African Trypanosomiasis Sleeping Sickness

African trypanosomiasis, or sleeping sickness, is a fatal disease caused by a protozoan hemoflagellate parasite, the trypanosome. It is transmitted through the bite of a tsetse fly, a member of the genus Glossina. Sleeping sickness is endemic, sometimes epidemic, across a wide band of sub-Saharan Africa, the so-called tsetse belt that covers some 11 million square kilometers. Although the disease was not scientifically understood until the first decade of the twentieth century, it had been recognized in West Africa from the fourteenth century.

The chemotherapy to combat trypanosomiasis has remained archaic, with no significant advances made and, indeed, very little research done between the 1930s and the 1980s. Most of the victims are poor, rural Africans, which has meant that there is little or no economic incentive for pharmaceutical firms to devote research resources to the disease (Goodwin 1987). However, in the mid-1980s field trials of a promising new drug, Dl-alpha-difluoro-methylornithine (DFMO), demonstrated the drug's efficacy in late-stage disease when there is central nervous system involvement. In addition, there have been exciting recent developments in the field of tsetse eradication with the combined use of fly traps and odor attractants (Hall et al. 1984). And, the World Health Organization's Special Program on Tropical Disease is trying to overcome the research problem resulting from the reluctance of pharmaceutical firms to get involved.

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