Neglected tropical diseases

New cases of human African trypanosomiasis continue to drop

Decline strengthens prospects for elimination

23 May 2011 | Geneva

©Dr Simarro Pere

The number of reported cases of human African trypanosomiasis, more commonly known as sleeping sickness, dropped further in 2010, signalling that the disease may be approaching elimination as a public-health problem.

A total of 7139 new cases were reported to WHO from 36 endemic countries during 2010, compared with 9878 cases in 2009. This represents a decrease of 28% in one year.

"Sustainable elimination of sleeping sickness as a public-health problem is feasible and requires continuous efforts and innovative approaches," said Dr Pere Simarro, Medical Officer in charge of WHO’s programme to control human African trypanosomiasis. "Systematic screening of patients and disease surveillance activities should be gradually integrated in health services while maintaining capacity to react rapidly".

In 2004, more than 17 600 cases of sleeping sickness were reported and in 1998 almost 38 000. The Democratic Republic of the Congo, Angola, Sudan, Uganda, the Central African Republic and Chad are among the countries reporting high numbers of cases.

Control and surveillance

Strengthened control and surveillance activities by national sleeping sickness control programmes in endemic countries, often using cumbersome tools, are producing results.

Collaboration between WHO and two of its regional offices – the Regional Office for Africa and the Regional Office for the Eastern Mediterranean – has contributed to reducing transmission of the disease. This reduction has been made possible by support provided to endemic countries and through improved surveillance and case reporting. A partnership between WHO and sanofi-aventis has enabled the systematic screening and treatment of affected populations. Bilateral cooperation and support from nongovernmental organizations as well as a drug donation from Bayer Healthcare have also contributed to these achievements.

In her address to the 64th World Health Assembly on 16 May 2011, WHO’s Director-General Dr Margaret Chan commented that progress achieved in controlling sleeping sickness has been "against all expectations," noting for the first time that the disease "looks slated for elimination in the near future."

New tools and funding

Institutional support and adequate funding remain fundamental to eliminating sleeping sickness and in avoiding any lapse in control activities, such as occurred in the late 1960s, triggering the re-emergence of the disease in many countries. Less cumbersome diagnostic methods and new treatment tools need to be developed to facilitate the elimination process and the sustainability of results.

Human African trypanosomiasis is a parasitic disease transmitted by the bite of an infected Glossina insect, commonly known as the tsetse fly. The disease affects mostly poor populations living in remote rural areas of Africa.

Left untreated, human African trypanosomiasis is usually fatal.

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