Date Published: February 26, 2008
Publisher: Public Library of Science
Author(s): Pere P Simarro, Jean Jannin, Pierre Cattand
Abstract: While the number of new detected cases of HAT is falling, say the authors, sleeping sickness could suffer the “punishment of success,” receiving lower priority by public and private health institutions.
Partial Text: In the early part of the twentieth century, human African trypanosomiasis (HAT), also known as sleeping sickness, decimated the population in many parts of sub-Saharan Africa. In the 1930s, the colonial administrations, conscious of the negative impact of the disease on its territories, established disease control programmes. Systematic screening, treatment, and follow-up of millions of individuals in the whole continent led to transmission coming to a near halt by the 1960s.
HAT is a vector-borne parasitic disease that is fatal if left untreated. It is caused by a single-celled protozoa belonging to the Trypanosoma genus. Parasites are transmitted to humans by the bite of a tsetse fly (Glossina genus) that has acquired the infection from human beings or from animals harbouring the human pathogenic parasites (Figure 2).
Since WHO expressed its concerns in 1995, there have been great improvements in HAT control. In addition to political will at the highest levels, capacities for control and surveillance in endemic countries were strengthened through training and the provision of equipment for screening, diagnosis, and treatment.
While the number of new detected cases of HAT is falling, sleeping sickness could suffer the “punishment of success,” receiving lower priority by public and private health institutions with the consequent risk of losing the capacity to maintain disease control. While waiting for new tools for sleeping sickness control, the greatest challenge for the coming years will be to increase and sustain the current control efforts using existing tools. Effective surveillance and control followed by good reporting will be crucial. Furthermore, advocacy in endemic countries should continue to be maintained in the face of decreasing cases reported; sleeping sickness should retain its high priority with health policy makers and planners. Research must be encouraged to resolve the technical issues preventing the development of a new approach to surveillance and control that could be sustained by countries themselves.