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African trypanosomiasis, also called African sleeping sickness, is a systemic disease caused by a parasite and transmitted by the bite of the tsetse fly. There are two types of the disease, named for the areas of Africa in which they are found. West African trypanosomiasis, which causes a chronic infection lasting years, is caused by the parasite Trypanosoma brucei gambiense. East African trypanosomiasis, which causes acute illness lasting several weeks, is caused by Trypanosoma brucei rhodesiense. Worldwide, almost 13,000 new cases of both East and West African trypanosomiasis are reported each year to the World Health Organization (WHO).
African trypanosomiasis is confined mainly to tropical Africa between 15 degrees North and 20 degrees South latitude. The greatest risks of contracting the disease occurs in parts of Eastern, Southeastern, and Central Africa, including:
West African trypanosomiasis can be contracted in parts of Western and Central Africa. Because tsetse flies inhabit rural areas only, living in woodland thickets of savanna and dense vegetation along streams, visitors to urban areas are generally not at risk.
The following are the most common symptoms of African trypanosomiasis. However, each individual may experience symptoms differently.
Symptoms, which occur within one to four weeks of infection, are often initially nonspecific and may include fever, skin lesions, rash, edema, or swollen lymph nodes on the back of the neck. The infection then generally progresses to meningoencephalitis. As the illness progresses, symptoms may include:
If left untreated, death will occur within several weeks to months. The symptoms of African trypanosomiasis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
There is no vaccine or recommended drug available to prevent African trypanosomiasis. Therefore, preventive measures should be aimed at avoiding insect bites. The Centers for Disease Control and Prevention (CDC) recommends the following:
See your physician as soon as possible if you suspect an infection. He/she will order several tests to detect the parasite. Common tests include blood samples and a spinal tap. A sample of chancre fluid or tissue, or fluid from swollen lymph nodes may also be taken.
Specific treatment for African trypanosomiasis will be determined by your physician based on:
Medication for the treatment of African trypanosomiasis is available. Hospitalization is necessary and periodic follow-up exams, which include a spinal tap, are generally necessary for about two years.