A new approach to tackle sleeping sickness

One small team, one big goal

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Human African trypanosomiasis (HAT), generally known as sleeping sickness, is a parasitic infection that occurs in sub-Saharan

Africa and is transmitted by tsetse flies. MSF has been actively engaged in controlling and treating sleeping sickness for the past 25 years. In that time MSF has screened 3,000,000 people and treated more than 50,000. Today, MSF continues to treat a significant number of all known cases, working together with national programmes. The organisation also plays an important role nationally and internationally advocating for increased access to diagnosis and treatment, and pushing for better research and development. 

Recently, MSF implemented a new approach to tackle sleeping sickness – the mobile HAT team. The international team, made up of a laboratory technician, a medical doctor, two logisticians and a project coordinator, work together with national doctors, nurses, laboratory staff, logisticians and community outreach workers, in countries with a high prevalence and/or historical foci of sleeping sickness to implement active village screening and treatment, along with training, surveillance, and advocacy.  The aim is simple: to save lives and work together with national programmes toward sustained elimination of the disease in the areas in which MSF is working. To date MSF’s mobile HAT team has worked in Central African Republic (CAR), Chad, and Republic of Congo, and is soon to work in South Sudan. MSF also runs ongoing HAT programmes in South Sudan, CAR, and Democratic Republic of the Congo (DRC).  

Active Screening – reaching those in need

The complex process of diagnosing sleeping sickness is a challenge in remote rural settings. MSF’s mobile HAT team moves from place to place taking blood screening directly into villages, so people do not have to travel to large hospitals to get tested. Those whose blood tests are positive must have a painful needle inserted in the spine, known as a lumbar puncture, to draw out cerebral fluid, and then laboratory facilities are needed to process the results.

The team was recently in Mboki, CAR, where they used land cruisers to traverse the countryside to reach isolated villages. There they erected makeshift clinics and laboratories out of plastic sheeting, and worked with village elders and community leaders to rally people to attend screening.  Each day, the team screened around 500 people in a village, directly starting treatment for those who tested positive.

Around 15 to 20 staff is needed to do a screening of this size, and they need sensitive laboratory equipment like centrifuges and microscopes. All this must be transported to remote rural places, many of which are affected by ongoing conflicts. This is a big challenge both medically and logistically. However, MSF shows that it can be done. With the right investment and capacity, lives can be saved both now and in the future.