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Human African trypanosomiasis in non-endemic countries (2000-2010)
Pere P Simarro1, José R Franco, Giuliano Cecchi
1World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland. simarrop@who.int
Journal of Travel Medicine
|January 7, 2012
Summary
Human African trypanosomiasis (HAT) poses diagnostic challenges in non-endemic countries. Early diagnosis and awareness are crucial for travelers and migrants to prevent severe outcomes.
Area of Science:
- Medical Parasitology
- Global Health
- Travel Medicine
Background:
- Human African trypanosomiasis (HAT) affects travelers and migrants, presenting diagnostic challenges in non-disease endemic countries (non-DECs).
- Diagnosis is complicated by the rarity of cases and lack of awareness among healthcare professionals in non-DECs.
Purpose of the Study:
- To analyze reported cases of HAT in non-DECs between 2000 and 2010.
- To highlight diagnostic difficulties and outcomes for HAT patients in non-DEC settings.
Main Methods:
- Bibliographic research and case data collection from the World Health Organization (WHO).
- Analysis of epidemiological and clinical data for HAT cases reported in non-DECs.
Main Results:
- 94 HAT cases were reported in 19 non-DECs (2000-2010), predominantly the Rhodesiense form (72%) in short-term travelers.
- Rhodesiense HAT was often misdiagnosed as malaria or tick-borne diseases; Gambiense HAT (28%) affected long-term expatriates/migrants and was diagnosed later, often in second stage.
- Misdiagnosis was frequent, leading to delayed treatment and increased disease severity.
Conclusions:
- The risk of HAT in travelers and migrants, though low, requires attention in non-DECs.
- Diagnostic challenges in non-DECs include rarity, nonspecific symptoms, and limited healthcare staff awareness, leading to misdiagnosis and increased fatality risk.
- WHO's centralized drug distribution supports an HAT surveillance system in non-DECs, crucial for monitoring disease transmission.
