人类非洲锥虫病（昏睡病）——流行病学、临床表现、诊断、治疗及预防
Human African Trypanosomiasis (Sleeping Sickness)-Epidemiology, Clinical Manifestations, Diagnosis, Treatment, and Prevention.
作者信息
Ortiz-Martínez Yeimer, Kouamé Menan Gérard, Bongomin Felix, Lakoh Sulaiman, Henao-Martínez Andrés F
机构信息
Department of Internal Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia.
Programme PAC-CI, CHU de Treichville, Abidjan, Ivory Coast.
出版信息
Curr Trop Med Rep. 2023 Dec;10(4):222-234. doi: 10.1007/s40475-023-00304-w. Epub 2023 Oct 25.
PURPOSE OF REVIEW
Human African Trypanosomiasis (HAT), also known as sleeping sickness, is a vector-borne parasitic neglected tropical disease (NTD) endemic in sub-Saharan Africa. This review aims to enhance our understanding of HAT and provide valuable insights to combat this significant public health issue by synthesizing the latest research and evidence.
RECENT FINDINGS
HAT has reached a historical < 1000 cases in 2018. In patients without neurologic symptoms and signs, the likelihood of a severe meningoencephalitic stage is deemed low, obviating the need for a lumbar puncture to guide treatment decisions using fexinidazole.
SUMMARY
Both forms of the disease, gambiense HAT (gHAT) and rhodesiense HAT (rHAT), have specific epidemiology, risk factors, diagnosis, and treatment. Disease management still requires a high index of suspicion, infectious disease expertise, and specialized medical care. Essential stakeholders in health policy are critical to accomplishing the elimination goals of the NTD roadmap for 2021-2030.
综述目的
人类非洲锥虫病（HAT），又称昏睡病，是一种由媒介传播的寄生虫性被忽视热带病（NTD），在撒哈拉以南非洲地区流行。本综述旨在通过综合最新研究和证据，增进我们对HAT的理解，并为应对这一重大公共卫生问题提供有价值的见解。
最新发现
2018年HAT病例数已降至历史最低水平，不足1000例。对于没有神经症状和体征的患者，出现严重脑膜脑炎阶段的可能性被认为较低，因此无需进行腰椎穿刺来指导使用非昔硝唑的治疗决策。
总结
冈比亚型HAT（gHAT）和罗德西亚型HAT（rHAT）这两种形式的疾病都有特定的流行病学、危险因素、诊断方法和治疗方式。疾病管理仍需要高度的怀疑指数以及传染病专业知识和专门的医疗护理。卫生政策中的关键利益相关者对于实现2021 - 2030年NTD路线图的消除目标至关重要。
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