Skip to main content

Advertisement

SpringerLink
Log in

African trypanosomiasis: Changing epidemiology and consequences

  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Human African trypanosomiasis has re-emerged as a serious public health threat after near-elimination because of diminished investment in previously successful control programs. The continued, occasional importation of African trypanosomiasis to the United States can be expected as tourists and immigrants travel from high-risk areas. No vaccine or chemoprophylaxis is available for this disease, and travelers to affected areas should be counseled on tsetse fly avoidance. New diagnostic and staging tests are promising but have not replaced the classical method of examining body fluids for trypanosomes. Prompt diagnosis and staging is essential because if untreated, East African and West African sleeping sickness are fatal. Drug regimens are toxic and cumbersome, and short-term prospects for therapeutic advances are limited.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. World Health Organization: African Trypanosomiasis. In WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases. Geneva, Switzerland: World Health Organization; 2000. http://www.who.int/emc-documents/surveillance/docs/ whocdscsrisr2001.html/African_Trypanosomiasis/ A_Trypanosomiasis.htm. This report contains the national-level African trypanosomiasis reporting data from 1902 to 1998 and discussion of data quality issues, which demonstrates the challenges in defining the extent of the disease across Africa.

    Google Scholar 

  2. Moore A: Human African trypanosomiasis: a reemerging public health threat. In Emerging Infections, edn 6. Edited by Scheld WM, Murray BE, Hughes JM. Washington, DC: ASM Press; 2004:143–157. This is a comprehensive clinical and epidemiologic review of African trypanosomiasis.

    Google Scholar 

  3. Magnus E, Vervoort T, Van Meirvenne N: A card-agglutination test with stained trypanosomes (C.A.T.T.) for the serological diagnosis of T. B. gambiense trypanosomiasis. Ann Soc Belg Med Trop 1978, 58:169–176.

    PubMed  CAS  Google Scholar 

  4. Abel PM, Kiala G, Loa V, et al.: Retaking sleeping sickness control in Angola. Trop Med Int Health 2004, 9:141–148.

    Article  PubMed  Google Scholar 

  5. Stanghellini A, Josenando T: The situation of sleeping sickness in Angola: a calamity. Trop Med Int Health 2001, 6:330–334.

    Article  PubMed  CAS  Google Scholar 

  6. Moore A, Richer M: Re-emergence of epidemic sleeping sickness in southern Sudan. Trop Med Int Health 2001, 6:342–347.

    Article  PubMed  CAS  Google Scholar 

  7. Van Nieuwenhove S, Betu-Ku-Mesu VK, Diabakana PM, et al.: Sleeping sickness resurgence in the DRC: the past decade. Trop Med Int Health 2001, 6:335–341.

    Article  PubMed  Google Scholar 

  8. Robays J, Ebeja Kadima A, Lutumba P, et al.: Human African trypanosomiasis amongst urban residents in Kinshasa: a case-control study. Trop Med Int Health 2004, 9:869–875.

    Article  PubMed  CAS  Google Scholar 

  9. Hutchinson OC, Fevre EM, Carrington M, Welburn SC: Lessons learned from the emergence of a new Trypanosoma brucei rhodesiense sleeping sickness focus in Uganda. Lancet Infect Dis 2003, 3:42–45.

    Article  PubMed  CAS  Google Scholar 

  10. Waiswa C, Olaho-Mukani W, Katunguka-Rwakishaya E: Domestic animals as reservoirs for sleeping sickness in three endemic foci in south-eastern Uganda. Ann Trop Med Parasitol 2003, 97:149–155.

    Article  PubMed  CAS  Google Scholar 

  11. Lejon V, Boelaert M, Jannin J, et al.: The challenge of Trypanosoma brucei gambiense sleeping sickness diagnosis outside Africa. Lancet Infect Dis 2003, 3:804–808.

    Article  PubMed  CAS  Google Scholar 

  12. Jelinek T, Bisoffi Z, Bonazzi L, et al.: Cluster of African trypanosomiasis in travelers to Tanzanian national parks. Emerg Infect Dis 2002, 8:634–635.

    PubMed  Google Scholar 

  13. Lejon V, Sindic CJ, Van Antwerpen MP, et al.: Human African trypanosomiasis: quantitative and qualitative assessment of intrathecal immune response. Eur J Neurol 2003, 10:711–719.

    Article  PubMed  CAS  Google Scholar 

  14. Burri C, Brun R: Human African trypanosomiasis. In Manson’s Tropical Diseases, edn 21. Edited by Cook GC, Zumla A. London: WB Saunders Company; 2003:1303–1323.

    Google Scholar 

  15. Stich A, Abel PM, Krishna S: Human African trypanosomiasis. BMJ 2002, 325:203–206.

    Article  PubMed  Google Scholar 

  16. Kennedy PG: Human African trypanosomiasis of the CNS: current issues and challenges. J Clin Invest 2004, 113:496–504. This is an excellent discussion of the clinical manifestations and pathogenesis of CNS disease in African trypanosomiasis.

    Article  PubMed  CAS  Google Scholar 

  17. Buguet A, Bourdon L, Bouteille B, et al.: The duality of sleeping sickness: focusing on sleep. Sleep Med Rev 2001, 5:139–153.

    Article  PubMed  Google Scholar 

  18. Lumsden WH, Kimber CD, Dukes P, et al.: Field diagnosis of sleeping sickness in the Ivory Coast. I. Comparison of the miniature anion-exchange/centrifugation technique with other protozoological methods. Trans R Soc Trop Med Hyg 1981, 75:242–250.

    Article  PubMed  CAS  Google Scholar 

  19. Bailey JW, Smith DH: The use of the acridine orange QBC technique in the diagnosis of African trypanosomiasis. Trans R Soc Trop Med Hyg 1992, 86:630.

    Article  PubMed  CAS  Google Scholar 

  20. World Health Organization: Control and surveillance of African trypanosomiasis. World Health Organ Tech Rep Ser 1998, 881:1–114.

    Google Scholar 

  21. Truc P, Aerts D, McNamara JJ, et al.: Direct isolation in vitro of Trypanosoma brucei from man and other animals, and its potential value for the diagnosis of gambian trypanosomiasis. Trans R Soc Trop Med Hyg 1992, 86:627–629.

    Article  PubMed  CAS  Google Scholar 

  22. Magnus E, Lejon V, Bayon D, et al.: Evaluation of an EDTA version of CATT/Trypanosoma brucei gambiense for serological screening of human blood samples. Acta Trop 2002, 81:7–12.

    Article  PubMed  CAS  Google Scholar 

  23. Penchenier L, Simo G, Grebaut P, et al.: Diagnosis of human trypanosomiasis, due to Trypanosoma brucei gambiense in central Africa, by the polymerase chain reaction. Trans R Soc Trop Med Hyg 2000, 94:392–394.

    Article  PubMed  CAS  Google Scholar 

  24. Jamonneau V, Solano P, Garcia A, et al.: Stage determination and therapeutic decision in human African trypanosomiasis: value of polymerase chain reaction and immunoglobulin M quantification on the cerebrospinal fluid of sleeping sickness patients in Cote d’Ivoire. Trop Med Int Health 2003, 8:589–594.

    Article  PubMed  CAS  Google Scholar 

  25. Lejon V, Legros D, Richer M, et al.: IgM quantification in the cerebrospinal fluid of sleeping sickness patients by a latex card agglutination test. Trop Med Int Health 2002, 7:685–692.

    Article  PubMed  CAS  Google Scholar 

  26. Pepin J, Milord F: The treatment of human African trypanosomiasis. Adv Parasitol 1994, 33:1–47.

    Article  PubMed  CAS  Google Scholar 

  27. Pepin J, Milord F, Khonde AN, et al.: Risk factors for encephalopathy and mortality during melarsoprol treatment of Trypanosoma brucei gambiense sleeping sickness. Trans R Soc Trop Med Hyg 1995, 89:92–97.

    Article  PubMed  CAS  Google Scholar 

  28. Pepin J, Milord F, Khonde A, et al.: Gambiense trypanosomiasis: frequency of, and risk factors for, failure of melarsoprol therapy. Trans R Soc Trop Med Hyg 1994, 88:447–452.

    Article  PubMed  CAS  Google Scholar 

  29. Schmid C, Nkunku S, Merolle A, et al.: Efficacy of 10-day melarsoprol schedule 2 years after treatment for late-stage gambiense sleeping sickness. Lancet 2004, 364:789–790.

    Article  PubMed  CAS  Google Scholar 

  30. Legros D, Evans S, Maiso F, et al.: Risk factors for treatment failure after melarsoprol for Trypanosoma brucei gambiense trypanosomiasis in Uganda. Trans R Soc Trop Med Hyg 1999, 93:439–442.

    Article  PubMed  CAS  Google Scholar 

  31. Burri C, Keiser J: Pharmacokinetic investigations in patients from northern Angola refractory to melarsoprol treatment. Trop Med Int Health 2001, 6:412–420.

    Article  PubMed  CAS  Google Scholar 

  32. Iten M, Matovu E, Brun R, Kaminsky R: Innate lack of susceptibility of Ugandan Trypanosoma brucei rhodesiense to DLalpha-difluoromethylornithine (DFMO). Trop Med Parasitol 1995, 46:190–194.

    PubMed  CAS  Google Scholar 

  33. Bouteille B, Oukem O, Bisser S, Dumas M: Treatment perspectives for human African trypanosomiasis. Fundam Clin Pharmacol 2003, 17:171–181. This report provides detailed coverage of current treatment and a discussion of drugs in development.

    Article  PubMed  CAS  Google Scholar 

  34. Centers for Disease Control and Prevention: African trypanosomiasis (African sleeping sickness). In The Yellow Book. Health Information for International Travel, 2003–2004. Atlanta, GA: US Department of Health and Human Services, Public Health Service; 2004:45–46. http://www.cdc.gov/travel/ diseases/afrtrypano.htm.

    Google Scholar 

  35. Pepin J: African trypanosomiasis. In Hunter’s Tropical Medicine and Emerging Infectious Diseases, edn 8. Edited by Strickland GT. Philadelphia: WB Saunders Company; 2000:643–653.

    Google Scholar 

  36. Kirchhoff LV: Agents of African trypanosomiasis (sleeping sickness). In Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, vol 2, edn 5. Edited by Mandell GL, Bennett JE, Dolin R. Philadelphia: Churchill Livingstone; 2000:2853–2858.

    Google Scholar 

  37. The Medical Letter on Drugs and Therapeutics: Drugs for Parasitic Infections. New Rochelle, NY: The Medical Letter Inc.; 2002.

Download references

Author information

Authors and Affiliations

  1. Department of Defense Global Emerging Infections Surveillance & Response System (DoD-GEIS), Division of Preventive Medicine, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, 20910, Silver Spring, MD, USA

    Bonnie L. Smoak MD, PhD, MPH

Authors
  1. Jean-Paul Chretien MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bonnie L. Smoak MD, PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chretien, JP., Smoak, B.L. African trypanosomiasis: Changing epidemiology and consequences. Curr Infect Dis Rep 7, 54–60 (2005). https://doi.org/10.1007/s11908-005-0024-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11908-005-0024-y

Keywords

Search

Navigation