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11 : Human African Trypanosomiasis: a Reemerging Public Health Threat

Author: Anne C. Moore1
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Affiliations: 1: Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway, Atlanta, GA 30341
Content Type: Monograph
Publication Year: 2004

Category: Clinical Microbiology

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Abstract:

The explosive increase in the prevalence of human African trypanosomiasis at the beginning of the 20th century is one of the best examples of an emerging infection. Human African trypanosomiasis is caused by two subspecies of , an extracellular, flagellate protozoan parasite. Although the two subspecies that infect humans, and , are morphologically indistinguishable, there are key differences in their abilities to infect nonhuman hosts. Human African trypanosomiasis is a progressive illness that is invariably fatal if untreated. Detection of trypanosome DNA by PCR, although successfully used clinically for the detection of infections imported to other countries from Africa or in research studies, is not practical for diagnosis in the field at present. Accurate assessment of the stage is critical because it dictates the choice of therapy; however, existing tools are not optimal. Chemotherapy for human African trypanosomiasis is far from ideal. Two strategies are used for control of African trypanosomiasis: reduction of the disease reservoir through case detection and treatment and reduction of human-fly contact through vector control. The threat has two components: the lack of secure production of antitrypanosomal drugs and the decreasing efficacy of the most important agent, melarsoprol. Human African trypanosomiasis has dramatically reemerged as a serious public health problem in the central African region. Huge challenges occur in implementing previously successful strategies to regain control of the disease, in view of the weak or absent health systems in some of the most affected areas.

Citation: Moore A. 2004. Human African Trypanosomiasis: a Reemerging Public Health Threat, p 143-157. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch11
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Human African Trypanosomiasis: a Reemerging Public Health Threat
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Citation: Moore A. 2004. Human African Trypanosomiasis: a Reemerging Public Health Threat, p 143-157. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch11
/content/10.1128/9781555816995.chap11.fig11-1
Figure 1

Reported incidence of African trypanosomiasis, 1926 to 2000. Data are from the WHO. The countries reporting are shaded.

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10.1128/9781555816995/fig11-1.gif
Image of Figure 1
Figure 1

Reported incidence of African trypanosomiasis, 1926 to 2000. Data are from the WHO. The countries reporting are shaded.

Citation: Moore A. 2004. Human African Trypanosomiasis: a Reemerging Public Health Threat, p 143-157. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch11
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Figure 2

Geographic distribution of African trypanosomiasis, 2000. In each country, the spatial distribution is uneven and the disease occurs in foci.

10.1128/9781555816995/fig11-2_thmb.gif
10.1128/9781555816995/fig11-2.gif
Image of Figure 2
Figure 2

Geographic distribution of African trypanosomiasis, 2000. In each country, the spatial distribution is uneven and the disease occurs in foci.

Citation: Moore A. 2004. Human African Trypanosomiasis: a Reemerging Public Health Threat, p 143-157. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch11
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Figure 3

Imported trypanosomiasis in the United States, by year, 1967 to 2002

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10.1128/9781555816995/fig11-3.gif
Image of Figure 3
Figure 3

Imported trypanosomiasis in the United States, by year, 1967 to 2002

Citation: Moore A. 2004. Human African Trypanosomiasis: a Reemerging Public Health Threat, p 143-157. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch11
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