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Sleeping Sickness
© Juan Carlos Tomasi Sleeping sickness, or human African trypanosomiasis (HAT), is a fatal and much neglected disease that plagues parts of Africa. It is transmitted by the tsetse fly, which harbors the t. gambiense parasite. Tsetse flies are found in 36 countries in sub-Saharan Africa, putting 60 million people at risk. According to World Health Organization (WHO) figures, trypanosomiasis affects 50,000 to 70,000 people each year. The World Health Organization (WHO) estimates the current number of cases to be between 50,000 and 70,000. Nearly eliminated in the 1960s, sleeping sickness has made a comeback of epidemic proportions due to war, population movements, and the collapse of health systems over the past two decades. Transmissions and SymptomsThe parasite causing sleeping sickness is transmitted to humans through the bite of the infected tsetse flies breeding in warm and humid areas. Inhabiting the vast savannah across sub-Saharan Africa, tsetse flies come into contact with man, cattle and wild animals, all acting as reservoirs for the parasites. The first stage of sleeping sickness presents with non-specific symptoms such as fever and weakness. This stage is difficult to diagnose but relatively easy to treat. If no treatment is given, the parasite will invade the infected person's central nervous system and the second stage sets in. This stage may be characterized by confusion, violent behavior or convulsions. Named after one of its most striking symptoms, patients with sleeping sickness experience an inability to sleep during the night but are overcome by sleep during the day. If left untreated, the disease inevitably leads to coma and death. Treatment
© Juan Carlos Tomasi Currently, the drug most commonly used to treat sleeping sickness is melarsoprol. A derivative of arsenic developed more than 50 years ago. Treatment from this drug is excruciatingly painful and potentially fatal. Often described by patients as “fire in the veins,” between 5 and 20 percent of those treated die of complications from the injected drug. Recent research suggests a safe, alternative treatment is available through the combination of two drugs, eflornithine and nifurtimox. While this combination represents an improved therapy for patients, it is not ideal. The treatment is complicated to administer and requires close patient monitoring—something frequently unavailable in sub-Saharan Africa. Hence, major efforts are needed to bring truly innovative drugs into the pipeline. Doctors Without Borders/Médecins Sans Frontières (MSF) and Sleeping Sickness
© Juan Carlos Tomasi MSF has been treating patients with the disease for over 20 years, since it opened its first project in northern Uganda in 1986. MSF runs programs to treat sleeping sickness in the Democratic Republic of Congo and Sudan and has transferred its treatment programs to national health authorities in Angola and the Republic of Congo. Last year alone, MSF treated one out of every five patients treated for the disease. In total, MSF has screened more than 2.4 million people for the disease and has treated over 43,000. MSF is currently responsible for the efficient supply and distribution of all sleeping sickness drugs used in the world today. Prevention efforts such as vector control are crucial to MSF’s efforts to keep sleeping sickness at bay. But the greatest obstacle to fighting the disease is the lack of new, better diagnostic tools and medicines. MSF is working to improve access to and quality of care offered to people suffering from sleeping sickness. |
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