The number of detected cases of African sleeping sickness detected annually has been falling since the late 1990s. But, according to tropical disease experts in a report released on February 25, 2008 in the Neglected Disease feature of PLoS Medicine, unless efforts are maintained to eliminate the disease, it could be revived in the near future.

African sleeping sickness, or human African trypanosomiasis (HAT), is a parasitic disease endemic to regions of sub-Saharan Africa. It is caused by a protozoan parasite of the genus Trypanosoma, which is usually transmitted by the blood sucking bites of the tsetse fly. Symptoms include first muscle and joint aches and enlarged lymph glands; they are followed by the alternating disorientation, fatigue and insomnia for which the disease has its name. Untreated, it can be fatal.

HAT is considered to be a neglected disease, because the funding available for research and health initiatives is significantly than the major three (HIV/AIDS, tuberculosis and malaria,) and it affects a population that is generally deficient in health care coverage. According to Pere Simarro of the World Health Organization and colleagues, elimination of the disease is considered to be within reach. But, they say, since recent efforts have been so successful, they might be cut short by a resulting drop in priority among public and private health institutions. Consequently, the capacity to maintain control of the disease could be lost again.

The authors conclude with words of caution for the efforts of the future. "While waiting for new tools for sleeping sickness control," they say, "the greatest challenge for the coming years will be to increase and sustain the current control efforts using existing tools."

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Eliminating Human African Trypanosomiasis: Where Do We Stand and What Comes Next
Pere P. Simarro, Jean Jannin, Pierre Cattand
PLoS Med 5(2): e55
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Anna Sophia McKenney

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