Sleeping Sickness

MSF lab tech team retests blood samples after the first screening show potential signs of sleeping sickness in a remote village outside of Kajo Keji, South Sudan. Over 500 people arrived this day by foot in order to have their blood tested for sleeping sickness with three cases confirmed positive. For centuries, sleeping sickness, or Human African Trypanosomiasis (HAT), caused havoc in isolated reaches of Africa, preying on people with no access to medical care or those unaware of the biological dangers they faced when wading into a foreign land.Sleeping sickness is endemic in 36 African countries and around 60 million people are at risk of being infected. Spread by the bite of a tsetse fly, the disease was signaled by the onset of fever, headaches, and joint pain, followed by disorientation and profound fatigue that makes it difficult to stay awake—hence the name sleeping sickness.Sustained efforts to fight the disease have been largely successful, but there remain “hot spots” and “blind spots” in Central and West Africa, particularly in areas where conflict reigns but medical coverage and disease surveillance are weak. (Seventeen sub-Saharan Africa countries reported cases in 2009, for instance, and the Democratic Republic of Congo alone recorded three-quarters of all known cases.)Between 1986 and 2010, MSF teams in several countries screened nearly 3 million people and treated more than 51,000 for the disease. At present, MSF has sleeping sickness programs in several other African countries as well. Collectively, this experience has made clear the need not only for ongoing vigilance, but also for new and easier diagnostic tests and shorter, more adaptable treatment regimens for patients.VII Photo’s John Stanmeyer joined one of MSF’s mobile HAT teams, which was designed to augment fixed-site screening and treatment activities in Central Africa, allowing him a firsthand look at the modern-day effort to battle this age-old scourge.

Sleeping sickness, or human African trypanosomiasis, is a parasitic infection which attacks the body’s central nervous system; without treatment the disease is fatal.

Considered a neglected disease, there are two forms of sleeping sickness, caused by two different parasites: Trypanosoma brucei gambiense, which is found in western and central Africa accounts for 98 per cent of cases; Trypanosoma brucei rhodesiense, accounts for less than two percent of cases and is found in eastern and southern Africa. Both parasites are transmitted by the bite of the tsetse fly.

The disease causes severe neurological conditions, including poor coordination, confusion, agitation, aggressiveness or disinhibition. The more commonly-known name of the disease, sleeping sickness, derives from the symptom where patients experience an inability to sleep during the night but are often overcome by sleep during the day.