article · PLoS Biology
Human African trypanosomiasis, known as African sleeping sickness, is a fatal condition across sub-Saharan Africa. Although the disease is nearing elimination in several regions, it has previously re-emerged despite seemingly low transmission rates. Understanding how disease hotspots persist despite this apparent transmission paradox is crucial for permanent eradication. An evaluation of clinical, laboratory, and mathematical data reveals that asymptomatic infections help drive transmission through an overlooked reservoir of parasites living in the skin. Together, asymptomatic individuals and individuals with detectable parasites in the blood can sustain transmission in areas that lack animal reservoirs. These findings indicate that existing public health guidelines, which currently advise against treating asymptomatic cases of human African trypanosomiasis, require reconsideration to prevent further disease resurgence.
Sleeping sickness remains a fatal threat across sub-Saharan Africa. Pinpointing how the infection hides in symptom-free carriers explains past disease resurgences and provides public health authorities with essential evidence to adapt intervention programmes, stop hidden transmission cycles, and achieve permanent disease elimination.
The research informs public health policy and intervention design, primarily targeted at health ministries and disease control programme managers working on sleeping sickness eradication. As the work consists of an evidence-based assessment of clinical, laboratory, and mathematical data advocating for revised treatment strategies, it sits at a conceptual policy stage rather than offering a near-market commercial tool.
AI-generated from the published abstract. Always read the original work before citing.
Human African trypanosomiasis (HAT), or African sleeping sickness, is a fatal disease found throughout sub-Saharan Africa. The disease is close to elimination in many areas, although it was similarly close to elimination once before and subsequently reemerged, despite seemingly low rates of transmission. Determining how these foci persisted and overcame an apparent transmission paradox is key to finally eliminating HAT. By assessing clinical, laboratory, and mathematical data, we propose that asymptomatic infections contribute to transmission through the presence of an overlooked reservoir of skin-dwelling parasites. Our assessment suggests that a combination of asymptomatic and parasitaemic cases is sufficient to maintain transmission at foci without animal reservoirs, and we argue that the current policy not to treat asymptomatic HAT should be reconsidered.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1371/journal.pbio.3000105
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
