Abstract
Human African trypanosomiasis (HAT), also known as sleeping sickness, continues to be a major hazard to human health in 36 countries in sub-Saharan Africa. One of the most important problems in disease management is the considerable difficulty in distinguishing the early (hemolymphatic) from the late (encephalitic) stage when the parasites have crossed the blood-brain barrier to enter the Central Nervous System (CNS). Treatment of the two stages is different with the highly toxic arsenical drug melarsoprol being the most commonly used therapy for CNS disease. Since melarsoprol kills 5% of treated patients, it is vital to develop reliable and agreed diagnostic staging markers for HAT. Although the current WHO staging criteria on the cerebrospinal fluid (CSF) are the most commonly used, there is still a lack of consensus as to their efficacy which has driven the current search for improved methods of HAT diagnostic staging which are considered here.
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