RT Book, Section A1 Van Den Abbeele, Jan A2 Boulton, Matthew L. A2 Wallace, Robert B. SR Print(0) ID 1182666477 T1 Human African Trypanosomiasis T2 Maxcy-Rosenau-Last Public Health & Preventive Medicine, 16e YR 2022 FD 2022 PB McGraw Hill PP New York, NY SN 9781259644511 LK accessmedicine.mhmedical.com/content.aspx?aid=1182666477 RD 2024/03/28 AB Human African trypanosomiasis (HAT), or sleeping sickness, is a vector-borne parasitic disease that is restricted to sub-Saharan Africa. It is caused by extracellular protozoa belonging to the genus Trypanosoma, which are transmitted by the bite of a blood-feeding insect, the tsetse fly (Diptera; Glossina). Two human-pathogenic subspecies of trypanosomes, T. brucei gambiense and T. brucei rhodesiense, cause different forms of the disease: the slow-progressing form (gambiense-HAT) which is endemic in western and central Africa, and the faster progressing form (rhodesiense-HAT) found in eastern and southern Africa.1 About 97% of cases of HAT are due to T. b. gambiense. HAT still has a severe social and economic impact in various countries in sub-Saharan Africa, with an estimated 55 million people at risk and over 10 million people living in areas where gambiense-HAT is considered a public health problem.2 Sleeping sickness has been responsible for devastating epidemics in the twentieth century. However, due to increased disease surveillance efforts and large-scale use of control tools, major improvements have been achieved during the last two decades. Today, the number of newly reported cases is low. The World Health Organization (WHO) has targeted the elimination of HAT as a public health problem by 2020 with a target of fewer than 2000 reported cases per year.2–5 For T. b. rhodesiense-HAT, sporadic cases are diagnosed outside endemic African countries, mainly among travelers from Europe and the United States returning from visits to east African game parks, as well as expatriates and migrants.5–8