DO YOU KNOW ABOUT SLEEPING SICKNESS? HERE IS IT, WHERE AND ITS TREATMENT

DO YOU KNOW ABOUT SLEEPING SICKNESS? HERE IS IT, WHERE AND ITS TREATMENT

The majority of patients with sleeping sickness live in the Democratic Republic of Congo, where 85% of cases caused by the parasite Trypanosoma brucei gambiense were concentrated in 2017.

Then come the Central African Republic, Guinea and Chad. The latest data published by the WHO in July 2018 confirms the decline in the number of new cases. Only 1,447 new cases were notified to WHO in 2017, compared to 2,164 in 2016 and 9,870 in 2009.

The history of this disease is however marked by resurgences, followed by several decades during which it seems largely under control.

The WHO Roadmap for Neglected Tropical Diseases, published in 2012 and supported the same year by the London Declaration, listed sleeping sickness as one of the diseases to be tackled and plans to achieve its elimination as as a public health problem by 2020.

In this perspective, therefore, the Democratic Republic of Congo (DRC) has issued a marketing authorization for fexinidazole for the treatment of Human African Trypanosomiasis (HAT) or sleeping sickness caused by the parasite Trypanosoma brucei gambiense.

This approval paves the way for the distribution of fexinidazole this year in countries where sleeping sickness is endemic, with another regulatory submission expected in Uganda as well.

Sleeping sickness is usually fatal if left untreated. Transmitted by the bite of a tsetse fly, it is characterized by neuropsychiatric symptoms such as aggressive behavior, psychosis and disabling sleep disturbances, hence the name given to this neglected disease.

About 65 million people are threatened by this disease in sub-Saharan Africa.

The current treatment for sleeping sickness, although effective, is very restrictive for patients and health workers because it requires hospitalization of patients, raising significant logistical difficulties, in particular for people living in regions remote.

Fexinidazole is approved in the Democratic Republic of the Congo once a day for 10 days for the treatment of sleeping sickness caused by the Tb gambiense parasite (the most common form, which is found in African countries West and Central Africa).

It is above all the first treatment entirely by oral route which acts against both 1) the early phase of the disease and 2) its second phase, when the parasite has crossed the blood-brain barrier causing the appearance of neuropsychiatric symptoms. Fexinidazole could therefore eliminate routine hospitalizations of patients.

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