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Sleeping sickness
A tsetse fly on the skin of a domestic animal
Information
Region (s)	Sub-Saharan Africa
Cause	Parasitosis (Trypanosoma)
Vector	Tsetse fly
Contagiousness	no
CIM-10	B56
CIM-9	086.5
Prophylaxis:
* vaccine	no
* medication	no
Therapy:	Yes
Location
Regions at risk in 2015      Raised      Way      Low      No
Medical warning
edit

The African trypanosomiasis, more commonly called sleeping sickness, is a parasitosis, essentially specific to certain regions of sub-Saharan Africa, transmitted by the bite of a female hematophagous fly (which feeds on blood): the tsetse fly (Glossina) better known as the "tsetse fly". Tse-tse comes from the word tsetse which means "fly that kills cattle" in Tswana, a language spoken in Botswana and in the North West Province in South Africa.

Understand

The culprit parasite is a dixene flagellate protozoan (i.e. requiring an intermediate host and a definitive host during its life cycle) called a trypanosome (Trypanosoma brucei). Here, the definitive host is the human being. Its size is 20 µm long by 2 to 3 µm wide and it is fully mobile thanks to its flagellum. Two subspecies are responsible for all pathogenic cases in humans: Trypanosoma brucei gambiense, responsible for 98% of cases, which is rife in West Africa and in central Africa and induces chronic disease while Trypanosoma brucei rhodesiense, responsible for 2% of cases, is rife in East Africa and in Southern Africa and induces acute illness. Only theUganda is affected by both subspecies of trypanosomes.

One of the major problems in being able to treat this disease quickly is that the incubation phase can range from a few weeks to a few months, or even a few years for T. brucei gambiense, and that from the start of the invasion phase, the protozoan invades the central nervous system of its host.

Location

Formerly widespread throughout subtropical Africa and to a lesser extent in North Africa, the disease was strongly fought from the beginning of the years 2000. Important foci remain however localized in Republic of Congo, in Democratic Republic of Congo, in Uganda and at South sudan as well as a certain upsurge in the south of Somalia. While some countries have not registered any new cases since 2005, the possibility of seeing this infection reappear is great because of the flow of populations fleeing areas of famine or war and, most often, accompanied by meager livestock. So the Kenya which had succeeded in eradicating the disease, thanks among other things to the technique of breeding sterile males in its parks and nature reserves, sees it again appearing on its borders with South Sudan and Somalia and, more particularly, around the refugee camps of Dadaab (Eastern Kenya) and Kakuma (Great North Rift Valley). The same goes for theEthiopia with the many camps set up north of the city of Dolo (Somali) in the Juba Valley.

Vector protection

Avoiding sleeping sickness means first of all avoiding tsetse fly bites when you go to a rural area, to a nature reserve or to a place with thick vegetation by taking a few precautions:

• wearing clothing covering the legs and arms with thick enough fabric, the insect's rostrum is strong enough to pass through light fabrics, of pale colors and blending, if possible, with the environment. Wear closed shoes or boots. Wear a hat ;
• do not get too close to herds of bovids (domestic or wild), especially in East Africa where they constitute the main reservoir of the insect;
• when leaving a vehicle, close doors and windows or, in the case of an open vehicle, inspect it before returning to the vehicle; the tsetse fly is attracted to the movement of dust.

Traps

There are two fairly simple ways to trap the tsetse fly:

• buy a horsefly trap (approximately 200 € (~ 221.03 Fr. - price of 04/27/2021) (~ C $ 299.45 - price of 04/27/2021) (~ $ 241.46 - class on 04/27/2021) (~ 131,121.21 F CFA - price of 04/27/2021)) and install it hanging from a branch. It is a dark ball surmounted by a mosquito net in the shape of an inverted cone, the tsetse taking flight upwards is then trapped by the mosquito net;
• less expensive, take a piece of synthetic fabric (so that the impregnated product does not wash off too quickly) bright blue (electric blue) or dark (royal blue), impregnate it with acetone to further increase the attractiveness and, above all, imbue it with pyrethroid which will create a shock action on the tsetse fly (Knock Down) killing it or, at worst, neutralizing it directly.

Recognize the aggressor

The tsetse fly is the size of a bee, is gray-brown in color and is active during the day. It does not have a single pair of wings used for locomotion. The sting is felt like a hot needle stuck into the flesh.

Parasite protection

There is currently no vaccine or prophylactic drug to protect against trypanosome.

Diagnostic

Symptoms

Clinical signs

Therapy

Possible consequences

Remarks

• The parasite can be transmitted from mother to fetus by crossing the placental barrier with a risk of perinatal death.
• Having unprotected sex with someone who has the condition could also transmit the parasite. However, the few proven and recognized cases, although they have been documented, have never been followed up with an in-depth study.

Further information

• Health topics, African trypanosomiasis  – The sleeping sickness page on the WHO website. (last update March 2018)

See as well

• Chagas disease