African trypanosomiasis: Comprehending the parasite pathogenesis in the brain

In this chapter we describe African trypanosomiasis or sleeping sickness, which is one of the neglected tropical diseases. Human African trypanosomiasis (HAT) is caused by two subspecies of Trypanosoma brucei, i.e., T. b. rhodesiense and T. b. gambiense, which are transmitted by tsetse flies in various areas of sub-Saharan Africa. Besides the health effects African trypanosomiasis causes a great economic impact as it also affects livestock and wild animals. We cover the epidemiology of the parasite and the disease, as well as the clinical features, diagnosis, and treatment of the disease. HAT is clinically divided into an early hemolymphatic stage and a late meningoencephalitic stage. Since the most devastating part of the disease occurs at later stages when the disease affects the CNS, the mechanisms of parasite invasion of the CNS, neuroinflammation and pathology in CNS and brain dysfunctions, mainly sleep pattern disruption, during trypanosomiasis are covered in more detail.