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African Sleeping Sickness (Human African Trypanosomiasis)

Trypanosoma brucei infection transmitted by tsetse flies

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is African Sleeping Sickness (Human African Trypanosomiasis)?

Human African trypanosomiasis (HAT) is caused by two subspecies of the protozoan Trypanosoma brucei: T. b. gambiense (West and Central Africa, >95% of cases, chronic course over months to years) and T. b. rhodesiense (East and Southern Africa, acute course over weeks to months). Transmission occurs through bites of infected tsetse flies (Glossina genus).

Disease evolves through two stages. Stage 1 (hemolymphatic) presents with intermittent fever, headache, lymphadenopathy (Winterbottom's sign in posterior cervical chain), pruritus, hepatosplenomegaly, and a chancre at bite site. Stage 2 (meningoencephalitic) develops as parasites cross the blood-brain barrier, manifesting with sleep-wake cycle disruption, behavioral changes, motor abnormalities, ataxia, seizures, coma, and death without treatment.

Diagnosis includes blood smear, lymph node aspirate, serologic screening (CATT for gambiense), and lumbar puncture for staging (CSF white cells and trypanosomes). Treatment depends on stage and species: pentamidine or fexinidazole for stage 1 gambiense, suramin for stage 1 rhodesiense, NECT (nifurtimox-eflornithine combination) or fexinidazole for stage 2 gambiense, and melarsoprol for stage 2 rhodesiense (with significant arsenical toxicity).

Symptoms

Trypanosomal chancre at bite site
Intermittent fever and malaise
Posterior cervical lymphadenopathy (Winterbottom's sign)
Severe pruritus
Hepatosplenomegaly
Stage 2: somnolence, sleep cycle reversal
Behavioral changes, tremor, ataxia, coma

Risk Factors

Travel or residence in endemic Sub-Saharan Africa
Outdoor activities in tsetse fly habitat
Occupational exposure (forestry, hunting, fishing, farming)
Limited access to healthcare in rural areas
Wearing dark or bright blue clothing (attracts tsetse flies)
Game park visits in East Africa (rhodesiense risk)
Pregnancy (vertical transmission possible)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Fever after return from endemic Africa
  • Painful chancre at suspected fly bite site
  • Posterior cervical lymphadenopathy with epidemiologic exposure
  • Severe pruritus with travel history
  • Behavioral changes, somnolence, or sleep disturbance
  • Neurologic symptoms post-travel
  • Pregnancy with travel history to endemic area

Treatment Methods

01
Blood smear, buffy coat, lymph node aspirate
02
Serologic screening (CATT for gambiense)
03
Lumbar puncture for staging (CSF analysis)
04
Stage 1 gambiense: pentamidine or fexinidazole
05
Stage 1 rhodesiense: suramin
06
Stage 2 gambiense: NECT or fexinidazole
07
Stage 2 rhodesiense: melarsoprol (with monitoring for encephalopathy)

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.