Gambiense human African trypanosomiasis: the bumpy road to elimination

Abstract

Purpose of reviewGambiense human African trypanosomiasis (gHAT), a disease that has killed hundreds of thousands as recently as the 1990s, could be on the verge of elimination or even eradication. This review describes recent developments that give us reasons for optimism as well as some caveats. Recent findingsNew developments in diagnostic and vector control tools, and especially in treatment, make it possible to strive for elimination of transmission of gHAT by 2030, perhaps even eradication. SummaryGambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid diagnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.

Polyamine Metabolism for Drug Intervention in Trypanosomatids

“…Thanks to WHO surveillance and control plans, more and more traditionally endemic African countries are declared free of sleeping sickness [7]. From an estimated 30,000 affected around the corner of the 21st century, the incidence of the disease has been reduced to <1 case per 10,000 population/year for five consecutive years in several regions of sub-Saharan Africa, being on the road to eradication [8].…”