Sleeping Sickness Prevention: Protecting Yourself from African Trypanosomiasis

African trypanosomiasis (sleeping sickness) is caused by Trypanosoma brucei (gambiense: West/Central Africa; rhodesiense: East/Southern Africa), transmitted by tsetse flies (Glossina spp.). Prevention targets the vector, reservoir, and human behavior.

Vector Control (Primary Strategy)

• Tsetse Traps/Targets: Blue/black cloth + attractants (acetone, octenol, cow urine). Insecticide-impregnated. Reduce fly density 90%+.
• Insecticide-Treated Cattle (ITC): Pour-on pyrethroids on livestock (reservoir for T.b. rhodesiense). Kills feeding flies.
• Aerial/Ground Spraying: Sequential aerosol technique (SAT) for emergency suppression.
• Sterile Insect Technique (SIT): Release irradiated males; used in Zanzibar eradication.

Personal Protection

• Wear long sleeves, pants, neutral colors (tsetse attracted to blue/black).
• Insect repellent: DEET (20–30%), picaridin, IR3535. Limited efficacy against tsetse.
• Permethrin-treated clothing.
• Avoid bush/riverine areas during peak fly activity (mid-morning, late afternoon).

Surveillance & Case Management

• Active Screening: Mobile teams in endemic foci (CATT test for T.b. gambiense).
• Passive Surveillance: Health facility diagnosis (microscopy, RDTs).
• Prompt Treatment: Fexinidazole (oral, both stages gambiense), pentamidine (early), nifurtimox-eflornithine (NECT), melarsoprol (late rhodesiense).

One Health & Elimination

WHO targets elimination of transmission by 2030. Requires integrated vector control, surveillance, community engagement, and cross-border coordination. Animal reservoir control critical for rhodesiense.