Travel Clinics and Division of Tropical Medicine and Imported Diseases, Department of Internal Medicine and Tropical Diseases, University Hospital Centre, Bordeaux, France.
Clin Microbiol Infect. 2011 Jul;17(7):986-95. doi: 10.1111/j.1469-0691.2011.03536.x.
Human African trypanosomiasis (HAT), or sleeping sickness, is a vector-borne disease that flourishes in impoverished, rural parts of sub-Saharan Africa. It is caused by infection with the protozoan parasite Trypanosoma brucei and is transmitted by tsetse flies of the genus Glossina. The majority of cases are caused by T. b. gambiense, which gives rise to the chronic, anthroponotic endemic disease in Western and Central Africa. Infection with T. b. rhodesiense leads to the acute, zoonotic form of Eastern and Southern Africa. The parasites live and multiply extracellularly in the blood and tissue fluids of their human host. They have elaborated a variety of strategies for invading hosts, to escape the immune system and to take advantage of host growth factors. HAT is a challenging and deadly disease owing to its complex epidemiology and clinical presentation and, if left untreated, can result in high death rates. As one of the most neglected tropical diseases, HAT is characterized by the limited availability of safe and cost-effective control tools. No vaccine against HAT is available, and the toxicity of existing old and cumbersome drugs precludes the adoption of control strategies based on preventive chemotherapy. As a result, the keystones of interventions against sleeping sickness are active and passive case-finding for early detection of cases followed by treatment, vector control and animal reservoir management. New methods to diagnose and treat patients and to control transmission by the tsetse fly are needed to achieve the goal of global elimination of the disease.
人类非洲锥虫病（HAT），又称昏睡病，是一种由原生动物寄生虫布氏锥虫引起的媒介传播疾病，主要流行于撒哈拉以南非洲的贫困农村地区。该疾病通过采采蝇属的采采蝇传播。大多数病例是由布氏冈比亚锥虫引起的，它导致了西非和中非的慢性、人际传播的地方性疾病。感染布氏罗得西亚锥虫会导致东非和南非的急性、人畜共患形式。寄生虫在其人类宿主的血液和组织液中体外生存和繁殖。它们已经发展出多种策略来入侵宿主，逃避免疫系统，并利用宿主生长因子。由于其复杂的流行病学和临床表现，昏睡病是一种具有挑战性和致命性的疾病，如果不治疗，可能导致高死亡率。作为最被忽视的热带病之一，昏睡病的特点是安全且具有成本效益的控制手段有限。目前尚无针对昏睡病的疫苗，现有的老旧药物毒性大，这使得基于预防性化疗的控制策略无法采用。因此，针对昏睡病的干预措施的关键是主动和被动的病例发现，以便早期发现病例，随后进行治疗、媒介控制和动物储存管理。需要新的方法来诊断和治疗患者，并控制采采蝇传播，以实现全球消除该疾病的目标。
