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Lancet. 2017 Nov 25;390(10110):2397-2409. doi: 10.1016/S0140-6736(17)31510-6. Epub 2017 Jun 30.

Human African trypanosomiasis.

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Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address:
Food and Agriculture Organization of the United Nations, Sub-regional Office for Eastern Africa, Addis Ababa, Ethiopia.
UMR INTERTRYP, Institut de Recherche pour le Développement, Montpellier, France.
World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland.


Human African trypanosomiasis (sleeping sickness) is a parasitic infection that almost invariably progresses to death unless treated. Human African trypanosomiasis caused devastating epidemics during the 20th century. Thanks to sustained and coordinated efforts over the past 15 years, the number of reported cases has fallen to an historically low level. Fewer than 3000 cases were reported in 2015, and the disease is targeted for elimination by WHO. Despite these recent successes, the disease is still endemic in parts of sub-Saharan Africa, where it is a considerable burden on rural communities, most notably in central Africa. Since patients are also reported from non-endemic countries, human African trypanosomiasis should be considered in differential diagnosis for 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 suboptimal, but ongoing clinical trials provide hope for safer and simpler treatments.

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