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AFRICA’S LATEST NIGHTMARE
The African Union has requested assistance from US Doctors For Africa to help combat the resurgence of Human African Trypanosomiasis, more commonly known as sleeping sickness. Sleeping sickness is a parasitic illness transmitted by tsetse flies which are endemic to certain regions of sub-Saharan Africa(1). USDFA will send volunteer medical teams to work in four countries seriously affected by the disease. The USDFA volunteer medical team will treat patients and train local health care providers in the methods of sleeping sickness screening and treatment.
There are two types of sleeping sickness affecting humans in Africa - the first is East African Trypanosomiasis caused by the Trypanosoma Brucei Rhodesiense parasite. Symptoms of East African Trypanosomiasis include a red sore, or chancre, where the bite occurred, fever, severe headaches, extreme fatigue, aching joints and muscles and rash. Once the disease has progressed to the neurological stage the patient will experience more severe symptoms including seizures, difficulty walking, confusion and slurred speech. East African Trypanomsomiasis is acute and symptoms appear in a manner of weeks, sometimes months, and will ultimately cause death. East African Trypanosomiasis is found in parts of Eastern and Southern Africa including Uganda, Malawi, Zimbabwe, Kenya, Ethiopia, Botswana, Tanzania and Zaire(2).
The other type of sleeping sickness is called West African Trypanosomiasis and is caused by the Trypanosoma Brucei Gambiense parasite. Symptoms of West African Trypanosomiasis are fever, severe headaches, extreme fatigue, aching muscles and joints and weight loss. Signs that the disease has reached the neurological stage are increased confusion, difficulty walking, sleeping during the day and insomnia at night, seizures and slurred speech. The disease is chronic and symptoms often don’t appear until the patient is in the advanced stages. West African Trypanosomiasis is found in parts of West and Central Africa and is always fatal in patients who do not receive medical treatment(3).
Rural populations are at a much higher risk of contracting trypanosomiasis because the Tsetse fly populations live in vegetation along lakes and rivers and in rural wooded areas. To compound the situation, most residents of rural areas have limited or no access to health care facilities and may not travel to see a doctor until their symptoms are severe and the disease is in the advanced stages. The most effective way to control the epidemic of sleeping sickness is mass health screenings for at risk populations so health care practitioners have a chance to detect and treat the illness during the early stage. The World Health Organization (WHO) estimates that 60 million people in sub-Saharan Africa are at risk of contracting sleeping sickness but only 3-4 million of those have access to medical screening programs that could catch the disease in its initial stage(4). Once either type of Trypanosomiasis has progressed into the advanced or neurological stage, treatment becomes more difficult and damage to the central nervous system is permanent(5).
There is no vaccine available for Trypanosomiasis and not much study has been done in the past few decades to develop new treatments for this disease. Most patients that are diagnosed early can be cured by either Pentamide or Suramin but neither drug is effective once the disease has reached the neurological stage. The drug commonly used for late stage treatment, Melarsoprol, is an antiquated drug that produces horrible side-effects, sometimes death. A newer late stage medication called Eflornithine was developed in 1990 but is only effective in treating West African Trypanosomiasis(6).
There is a desperate need for widespread Trypanosomiasis screening programs in regions affected by the disease. Early diagnosis and treatment of sleeping sickness gives the patient a much better chance of survival. US Doctors For Africa together with the African Union want to help ensure early diagnosis and treatment of this devastating illness through the use of widespread screening programs and local health care provider training. In the coming year, our doctors will treat patients suffering from sleeping sickness and train hundreds of local health care providers in the methods of early diagnosis and treatment of this debilitating illness. If you are a medical professional interested in joining this mission, please click here.