The re-emergence of sleeping sickness presents a major public health problem

Human African trypanosomiasis or sleeping sickness is one of the most important but equally most neglected tropical infections. It is caused by a protozoan, Trypanosoma brucei,which is transmitted to humans through the bite of a tsetse fly (Glossinaspp).1 Patchy distribution of the various vector species confines the disease to some 200 microfoci in sub-Saharan Africa (fig 1). The disease had been successfully controlled by a combination of approaches, including treatment of patients, active case finding, and measures to deal with the vector.2 Since the 1970s, however, the disease has re-emerged as a new epidemic of immense proportions, which, until recently, received little attention from the international community (fig 2). According to the World Health Organization, about 500 000 people already carry trypanosomes and will die if left untreated.3