The human trypanosomiases (sleeping sickness and Chagas disease)

The African and American trypanosomiases remain major public health problems. Parasitological diagnosis is often difficult because of the low number of blood-stream trypanosomes present. A number of advances in diagnostic methods have been made recently, ranging from direct parasite detection to polymerase chain reaction-based methods. Vector control remains the most effective transmission control measure in most ecological situations for both types of disease. Chemotherapy and prophylaxis do not hold much promise, except in African trypanosomiasis where a new but expensive drug is now available, and there is better understanding of the pharmacological properties of the established drugs. Impressive advances in our understanding of human trypanosome biology are being made in many areas of study; whether these advances can be translated into improved control and treatment remains to be seen.