Agents; Trypanosoma; Trypanosomiasis, African; Virulence
PubMed: 21609334
DOI: 10.1111/j.1365-3024.2011.01302.x -
Infectious Disease Clinics of North... Mar 2019Control efforts have considerably reduced the prevalence of human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense in West/Central Africa and to... (Review)
Review
Control efforts have considerably reduced the prevalence of human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense in West/Central Africa and to Trypanosoma brucei rhodesiense in East Africa. Management of T brucei gambiense HAT has recently improved, with new antibody-based rapid diagnostic tests suited for mass screening and clinical care, and simpler treatments, including the nifurtimox-eflornithine combination therapy and the new oral drug fexinidazole to treat the second stage of the disease. In contrast, no major advance has been achieved for the treatment of T brucei rhodesiense HAT, a zoonosis that occasionally affects short-term travelers to endemic areas.
Topics: Africa; Animals; Antiprotozoal Agents; Cost of Illness; Drug Therapy, Combination; Humans; Prevalence; Travel; Trypanosomiasis, African
PubMed: 30712768
DOI: 10.1016/j.idc.2018.10.003 -
Handbook of Clinical Neurology 2013Human African trypanosomiasis or sleeping sickness is a neglected tropical disease that affects populations in sub-Saharan Africa. The disease is caused by infection... (Review)
Review
Human African trypanosomiasis or sleeping sickness is a neglected tropical disease that affects populations in sub-Saharan Africa. The disease is caused by infection with the gambiense and rhodesiense subspecies of the extracellular parasite Trypanosoma brucei, and is transmitted to humans by bites of infected tsetse flies. The disease evolves in two stages, the hemolymphatic and meningoencephalitic stages, the latter being defined by central nervous system infection after trypanosomal traversal of the blood-brain barrier. African trypanosomiasis, which leads to severe neuroinflammation, is fatal without treatment, but the available drugs are toxic and complicated to administer. The choice of medication is determined by the infecting parasite subspecies and disease stage. Clinical features include a constellation of nonspecific symptoms and signs with evolving neurological and psychiatric alterations and characteristic sleep-wake disturbances. Because of the clinical profile variability and insidiously progressive central nervous system involvement, disease staging is currently based on cerebrospinal fluid examination, which is usually performed after the finding of trypanosomes in blood or other body fluids. No vaccine being available, control of human African trypanosomiasis relies on diagnosis and treatment of infected patients, assisted by vector control. Better diagnostic tools and safer, easy to use drugs are needed to facilitate elimination of the disease.
Topics: Animals; Humans; Neglected Diseases; Trypanosoma; Trypanosomiasis, African
PubMed: 23829907
DOI: 10.1016/B978-0-444-53490-3.00011-X -
Current Opinion in Infectious Diseases Oct 2022Gambiense human African trypanosomiasis (gHAT), a disease that has killed hundreds of thousands as recently as the 1990s, could be on the verge of elimination or even... (Review)
Review
PURPOSE OF REVIEW
Gambiense human African trypanosomiasis (gHAT), a disease that has killed hundreds of thousands as recently as the 1990s, could be on the verge of elimination or even eradication. This review describes recent developments that give us reasons for optimism as well as some caveats.
RECENT FINDINGS
New developments in diagnostic and vector control tools, and especially in treatment, make it possible to strive for elimination of transmission of gHAT by 2030, perhaps even eradication.
SUMMARY
Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid diagnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
Topics: Animals; Humans; Trypanosomiasis, African; Tsetse Flies; Uganda
PubMed: 35942856
DOI: 10.1097/QCO.0000000000000860 -
BMJ (Clinical Research Ed.) Jul 2002
Review
Topics: Africa South of the Sahara; Communicable Diseases, Emerging; Humans; Public Health; Trypanocidal Agents; Trypanosomiasis, African
PubMed: 12142311
DOI: 10.1136/bmj.325.7357.203 -
Journal of Neurology Sep 2019Human African trypanosomiasis (HAT), also known as sleeping sickness, is one of the Africa's 'neglected diseases' and is caused by infection with protozoan parasites of... (Review)
Review
Human African trypanosomiasis (HAT), also known as sleeping sickness, is one of the Africa's 'neglected diseases' and is caused by infection with protozoan parasites of the Trypanosoma genus. Transmitted by the bite of the tsetse fly, it puts 70 million people at risk throughout sub-Saharan Africa and is usually fatal if untreated or inadequately treated. In this brief overview, some important recent developments in this disease are outlined. These cover various aspects including a reduction in disease incidence, newly recognised parasite reservoir sites in humans, disease outcome, novel diagnostic methods, new and improved treatment, and disease neuropathogenesis.
Topics: Animals; Benzamides; Boron Compounds; Humans; Neglected Diseases; Trypanosoma brucei gambiense; Trypanosoma brucei rhodesiense; Trypanosomiasis, African
PubMed: 31209574
DOI: 10.1007/s00415-019-09425-7 -
Journal of Vector Borne Diseases 2020Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and... (Review)
Review
Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints. Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
Topics: Animals; Disease Eradication; Global Health; Humans; Insect Control; Insect Vectors; Trypanosomiasis, African; Tsetse Flies; World Health Organization
PubMed: 34290154
DOI: 10.4103/0972-9062.310860 -
Journal of Medical Entomology Mar 2022Human African trypanosomiasis (HAT), despite considerable progress in the control, is still occurring in many countries in both west and central African regions. The HAT... (Review)
Review
Human African trypanosomiasis (HAT), despite considerable progress in the control, is still occurring in many countries in both west and central African regions. The HAT situation in the Republic of Congo has always been overshadowed by its neighbor the Democratic Republic of Congo where over 60% of all HAT cases occur. In the Republic of Congo, HAT cases have been significantly reduced to about 20 reported cases yearly and the disease is still prevalent in few foci across the country. Although continuous assessment of HAT situation in Congo is been led by the National Control Program for HAT, research on the vector, parasite, and vector control has received little attention. Because there have not been enough reviews summarizing key findings from studies conducted so far, there is still a poor understanding of the global situation of HAT in Congo. In order to achieve sustainable elimination of HAT in Congo a deep appraisal of HAT situation is required. The present study provides a review of studies conducted on HAT in the republic of Congo since the 1950s to date in order to identify gaps in knowledge and help consolidate the gains and progress towards the elimination of sleeping sickness.
Topics: Animals; Democratic Republic of the Congo; Humans; Trypanosomiasis, African
PubMed: 35137146
DOI: 10.1093/jme/tjab225 -
Journal of Neurology Apr 2006Human African Trypanosomiasis (HAT),which is also known as sleeping sickness, is a major cause of death and disability in 36 countries in sub-Saharan Africa. The disease... (Review)
Review
Human African Trypanosomiasis (HAT),which is also known as sleeping sickness, is a major cause of death and disability in 36 countries in sub-Saharan Africa. The disease is caused by the protozoan parasite of the Trypanosoma genus which is transmitted by the bite of the tsetse fly. The two types of HAT, the East African form due to Trypanosoma b.rhodesiensei (T. b.rhodesiensi) and the West African form due to T. b.gambiense, differ in their tempo of infection but in both cases the disease is always fatal if untreated. As well as multiple systemic features seen in the early (haemolymphatic) stage of disease, the late (encephalitic stage) stage, is associated with a wide range of neurological features including neuropsychiatric, motor and sensory abnormalities. Accurate staging of the disease is absolutely essential because of the potentially fatal complications of melarsoprol treatment of late-stage disease, the most important of which is a severe post-treatment reactive encephalopathy (PTRE) the pathogenesis of which is not fully understood. However, there is not a universal consensus as to how late-stage disease should be diagnosed using CSF criteria, and this has been very problematic in HAT. A more recent alternative drug for late stage gambiense disease is eflornithine (DFMO). There is a pressing need for a non-toxic oral drug for both early and late stage disease that would obviate many of the problems of staging, and various possible strategies to achieve this goal are currently underway. However, control of the disease will also require more effective measures of reducing man/fly contact and also the allocation of much greater financial and infrastructural resources than are currently available in Africa.
Topics: Central Nervous System; Humans; Trypanosomiasis, African
PubMed: 16541214
DOI: 10.1007/s00415-006-0093-3 -
Clinical Infectious Diseases : An... Jun 2000
Topics: Female; Humans; Hypoglycemia; Middle Aged; Trypanosomiasis, African
PubMed: 10880327
DOI: 10.1086/313833