Views & Reviews Review of the Week

The sleeping giant

BMJ 2008; 336 doi: (Published 17 January 2008) Cite this as: BMJ 2008;336:159
  1. Brian Greenwood, professor of tropical medicine, London School of Hygiene and Tropical Medicine
  1. Brian.Greenwood{at}

    Overshadowed by AIDS, tuberculosis, and malaria, the tropical disease sleeping sickness has been wrongly neglected, a new book claims. Brian Greenwood reports

    An unintended consequence of the effort to control AIDS, tuberculosis, and malaria has been relative neglect of other major tropical infectious diseases, such as schistosomiasis, leishmaniasis, and trypanosomiasis. Together these infections are responsible for nearly as many deaths as malaria causes. The efforts of advocacy groups and media attention have resulted in widespread recognition among the public of AIDS, tuberculosis, and malaria, but there is little awareness of the continuing presence of major parasitic infections such as African trypanosomiasis. Trypanosome infections in humans are called sleeping sickness, because in the terminal phases of the infection patients often become comatose, sleeping all the time. However, in earlier phases of the disease the patient may have many other neurological signs and mood disturbances.

    Trypanosome infections are still important in large parts of sub-Saharan Africa, because of the direct effect on people of the West African (Gambian) or East African …

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