Current Treatments to Control African Trypanosomiasis and One Health Perspective

Abstract

Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reservoir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.

Keywords: animal African trypanosomiasis; antitrypanosomal drugs; drugs mechanism of action; human African trypanosomiasis; one health approaches.

Figure 2

Drugs used to treat HAT and their mechanisms of action are illustrated. The different targets and transporters have been reported [41,42,43,44,45,46,47]. Created with Biorender.com, agreement number PT23Y61FRT 22 May 2022.

Figure 2

Drugs used to treat HAT and their mechanisms of action are illustrated. The different targets and transporters have been reported [41,42,43,44,45,46,47]. Created with Biorender.com, agreement number PT23Y61FRT 22 May 2022.

Figure 3

Drugs used to treat AAT and their mechanisms of action are illustrated. The different targets and transporters are reported [41,42,43,44,45,46,63,64,65]. Created with Biorender.com, agreement number SY23SM5AX6 13 April 2022.

Figure 1

The transmission cycle and distribution of HAT (A) caused by T. b. gambiense has humans and domestic animals, especially pigs, as the main hosts. It is transmitted by the tsetse flies (Glossina sp.) of G. palpalis group and is distributed in Western and Central Africa (A,B). HAT caused by T. b. rhodesiense has wild animals and cattle as the main hosts. It is transmitted by G. morsitans and is distributed in Eastern and Southern Africa (A,C) [1]. (D). The map shows the distribution of the tsetse fly and cattle, AAT caused by T. congolense, and HAT caused by T. b. brucei. Each area of interest is within a colored line or with colored content as reported in the legend. The transmission between humans and animals causes a One Health problem (A,D). (Figure 1A,B were adapted with permission from references [1]. Copyright year 2022, Elsevier under the license number 5314910954512, 23 May 2022).