Current knowledge on epidemiology and control of sleeping sickness.

African trypanosomiasis (sleeping sickness) occurs in some 200 known foci within tsetse inhabited areas in sub-saharan Africa, where an estimated 50 million people are at risk of acquiring infection. Only 25,000 new patients are reported each year but this is an underestimate. Where medical surveillance was inadequate or lacking, serious epidemics could occur and this potential risk makes the disease one of the serious health problems in sub-saharan Africa. The chronic gambiense form of sleeping sickness occurs in West and Central Africa, while the acute rhodesiense form occurs in East and Southern Africa. Recent advances in science have improved knowledge on the epidemiology of the disease and provided tools for improved diagnosis, treatment and vector control. The current strategy for control of the disease is based upon continuous suppression through diagnosis and treatment and limited vector control with community participation. Nevertheless, long-term solution to the problem of African trypanosomiasis lies in effective land-use management and rural development.