Lejon Veerle, Lindner Andreas K, Franco Jose R
Intertryp, French National Research Institute for Sustainable Development, CIRAD, University of Montpellier, Montpellier, France.
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany.
Lancet. 2025 Mar 15;405(10482):937-950. doi: 10.1016/S0140-6736(25)00107-2.
Human African trypanosomiasis or sleeping sickness is caused by infection with Trypanosoma brucei gambiense or Trypanosoma brucei rhodesiense parasites, which are transmitted by tsetse flies in sub-Saharan Africa. Control of human African trypanosomiasis is based on case detection, treatment, and vector control. In the past decade, simple rapid diagnostic tests were introduced for gambiense human African trypanosomiasis, facilitating screening in primary health-care facilities. A new oral drug, fexinidazole, became the first-line treatment for gambiense human African trypanosomiasis without severe meningo-encephalitic disease, as well as for rhodesiense human African trypanosomiasis. Medical interventions, in some areas combined with tiny target-based vector control, have substantially reduced human African trypanosomiasis incidence, despite temporary disruptions to health-care systems. The elimination of human African trypanosomiasis as a public health problem has been achieved, and elimination of gambiense human African trypanosomiasis transmission is now targeted for 2030. Improved diagnostics and drugs, continued involvement of populations at risk of disease, health staff, national authorities, and partners and donors all contribute to achieve this goal.
人类非洲锥虫病，即昏睡病，是由布氏冈比亚锥虫或布氏罗得西亚锥虫寄生虫感染引起的，这些寄生虫在撒哈拉以南非洲由采采蝇传播。人类非洲锥虫病的控制基于病例检测、治疗和病媒控制。在过去十年中，针对冈比亚型人类非洲锥虫病引入了简单的快速诊断检测方法，便于在初级卫生保健机构进行筛查。一种新型口服药物非昔硝唑，成为无严重脑膜脑炎的冈比亚型人类非洲锥虫病以及罗得西亚型人类非洲锥虫病的一线治疗药物。尽管卫生保健系统受到暂时干扰，但在一些地区，医学干预措施与基于微小目标的病媒控制相结合，已大幅降低了人类非洲锥虫病的发病率。作为一个公共卫生问题，人类非洲锥虫病已被消除，目前目标是到2030年消除冈比亚型人类非洲锥虫病的传播。改进的诊断方法和药物、疾病高危人群、卫生工作人员、国家当局以及合作伙伴和捐助方的持续参与都有助于实现这一目标。
