Authors: J A Blum A L Neumayr C F Hatz
Publish Date: 2011/09/07
Volume: 31, Issue: 6, Pages: 905-913
Abstract
Human African trypanosomiasis HAT or sleeping sickness is caused by the protozoan parasites Trypanosoma brucei Tb gambiense West African form and Tb rhodesiense East African form that are transmitted by the bite of the tsetse fly Glossina spp Whereas most patients in endemic populations are infected with Tb gambiense most tourists are infected with Tb rhodesiense In endemic populations Tb gambiense HAT is characterized by chronic and intermittent fever headache pruritus and lymphadenopathy in the first stage and by sleep disturbances and neuropsychiatric disorders in the second stage Recent descriptions of the clinical presentation of Tb rhodesiense in endemic populations show a high variability in different foci The symptomatology of travellers is markedly different from the usual textbook descriptions of African HAT patients The onset of both infections is almost invariably an acute and febrile disease Diagnosis and treatment are difficult and rely mostly on old methods and drugs However new molecular diagnostic technologies are under development A promising new drug combination is currently evaluated in a phase 3 b study and further new drugs are under evaluation
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