Human African trypanosomiasis, also identified as sleeping sickness, is a vector-borne parasitic illness. It is caused by infection with protozoan parasites of the genus Trypanosoma. They are transmitted to people by tsetse fly (Glossina genus) stings which have attained their infection from people or from animals harbouring the human pathogenic parasites.

Tsetse flies are found just in sub-Saharan Africa although only particular kinds spread the disease. Rural populations existing in areas where spreading happens and which is influenced by agriculture, fishing, animal husbandry or hunting are the most susceptible to the tsetse fly and hence to the illness.

According to WHO, the disease incidence differs from one country to another as well as in different parts of a single country. In the last 10 years, over 70% of reported cases occurred in the Democratic Republic of Congo (DRC). The DRC is the only country that has reported more than 1000 new cases annually and accounts for 89% of the cases reported in 2013.

  • Chad and South Sudan declared between 100 and 200 new cases in 2013. Similar figures were expected in Central African Republic but insecurity hampered the regular case detection activities.
  • Countries such as Angola, Cameroon, Congo, Côte d’Ivoire, Equatorial Guinea, Gabon, Ghana, Guinea, Kenya, Malawi, Nigeria, Uganda, United Republic of Tanzania, Zambia and Zimbabwe are reporting fewer than 100 new cases per year.
  • Countries like Benin, Botswana, Burkina Faso, Burundi, Ethiopia, Gambia, Guinea Bissau, Liberia, Mali, Mozambique, Namibia, Niger, Rwanda, Senegal, Sierra Leone, Swaziland and Togo have not reported any new cases for over a decade. Transmission of the disease seems to have stopped but there are still some areas where it is difficult to assess the exact situation because the unstable social circumstances and/or remote accessibility hinder
    surveillance and diagnostic activities.

Symptoms

Irregularly, in 1 to 3 weeks, the bite grows into a red sore, also named a chancre. Numerous weeks to months later, additional symptoms of sleeping sickness happen. These include the following:

  • fever,
  • rash,
  • swelling of the face and hands,
  • headaches,
  • fatigue,
  • aching muscles and joints,
  • itching skin,
  • and swollen lymph nodes.

Weight loss happens as the illness progresses. Continuous confusion, behavior changes, daytime sleepiness with nighttime sleep troubles, and other neurologic difficulties happen after the infection has infected the central nervous system. These signs come to be worse as the disease progresses. If left untreated, death will ultimately happen after some years of infection.

Prevention

Avoid tsetse fly bites. Travelers must dress clothing that covers the wrist and ankle, made of medium-weight fabric in neutral colors, as tsetse flies are fascinated to bright or dark colors and can sting over lightweight attires. Permethrin-impregnated clothing and use of DEET repellent might decrease the amount of fly bites.

Treatment

All people detected with Trypanosomiasis must obtain treatment. The particular drug and treatment option will be influenced by the kind of infection ( T. b. gambiense or T. b. rhodesiense) and the illness phase (i.e. whether the central nervous system has been attacked by the parasite).
Pentamidine, which is the prescribed drug for early stage, the other drugs (suramin, melarsoprol, eflornithine, and nifurtimox) used to treat trypanosomiasis.

After treatment people are required to have sequential assessments of their cerebrospinal fluid for 2 years, so that deterioration can be discovered if it happens.