Kenya achieves elimination of human African trypanosomiasis or sleeping sickness as a public health problem

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The World Health Organization (WHO) has validated Kenya as having eliminated human African trypanosomiasis (HAT) or sleeping sickness as a public health problem, making it the tenth country to reach this important milestone. HAT is the second neglected tropical disease (NTD) to be eliminated in Kenya: the country was certified free of Guinea worm disease in 2018.

HAT is a vector-borne disease caused by the blood parasite Trypanosoma brucei. It is transmitted to humans through the bites of tsetse flies that have acquired the parasites from infected humans or animals. Rural populations dependent on agriculture, fishing, animal husbandry or hunting are most at risk of exposure.

As the name indicates, HAT is transmitted only on the African continent. The disease exists in two forms, gambiense and rhodesiense. The rhodesiense form (r-HAT), which is found in eastern and southern Africa, is the only one present in Kenya. It is caused by Trypanosoma brucei rhodesiense and progresses rapidly, invading multiple organs including the brain. Without treatment, it is fatal within weeks.

A total of 57 countries have eliminated at least one NTD. Of these, 10 (including Kenya) have successfully eliminated HAT as a public health problem. The other countries that have reached this milestone are Benin, Chad, Côte d’Ivoire, Equatorial Guinea, Ghana, Guinea, Rwanda, Togo and Uganda.

The treatment choice depends on the disease form and the disease stage. The earlier the disease is treated, the better the prospect of cure. The assessment of treatment outcome requires follow up for up to 24 months with clinical assessment and laboratory exams including sometimes of cerebrospinal fluid, because parasites may remain viable and reproduce the disease many months after treatment.

Treatment in the second stage requires drugs that cross the blood–brain barrier.

WHO News, WHO

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