Sleeping sickness cases drop 93% from 2012-2023 in the Democratic Republic of the Congo
Officials in the Democratic Republic of the Congo (DRC) announced last week that efforts in the battle against Human African Trypanosomiasis, or sleeping sickness, in the country are bearing fruit as a 93 percent drop in cases were reported from 2012 to 2023.
Deputy Minister of Public Health, Serge Emmanuel Holenn said:
“The actions undertaken have been promising in reducing cases, going from 6,000 to 394 from 2012 to 2023 (a decrease in 5,606 cases). It must be emphasized that the results and progress are spectacular, but the desire to eliminate this pandemic remains the main objective. Thus, we invite our compatriots to make more efforts at each level, each as far as they are concerned (providers, population, political-administrative authorities, technical and financial partners) in order to raise the combined efforts and multiply the appropriate strategies in with a view to further influencing trends so that in 2030, HAT is eliminated in the DRC”.
Testing and treatment were highlighted. The establishment of provincial reference laboratories equipped to carry out quality tests, thus facilitating the detection and treatment of the rare remaining cases.
Currently, sleeping sickness is treated with Fexinidazole, the first fully oral medication approved for both stages of the disease.
Possibly by 2026, another drug, Acoziborole, a new single-dose oral treatment developed by DNDi could pave the way for eliminating the transmission of the disease.
The DRC accounts for more than 70% of cases in Africa and worldwide, with the most affected provinces are Kwilu, Kwango and Maï-Ndombe.
One of the true tropical diseases, African sleeping sickness is endemic only in sub-Sahara Africa bounded by 15° North and South latitudes.
Two varieties of African sleeping sickness exist: one primarily in East Africa caused by the parasite Trypanosoma brucei rhodesiense. T.B. rhodesiense produces an acute infection that will usually cause severe illness and death in weeks to months.
The other species is Trypanosoma brucei gambiense. This parasite is found in West and Central Africa. However, the 2 species are showing some geographic overlap.
This infection progresses more slowly and may require months to years for disease to occur.
Over 92% of cases are caused by T. b. gambiense and around 8% caused by T. b. rhodesiense
Both types of sleeping sickness are caused by the bite of a tse tse fly. These vicious little bugs depend on blood meals for its nutrients. It gets the blood from mammals including humans. The tse tse fly has a very painful bite and a traveler will certainly remember getting bit.
When taking a blood meal, the fly injects the parasite into the skin. From here the parasite is carried to the lymphatic system and eventually the bloodstream.
They go through stages in the body and eventually end up in the spinal fluid.
Symptoms are as follows:
• East African sleeping sickness: the development of a chancre at the bite site followed by fever, fatigue, aching muscles and joints and swollen lymph nodes are characteristic. After central nervous system (CNS) invasion neurological manifestations may occur followed by death if untreated.
• West African sleeping sickness: symptoms are similar to the above however taking longer to appear. Progressive confusion, personality changes, daytime sleepiness with nighttime sleep disturbances are late stage symptoms. Death will happen after several years if left untreated.
There is no vaccine for African trypanosomes. The Centers for Disease Control and Prevention recommends the following preventive measures:
1. Wear protective clothing, including long-sleeved shirts and pants. The tsetse fly can bite through thin fabrics, so clothing should be made of medium-weight material.
2. Wear neutral-colored clothing. The tsetse fly is attracted to bright colors and very dark colors.
3. Inspect vehicles for tsetse flies before entering. The tsetse fly is attracted to moving vehicles.
4. Avoid bushes. The tsetse fly is less active during the hottest period of the day. It rests in bushes but will bite if disturbed.
5. Use insect repellant. Though insect repellants have not proven effective in preventing tsetse fly bites, they are effective in preventing other insects from biting and causing illness.
Areas of heavy infestation tend to be sporadically distributed and are usually well known to local residents. Avoidance of such areas is the best means of protection.