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Chapter 52 - Human African Trypanosomiasis

from Section 7 - Protozoal Infections

Published online by Cambridge University Press:  18 June 2025

By
Janelisa Musaya ,
Peter Nambala ,
Westain Tizgo Nyirenda ,
Julius Mulindwa  and
David Mabey
Edited by
David Mabey ,
Martin W. Weber ,
Moffat Nyirenda ,
Dorothy Yeboah-Manu ,
Jackson Orem ,
Laura Benjamin ,
Michael Marks  and
Nicholas A. Feasey
David Mabey
Affiliation:
London School of Hygiene and Tropical Medicine
Martin W. Weber
Affiliation:
World Health Organization
Moffat Nyirenda
Affiliation:
London School of Hygiene and Tropical Medicine
Dorothy Yeboah-Manu
Affiliation:
Noguchi Memorial Institute for Medical Research, University of Ghana
Jackson Orem
Affiliation:
Uganda Cancer Institute, Kampala
Laura Benjamin
Affiliation:
University College London
Michael Marks
Affiliation:
London School of Hygiene and Tropical Medicine
Nicholas A. Feasey
Affiliation:
Liverpool School of Tropical Medicine
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Summary

Human African trypanosomiasis (HAT), otherwise known as sleeping sickness, comes in two forms: the West African form caused by Trypanosoma brucei gambiense, which is found in West and Central Africa, accounts for 95% of cases and has no known animal reservoir; and the East African form caused by Trypanosoma brucei rhodesiense, a zoonotic infection, which contributes 5%. HAT is endemic in 36 countries in sub-Saharan Africa (Fig. 52.1), but more than 70% of cases reported in the past 10 years have been in the Democratic Republic of Congo. It is invariably fatal unless treated. The parasites are transmitted by tsetse flies of the Glossina palpalis and G. morsitans groups.

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Principles of Medicine in Africa , pp. 518 - 523
Publisher: Cambridge University Press
Print publication year: 2025

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References

Brun, R, Blum, J, Chappuis, F, Burri, C. Human African trypanosomiasis. Lancet 2010;375(9709):148-59.10.1016/S0140-6736(09)60829-1CrossRefGoogle ScholarPubMed
Büscher, P, Mertens, P, Leclipteux, T et al. Sensitivity and specificity of HAT Sero-K-SeT, a rapid diagnostic test for serodiagnosis of sleeping sickness caused by Trypanosoma brucei gambiense: a case-control study. Lancet Glob Health 2014;2(6):e359–63. doi: 10.1016/S2214-109X(14)70203-7.CrossRefGoogle ScholarPubMed
Kennedy, PG. Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness). Lancet Neurol. 2013;12(2):186–94.10.1016/S1474-4422(12)70296-XCrossRefGoogle ScholarPubMed
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Mesu, VKBK, Kalonji, WM, Bardonneau, C et al. Oral fexinidazole for late-stage African Trypanosoma brucei gambiense trypanosomiasis: a pivotal multicentre, randomised, non-inferiority trial. Lancet 2018;391:144–54. doi: 10.1016/S0140-6736(17)32758-7.CrossRefGoogle ScholarPubMed
Pepin, J, Milord, F, Guern, C et al. Trial of prednisolone for prevention of melarsoprol-induced encephalopathy in gambiense sleeping sickness. Lancet 1989;1(8649):1246–50. doi: 10.1016/s0140-6736(89)92340-4.Google ScholarPubMed
WHO (2022). Trypanosomiasis, human African (sleeping sickness). www.who.int/news-room/fact-sheets/detail/trypanosomiasis-human-african-(sleeping-sickness).Google Scholar

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