{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:35:10Z","timestamp":1791272110356,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,8,28]],"date-time":"2008-08-28T00:00:00Z","timestamp":1219881600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2008,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Human African trypanosomiasis, also known as sleeping sickness, is a neglected disease, and it continues to pose a major threat to 60 million people in 36 countries in sub\u2010Saharan Africa. Transmitted by the bite of the tsetse fly, the disease is caused by protozoan parasites of the genus <jats:italic>Trypanosoma<\/jats:italic> and comes in two types: East African human African trypanosomiasis caused by <jats:italic>Trypanosoma brucei rhodesiense<\/jats:italic> and the West African form caused by <jats:italic>Trypanosoma brucei gambiense.<\/jats:italic> There is an early or hemolymphatic stage and a late or encephalitic stage, when the parasites cross the blood\u2013brain barrier to invade the central nervous system. Two critical current issues are disease staging and drug therapy, especially for late\u2010stage disease. Lumbar puncture to analyze cerebrospinal fluid will remain the only method of disease staging until reliable noninvasive methods are developed, but there is no widespread consensus as to what exactly defines biologically central nervous system disease or what specific cerebrospinal fluid findings should justify drug therapy for late\u2010stage involvement. All four main drugs used for human African trypanosomiasis are toxic, and melarsoprol, the only drug that is effective for both types of central nervous system disease, is so toxic that it kills 5% of patients who receive it. Eflornithine, alone or combined with nifurtimox, is being used increasingly as first\u2010line therapy for <jats:italic>gambiense<\/jats:italic> disease. There is a pressing need for an effective, safe oral drug for both stages of the disease, but this will require a significant increase in investment for new drug discovery from Western governments and the pharmaceutical industry. Ann Neurol 2008;64:116\u2013126<\/jats:p>","DOI":"10.1002\/ana.21429","type":"journal-article","created":{"date-parts":[[2008,9,17]],"date-time":"2008-09-17T08:23:30Z","timestamp":1221639810000},"page":"116-126","source":"Crossref","is-referenced-by-count":186,"title":["The continuing problem of human African trypanosomiasis (sleeping sickness)"],"prefix":"10.1002","volume":"64","author":[{"given":"Peter G. E.","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,8,28]]},"reference":[{"key":"e_1_2_9_2_2","volume-title":"The fatal sleep","author":"Kennedy PGE","year":"2007"},{"key":"e_1_2_9_3_2","unstructured":"Epidemiology and control of African trypanosomiasis.Report of a WHO expert committee. 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