Human African trypanosomiasis: the current situation in endemic regions and the risks for non-endemic regions from imported cases.

Jiang-Mei Gao,De-Hua Lai,Zhong-Dao Wu,Zhao-Rong Lun,Zheng-Yu Qian,Geoff Hide

doi:10.1017/s0031182020000645

Abstract

Human African trypanosomiasis (HAT) is caused by Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense and caused devastating epidemics during the 20th century. Due to effective control programs implemented in the last two decades, the number of reported cases has fallen to a historically low level. Although fewer than 977 cases were reported in 2018 in endemic countries, HAT is still a public health problem in endemic regions until it is completely eliminated. In addition, almost 150 confirmed HAT cases were reported in non-endemic countries in the last three decades. The majority of non-endemic HAT cases were reported in Europe, USA and South Africa, due to historical alliances, economic links or geographic proximity to disease-endemic countries. Furthermore, with the implementation of the 'Belt and Road' project, sporadic imported HAT cases have been reported in China as a warning sign of tropical diseases prevention. In this paper, we explore and interpret the data on HAT incidence and find no positive correlation between the number of HAT cases from endemic and non-endemic countries. This data will provide useful information for better understanding the imported cases of HAT globally in the post-elimination phase.

Highlights

Human African trypanosomiasis (HAT), known as sleeping sickness, is a neglected tropical disease, which is found in 36 African endemic countries (Simarro et al, 2010)
Two subspecies are able to infect humans: Trypanosoma brucei gambiense causes a chronic form of HAT in West and Central Africa, while Trypanosoma brucei rhodesiense is the pathogenic agent for the acute form of the disease in Eastern Africa (Stich et al, 2002; Barrett et al, 2003)
We found that almost all of the new cases were reported in Uganda and United Republic of Tanzania, and the number of cases in both countries accounted for over 80% of all cases from 1990 to 2007 (Fig. 2B, Table S2)

Summary

Introduction

Human African trypanosomiasis (HAT), known as sleeping sickness, is a neglected tropical disease, which is found in 36 African endemic countries (Simarro et al, 2010). During the period 2000–2010, more than 100 cases of HAT were reported in 19 non-disease endemic countries (DECs) (Simarro et al, 2012). We found that almost all of the new cases were reported in Uganda and United Republic of Tanzania, and the number of cases in both countries accounted for over 80% of all cases from 1990 to 2007 (Fig. 2B, Table S2).

Results

Conclusion