African Trypanosomiasis - Prevention

Prevention

Two alternative strategies have been used in the attempts to reduce the African trypanosomiases. The primary method focuses on the eradication of the tsetse fly, which disrupts transmission rates by reducing the number of flies. Instances of sleeping sickness are being reduced by the use of the sterile insect technique. The second tactic is primarily medical or veterinary, and tries to reduce spread of the parasite by monitoring, prophylaxis, treatment, and surveillance to reduce the number of people or animals who carry the disease.

Regular active surveillance, involving detection and prompt treatment of new infections, and tsetse fly control is the backbone of the strategy used to control sleeping sickness. Systematic screening of at-risk communities is the best approach, because case-by-case screening is not practical in endemic regions. Systematic screening may be in the form of mobile clinics or fixed screening centres where teams travel daily to areas of high infection rates. Such screening efforts are important because early symptoms are not evident or serious enough to warrant patients with gambiense disease to seek medical attention, particularly in very remote areas. Also, diagnosis of the disease is difficult and health workers may not associate such general symptoms with trypanosomiasis. Systematic screening allows early-stage disease to be detected and treated before the disease progresses, and removes the potential human reservoir. A single case of sexual transmission of West African sleeping sickness has been reported, but this is not believed to be an important route of transmission.