Herbie Murray
Sleeping sickness, or African trypanosomiasis, is a disease caused by a parasite transmitted by the bite of an infected tsetse fly. The disease is endemic in sub-Saharan Africa and is known to have existed as early as the 14th century. It is characterised by two types: Trypanosoma brucei gambiense (chronic) and Trypanosoma brucei rhodesiense (acute), named for the regions in which they are found. The disease is typically found in rural areas and causes severe disruption to the sleep/wake cycle, body temperature, and hormonal regulation.
| Characteristics | Values |
|---|---|
| Common name | Sleeping Sickness |
| Scientific name | Human African Trypanosomiasis (HAT) |
| Cause | Parasitic disease caused by the species Trypanosoma brucei |
| Transmission | Bite of an infected tsetse fly (Glossina species) |
| Region | Sub-Saharan Africa |
| Risk factors | Travel to endemic regions, living in rural areas, proximity to infected humans or animals |
| Symptoms | Fever, headache, skin lesions, rash, swelling, swollen lymph nodes, sleep disorders, confusion, poor coordination, numbness, tremors, speech and walking difficulties, psychiatric disorders, seizures, coma |
| Diagnosis | Serological tests, parasitological findings, blood tests, lumbar puncture, cerebrospinal fluid examination |
| Treatment | Pentamidine, suramin, eflornithine, nifurtimox, melarsoprol, fexinidazole |
| Prevention | Avoid insect bites, wear protective clothing, use insect repellent, use bed nets |
| Historical references | 14th-century Arab writer, British naval surgeon John Atkins in 1734 |
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What You'll Learn
- Sleeping sickness is caused by the parasite Trypanosoma brucei
- The disease is transmitted by the bite of a tsetse fly
- It occurs in two types, West African and East African sleeping sickness
- Symptoms of sleeping sickness include fever, headache, rash, and swollen lymph nodes
- Treatment includes medication and hospitalisation
Sleeping sickness is caused by the parasite Trypanosoma brucei
Sleeping sickness, or Human African trypanosomiasis (HAT), is caused by the parasite Trypanosoma brucei. This parasite is transmitted to humans by the bite of an infected tsetse fly (Glossina species). Tsetse flies are found only in rural, sub-Saharan Africa. The disease is endemic in this region, with around 69 million people at risk. The parasite can also be passed from a pregnant woman to her unborn baby, although this is rare and not well documented.
There are two types of sleeping sickness, each named for the region in Africa where it was historically found: Trypanosoma brucei gambiense (TbG) and Trypanosoma brucei rhodesiense (TbR). These subspecies cause chronic and acute forms of the disease, respectively. TbG accounts for over 92% of reported cases and is found in 24 countries of west and central Africa. It can take months or even years for symptoms to emerge, and when they do, the disease is often already advanced, with the central nervous system affected. TbR is found in 13 countries of eastern and southern Africa and accounts for 8% of reported cases. The first signs and symptoms of this subspecies emerge a few weeks or months after infection, and the disease develops rapidly, with multi-organ invasion, including the brain.
The first stage of sleeping sickness is characterised by fevers, headaches, itchiness, and joint pains, beginning one to three weeks after the bite. The second stage, which can begin weeks to months later, is marked by confusion, poor coordination, numbness, and trouble sleeping. The disease is usually fatal if left untreated, with parasites invading the central nervous system and causing various neurological disturbances, including sleep disorders, deep sensory disturbances, abnormal movements, tremors, walking difficulties, speech difficulties, psychiatric disorders, seizures, coma, and ultimately death.
Treatment for sleeping sickness has improved in recent years, with the development of drugs such as fexinidazole, which can be taken orally for either stage of the disease. Early detection and treatment are crucial, as the disease is easier to treat before neurological symptoms occur. Available treatments can cure most patients, completely eliminating trypanosomes from the body. However, there is currently no vaccine or drug available to prevent sleeping sickness, so preventing infection through avoiding tsetse fly bites is essential.
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The disease is transmitted by the bite of a tsetse fly
Sleeping sickness, or human African trypanosomiasis (HAT), is a life-threatening disease caused by the parasite Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense. It is transmitted by the bite of an infected tsetse fly. Tsetse flies inhabit sub-Saharan Africa, and only certain species transmit the parasite. Male and female tsetse flies feed exclusively on blood, and act as a vector for transmitting the parasite to humans and livestock.
The risk of infection from a tsetse fly bite is estimated to be less than 0.1%. However, the more often a person is bitten, the higher the risk of infection. The disease is slow to progress, taking a few months to a year or more after exposure. During the first stage, the parasites in the bloodstream cause a range of general symptoms such as fever, headaches, itchiness, joint pains, and tiredness, making it hard to diagnose. The second stage begins several weeks to months later, with more severe symptoms such as confusion, poor coordination, numbness, and trouble sleeping.
To prevent infection, residents of affected areas are advised to use insect repellents, wear long-sleeved clothing, and avoid tsetse-dense areas. Systematic screening of at-risk communities is also important for early detection and treatment.
Sleeping sickness is a serious disease that can be fatal if left untreated. Treatment is more effective when the disease is detected early, before neurological symptoms occur. The use of pentamidine or suramin can treat the hemolymphatic stage of T. Brucei infection. However, if the disease progresses to the neurological stage, dosages of eflornithine or a combination of nifurtimox and eflornithine are required.
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It occurs in two types, West African and East African sleeping sickness
Sleeping sickness, or human African trypanosomiasis (HAT), is a parasitic disease spread by the tsetse fly. It occurs in two types, West African and East African sleeping sickness.
West African sleeping sickness is caused by the parasite Trypanosoma brucei gambiense (TbG). This long-term (chronic) infection can last for years. It is found in 24 countries of west and central Africa and currently accounts for 92% of reported cases. A person can be infected for months or even years without major signs or symptoms. When evident symptoms emerge, often the disease is advanced with the central nervous system already affected.
The first stage of the disease is characterized by fevers, headaches, itchiness, and joint pains, beginning one to three weeks after the bite. Weeks to months later, the second stage begins with confusion, poor coordination, numbness, and trouble sleeping.
East African sleeping sickness is caused by Trypanosoma brucei rhodesiense (TbR). It’s a short-term (acute) illness that may last several weeks to months. It is found in 13 countries of eastern and southern Africa and accounts for 8% of reported cases. The first signs and symptoms emerge a few weeks or months after infection. The disease develops rapidly with multi-organ invasion, including the brain.
The first stage of the disease is similar to West African sleeping sickness, typically causing mild, flu-like symptoms. The second stage causes more severe symptoms that affect the brain and central nervous system. Symptoms of each stage take longer to appear in West African sleeping sickness.
Sleeping sickness is caused by the parasite Trypanosoma brucei. It is passed on by the bite of an infected tsetse fly. The only risk factor is travel to parts of Africa where the tsetse fly is found. The only way to prevent the disease is to avoid insect bites. Medicine is available to treat sleeping sickness, and treatment is most effective when the disease is detected early. Without treatment, sleeping sickness is generally fatal.
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Symptoms of sleeping sickness include fever, headache, rash, and swollen lymph nodes
Sleeping sickness, or African trypanosomiasis, is a parasitic disease spread by the bites of infected tsetse flies. It is endemic in sub-Saharan Africa, with 69% of cases in 2023 reported in the Democratic Republic of the Congo. The disease is caused by two types of parasites: Trypanosoma brucei gambiense (TbG) and Trypanosoma brucei rhodesiense (TbR). TbG accounts for 92% of reported cases and is found in 24 countries in West and Central Africa, while TbR accounts for 8% of cases and is found in 13 countries in East and Southern Africa.
The second stage of sleeping sickness affects the brain and central nervous system, causing more severe symptoms. These include confusion, poor coordination, numbness, trouble sleeping, and various neurological disturbances such as sleep disorders, deep sensory disturbances, abnormal movements, tremors, walking and speech difficulties, psychiatric disorders, seizures, and coma. The second stage of infection can progress within a few weeks or months, and without treatment, it can lead to death within months.
Diagnosing sleeping sickness involves detecting the parasite in blood smears or lymph node fluid. Painful lumbar punctures may also be used to detect the parasite in spinal fluid, indicating an advanced stage of the disease. Treatment for sleeping sickness has traditionally been complex and toxic, but new oral treatments such as fexinidazole offer safer and more effective options for curing the disease.
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Treatment includes medication and hospitalisation
Human African trypanosomiasis (HAT), or sleeping sickness, is a parasitic disease caused by the species Trypanosoma brucei. Humans are infected by two types, Trypanosoma brucei gambiense (TbG) and Trypanosoma brucei rhodesiense (TbR), which are transmitted by the bite of an infected tsetse fly. It is endemic in sub-Saharan Africa, threatening mainly poor, rural populations. Without treatment, sleeping sickness is generally fatal.
Treatment of sleeping sickness includes medication and hospitalisation. The type of drug treatment used depends on the type and stage of the disease. Treatment is easier when the disease is detected early, before neurological symptoms occur. In the first stage of the disease, when the parasites are confined to the blood and lymph, intravenous suramin or pentamidine is used. In the second stage, when the parasites have invaded the central nervous system, eflornithine or a combination of nifurtimox and eflornithine can be used to treat late-stage sleeping sickness. Melarsoprol is also used for both types, but typically only for TbR due to serious side effects, which can be fatal. Fexinidazole is a more recent oral treatment that can be used for either stage of TbG.
Hospitalisation is often required for patients with sleeping sickness, particularly when neurological symptoms are severe. In such cases, patients may require intensive care while treatment is administered. After treatment, patients should be monitored for two years, and if symptoms return, they should be tested for the parasite that causes sleeping sickness.
The Drugs for Neglected Diseases Initiative has contributed to African sleeping sickness research by developing a compound called fexinidazole. This treatment has been shown to be effective and safe in both stages of the disease, in both adults and children. In 2024, the World Health Organization recommended fexinidazole to replace suramin and melarsoprol as the first-line treatment for sleeping sickness caused by TbR.
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Frequently asked questions
Sleeping sickness, or African Trypanosomiasis, has been around for at least a few hundred years. A 14th-century Arab writer described a sultan of the Mali Kingdom dying from "illat an-nawm" or "sleeping sickness".
Sleeping sickness occurs in two stages. The first stage causes mild, flu-like symptoms such as fever, headaches, itchiness, and joint pains. The second stage causes more severe symptoms that affect the brain and central nervous system, including confusion, poor coordination, numbness, and trouble sleeping.
Sleeping sickness is caused by the parasite Trypanosoma brucei and is transmitted by the bite of an infected tsetse fly. The disease occurs in two forms, Trypanosoma brucei gambiense (found in West and Central Africa) and Trypanosoma brucei rhodesiense (found in East and Southern Africa).
Treatment for sleeping sickness depends on the stage of the disease. For the first stage, the treatment is intravenous suramin or pentamidine. For the second stage, the only treatment is intravenous melarsoprol. A newer treatment, fexinidazole, can be taken orally for either stage of the disease.
