Central African Republic: Treating sleeping sickness, a neglected disease
As 11-year-old Natacha tosses and turns on a hospital bed in a village in Central African Republic (CAR), her parents sit close by, filled with worry. A doctor and nurse from Médecins Sans Frontières (MSF) are preparing to treat their daughter for sleeping sickness (human African trypanosomiasis), a tropical disease that penetrates the liquid around the brain and is fatal if not treated quickly enough.
Natacha Minissale first showed symptoms three months earlier. But armed groups were roaming the area, making all travel risky. So her parents delayed seeking treatment. As her condition worsened, her parents heard through the village leader that MSF doctors were in the nearby town of
Sleeping sickness is transmitted by the tsetse fly, which is mainly found in central
Mobile sleeping sickness team
MSF’s mobile sleeping sickness team spent 18 days in early July screening and treating people for the disease in Mboki, in CAR’s Haut M'boumou region. In the week before screening started, community health workers, with the help of local authorities, travelled around the area raising awareness of the disease and passing on the message that free testing and treatment was available.
Since 2006, monitoring and controlling sleeping sickness in the remote and inaccessible southeast of
During their 18 days in Mboki, MSF staff screened 4,534 people. Thirty were suspected of carrying the disease and six cases were confirmed. Currently, the most common treatment for the disease is nifurtimox-eflornithine combination therapy (NECT) which, while an improvement on previous treatments, is still complicated to administer, requiring multiple injections and close patient monitoring – things which are frequently unavailable in sub-Saharan Africa.
Number of cases dropped but obstacles remain
One of those diagnosed in Mboki was Marie Claire, a young woman in the early stages of pregnancy. To protect her unborn child from the toxic drugs, she will not start treatment until the second trimester of her pregnancy. In the meantime, MSF staff based permanently in Haut M'boumou will monitor her closely. "For now she is in good health, but sleeping sickness is a chronic disease and she will need to be evaluated weekly," says Brian d’Cruz, a doctor of the MSF mobile team.
Marie Claire is fortunate in that she was diagnosed before the disease had done permanent damage. But for others, treatment comes too late. Tragically, 11-year-old Natacha died two days after arriving at Mboki hospital.
MSF’s sleeping sickness specialists are determined that deaths like Natacha’s will soon be something of the past, and that the disease will be reduced in central
Until sleeping sickness is finally banished, MSF will continue to work on improving access to quality care of the people suffering from this neglected but devastating disease.