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BMJ 2005;331 (26 November), doi:10.1136/bmj.331.7527.0-b
Two foci of sleeping sickness caused by two different pathogens, Trypanosoma brucei rhodesiense (which causes an acute form of disease) and T b gambiense (which causes the chronic form), have been steadily converging and might soon merge in Uganda, causing major problems in diagnosis and treatment, if much needed public health interventions are not put in place. Picozzi and colleagues (p 1238) used polymerase chain reaction analysis to examine blood samples of 231 patients presenting with sleeping sickness between 2001 and 2005; they found that the foci have converged since the mid-1980s and are now only 150 km apart. The authors call for preventive actions targeted at the disease reservoir in livestock and monitoring with molecular diagnostic tools in livestock and humans.
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