Human African trypanosomiasis is a debilitating disease prevalent in rural sub-Saharan Africa. Control of this disease almost exclusively relies on chemotherapy that should be driven by accurate diagnosis, given the unacceptable toxicity of the few available drugs. Unfortunately, the available diagnostics are characterised by low sensitivities due to the inherent low parasitaemia in natural infections. Demonstration of the trypanosomes in body fluids, which is a prerequisite before treatment, often follows complex algorithms. In this paper, we review the available diagnostics and explore recent advances towards development of novel point-of-care diagnostic tests. 1. Introduction Human African trypanosomiasis (HAT), also known as sleeping sickness, is a parasitic disease caused by flagellated protozoa of the genus Trypanosoma. Transmitted by the Tsetse fly (Glossina sp), HAT is endemic in rural sub-Saharan Africa that offers suitable habitat for the vectors, mainly riverine forests and savanna. The disease occurs in two forms, namely, the chronic type attributed to T. brucei gambiense (Gambian sleeping sickness) that is prevalent in central and west Africa as well as the acute (Rhodesian) form due to T. b. rhodesiense in east and southern Africa. HAT has been a major public health problem since colonial times when it wiped out entire villages in hard to reach areas of Africa. This situation was reversed through vigorous mass screening campaigns and vector control. However, during the wave of political instability and civil strife that swept sub-Saharan Africa in the later part of the last century, there was an upsurge in HAT incidence. Out of the known 36 endemic countries, over 90% of the cases were reported from Angola, Democratic Republic of Congo, southern Sudan and Uganda. Presently, HAT incidence has registered a steady decline over the past decade. Previous estimates indicated an annual incidence of about 70,000 cases [1, 2]; in 2006, the DRC had the highest incidence reported as 8,023 followed by Angola (1,105) out of the overall 11,382 for that year [3]. By 2009, the numbers had dwindled even further [4]. Although there may be underreporting, this trend indicates that elimination of HAT is within reach, at least in a few countries that continue to report no cases. The disease is invariably fatal if left untreated and progresses through 2 stages: the early hemolymphatic stage, also known as stage I and the late meningoencephalitic stage (stage II) when the trypanosomes penetrate beyond the blood-brain-barrier. In addition, HAT exhibits 2 distinct
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