New face of sleeping sickness epidemiology highlights need for new tools

February 22, 2011, Public Library of Science

Recent developments have rekindled hopes of eliminating human African trypanosomiasis (HAT), more familiarly known as sleeping sickness, as a public health problem in those areas of sub-Saharan Africa where the disease is endemic.

In the February 2011 issue of the open-access journal PLoS Neglected Tropical Diseases, Simarro and colleagues at the WHO report in "The Control and Surveillance Programme of the World Health Organization 2000-2009: The Way Forward" that new cases of sleeping sickness fell below the symbolic number of 10,000 in 2009, setting the stage for a possible elimination of sleeping sickness in sub-Saharan Africa – a prospect that was unthinkable a decade ago. In order to highlight the existing literature that PLoS NTDs authors have contributed to the field, PLoS Neglected Deputy Editor-in-Chief Serap Aksoy has compiled a collection of articles on HAT with a specific emphasis on potential applications for disease control.

While previous efforts to curb the disease throughout the early twentieth century had met with some success, the subsequent loss of effective control programs in the 1960s resulted in a steep increase in sleeping sickness within endemic countries. According to Dr. Simarro, these more recent encouraging signs are the result of "leadership from the WHO and coordination of control activities in endemic countries, as well as the unfaltering commitment and determination of teams of National Sleeping Sickness Control Programmes, research institutions, bilateral cooperation, NGOs and the private sector. In the 2000s the objective was largely to hold sleeping sickness at bay, using systematic screening of at-risk populations and providing early treatment, followed by a decisive phase which focused on shrinking the map of endemic areas. In addition to generous drug donations and continuing research, funding for control activities, training, logistical improvement and infrastructure all contributed in helping to make diagnosis and treatment more accessible, safer and less cumbersome."

In the same issue, Serap Aksoy also elaborates on these findings in her editorial, " Elimination in Sight: Time to Celebrate, Reflect but not Relax," in which she provides a historical perspective to HAT epidemics and emphasizes the need for continued vigilance in preventing future re-emergence of the disease.

Both Drs. Simarro and Aksoy conclude that the future for HAT elimination is promising, but only if donors continue to maintain their commitment to control and research, stressing that a sustainable strategy for elimination must be implemented and that an awareness of the threat of re-emergence of the disease be maintained.

More information: Simarro PP, Diarra A, Ruiz Postigo JA, Franco JR, Jannin JG (2011) The Human African Trypanosomiasis Control and Surveillance Programme of the World Health Organization 2000: The Way Forward. PLoS Negl Trop Dis 5(2): e1007. doi:10.1371/journal.pntd.0001007

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