Sleeping sickness, also known as HAT (Human African Trypanosomiasis) is a much neglected fatal disease, which plagues different parts of Africa. It is spread by the tsetse fly, which releases a parasite (called T. gambiense) into the blood, from where it gets spread to the brain. Tsetse flies are found in around 36 countries in the sub-Saharan region of Africa. This puts around 60 million people at risk. According to the WHO (world health organization), 50,000 to 70,000 people get affected by Trypanosomniasis each year.
In the 1960’s, sleeping sickness was nearly eliminated. Unfortunately enough, it has made a “come back” since the past two decades due to wars, and the collapse of health systems and population movements.
Symptoms and Transmissions of Sleeping Sickness
The parasite T. gambiense, causing sleeping sickness gets transmitted to human beings through the bite of tsetse flies which breed in humid and warm areas. Widely spread all across sub-Saharan Africa, both man and animals serve as reservoirs for the parasites.
Sleeping sickness presents itself with very non-specific symptoms such as weakness and fever, especially in the first stage. The parasite is relatively easy to treat in the first stage, however, if not dealt with right at this stage, it moves on to the central nervous system of the infected person. When this happens, the second stage sets in. In this case, the symptoms are characterized by:
- Violent behaviors
- Changes in personality
- Alterations in the circadian rhythm
- Slurred speech
- Difficulty in walking and talking
One of the most prominent symptoms is that patients suffering of sleeping sickness face an inability to sleep during the night, but are overcome by excessive sleep during the day. If the illness is neglected and left untreated, it can eventually lead to death or a coma.
The WHO and Sleeping Sickness
Despite the world wide campaign going on to rid illnesses like leprosy and polio, WHO believes that, the chances of stamping out tropical diseases, such as sleeping sickness, are very low. One of the main problems of this is the lack of research funding. Upon this, there have been a number of diseases that have been identified as being in need for particular attention. Such as:
- Leishmaniasis and
- Leprosy or Hansen’s disease
WHO provides technical assistance and support to national control programs, and focuses on eradicating tropical diseases. An important thing is WHO’s partnership with Bayer AG (nifurtimox and suramin) and sanofi-aventis (melarsoprol, pentamidine and eflornithine), which provides the drugs to endemic countries free of charge.
A network for private foundations, donor countries, NGO’s, research centers, regional institutions and universities has been established to participate in the control and surveillance. These foundations constantly undertake researches in order to develop new diagnostic tools and drugs.
The WHO programme has certain objectives, which are:
- To coordinate and strengthen control measures, also to ensure that field activities are sustained.
- Strengthen surveillance systems that are existing
- To ensure treatment and the accessibility to diagnostics
- To support and monitor treatments and the drug resistances throughout the network
- To develop epidemiological analysis of data and information databases
- To implement training activities
- To promote collaborations with the Food and Agriculture organization (FAO) in order to deal with vector control
- To synergize and coordinate vector control activities being lead by Pan African Tsetse and Trypanosomiasis Eradication Campaign of the Africa Union
Factors That Contribute To Tropical Diseases
There are numerous factors that contribute to the spread of tropical diseases like the sleeping sickness. A few of these factors are:
- Lack of sanitation
- Poor nutrition
- Poor housing
- Over crowding
- Poor nutrition and
- The lack of access to clean and safe water supply.
Treatment of Sleeping Sickness
The First Stage:
The first stage is basically treated with two drugs:
- Suramin – This drug is used in treating sleeping sickness and T.b. rhodesiense. It causes urinary tract problems and allergic reactions.
- Pentamidine – This drug is generally well tolerated by patients, however, it also has some negative effects on patients.
The Second Stage:
The most common drug used to treat second stage Trypanosomiasis is Melarsoprol. Melarsoprol is a derivative of arsenic, which was developed more than 50 years ago. Treatment with this drug is very fatal and excruciatingly painful. Patients have described its action as “fire in the veins”. Between 5 and 20 percent of patients treated with melarsoprol die of complications as a result of its use.
Recently, researches have been suggesting that a safe and alternative treatment is available through the combination of two drugs; nifurtimox and eflornithine. However, the use of these two medicines is not ideal. This treatment of sleeping sickness is quite complicated to administer, and requires great care and close monitoring of the patients.