Human African trypanosomiasis

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


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.

Publication types

  • Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Animals
  • Developing Countries
  • Endemic Diseases / prevention & control
  • Endemic Diseases / statistics & numerical data*
  • Female
  • Global Health*
  • Humans
  • Incidence
  • Male
  • Neglected Diseases / diagnosis
  • Neglected Diseases / epidemiology*
  • Risk Assessment
  • Severity of Illness Index
  • Travel
  • Trypanosoma brucei gambiense / isolation & purification*
  • Trypanosomiasis, African / diagnosis
  • Trypanosomiasis, African / drug therapy*
  • Trypanosomiasis, African / epidemiology*
  • World Health Organization