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Human African trypanosomiasis

Year of publication 2017

Place of publication Rome, Italy ;

Pages 27 p.

Author Büscher Philippe, Cecchi Giuliano, Jamonneau Vincent, Priotto Gerardo

Publisher Elsevier B.V. ;

Product type Article

Synopsis (short abstract) Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ong oing clinical trials give hope for safer and simpler treatments.

Open Acess Article. This article is academically peer reviewed and published externally. This article is published in The Lancet Volume 390, page 2397-2409, 25 November–1 December 2017

Cite this content as:

Büscher Philippe, Cecchi Giuliano, Jamonneau Vincent, Priotto Gerardo (2017) Human African trypanosomiasis. The Lancet. Vol. 390, pp. 2397-2409. doi: 10.1016/S0140-6736(17)31510-6



Language English

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    Background: Human African trypanosomiasis (HAT), also known as sleeping sickness, persists as a public health problem in several sub-Saharan countries. Evidence-based, spatially explicit estimates of population at risk are needed to inform planning and implementation of field interventions, monitor disease trends, raise awareness and support advocacy. Comprehensive, geo-referenced epidemiological records from HAT-affected countries were combined with human population layers to map five categorie s of risk, ranging from ‘‘very high’’ to ‘‘very low,’’ and to estimate the corresponding at-risk population. Results: Approximately 70 million people distributed over a surface of 1.55 million km2 are estimated to be at different levels of risk of contracting HAT. Trypanosoma brucei gambiense accounts for 82.2% of the population at risk, the remaining 17.8% being at risk of infection from T. b. rhodesiense. Twenty-one million people live in areas classified as moderate to very high risk, where more than 1 HAT case per 10,000 inhabitants per annum is reported. Discussion: Updated estimates of the population at risk of sleeping sickness were made, based on quantitative information on the reported cases and the geographic distribution of human population. Due to substantial methodological differences, it is not possible to make direct comparisons with previous figures for at-risk population. By contrast, it will be possible to explore trends in the future. The presented maps of differ ent HAT risk levels will help to develop site-specific strategies for control and surveillance, and to monitor progress achieved by ongoing efforts aimed at the elimination of sleeping sickness.
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