Controlling sleeping sickness – a review

Abstract

SUMMARYFollowing a period characterized by severe epidemics of sleeping sickness, restoration of effective control and surveillance systems has raised the question of eliminating the disease from sub-Saharan Africa. Given sufficient political and financial support, elimination is now considered a reasonable aim in countries reporting zero or less than 100 cases per year. This success may lead health authorities across the affected region to downgrade the disease from ‘neglected’ to simply being ignored. In view of the significant levels of under-reporting of sleeping sickness mortality in rural communities, this could be a short-sighted policy. Loss of capacity to deal with new epidemics, which can arise as a consequence of loss of commitment or civil upheaval, would have serious consequences. The present period should be seen as a clear opportunity for public-private partnerships to develop simpler and more cost-effective tools and strategies for sustainable sleeping sickness control and surveillance, including diagnostics, treatment and vector control.

Interwoven Biology of the Tsetse Holobiont

“…Such measures have been successful within their targeted locales (113). Nevertheless, the threat of trypanosomiasis remains relevant, as political instability (23) and decreased priority status implemented by local authorities, due to the reduced numbers of reported cases (114), impede the continuous efforts required to prevent the reestablishment and subsequent heightened disease incidence (115). By gaining a more holistic view of tsetse biology, insights into novel strategies for controlling the spread of the disease may be gained.…”

Adult blood-feeding tsetse flies, trypanosomes, microbiota and the fluctuating environment in sub-Saharan Africa

“…This disease is responsible for dramatic losses in livestock production, estimated at US$ 4.5 billion/year (Reinhardt, 2002). Furthermore, the morsitans group is the vector of Trypanosoma brucei rhodesiense (Tbr), the causative agent of the acute form of HAT that is endemic in 13 east African countries (Welburn et al, 2009). On the other hand, the palpalis group, which poorly transmits Tbb and Tc (Kazadi, 2000), is the vector of Trypanosoma brucei gambiense, which is responsible for the chronic form of HAT in 24 countries of western and central Africa (Hoare, 1972;Kennedy, 2008;Welburn et al, 2009).…”

“…HAT is one of the most neglected tropical diseases in the world (Brun et al, 2010), even though in terms of mortality it ranks ninth out of 25 human infectious and parasitic diseases in Africa (Welburn et al, 2009). To this day, sleeping sickness is responsible for major disruptions to social, agricultural and economic development in Africa (Simarro et al, 2011).…”

Human African trypanosomiasis prevention, treatment and control costs: A systematic review

“…Several techniques are recommended for the control of tsetse fly populations: sequential aerial insecticide spraying to target adult flies during the first spray and tsetse flies as they emerge from pupal stages in the ground during subsequent sprays; ground spraying to target pupae and resting flies; the use of odor-baited or visual-baited (e.g. black or blue cloth) insecticide treated traps and targets; sterile insect release; and insecticide treatment of cattle (ICT) (Welburn et al 2009). A total of 13 Sleeping Sickness National Control Programs are developing vector control activities (out of 24 countries reporting HAT cases) (Franco et al 2014), although in some countries institutions other than national control programs are also engaged in vector control activities.…”