Importancia de la tripanosomiasis africana para Cuba / Importance of African Trypanosomiasis for Cuba

Introducción: La tripanosomiasis africana humana es producida por protozoos del género Trypanosoma y transmitida fundamentalmente por la picadura de la mosca tse-tsé. En el último siglo ha habido varias epidemias en el África, pero dado que el número de nuevos casos notificados había disminuido, la hoja de ruta de la OMS para las enfermedades tropicales desatendidas fijó el objetivo de su eliminación como problema de salud pública para 2020. Muchos de los países donde Cuba presta colaboración internacionalista son endémicos, por lo que los colaboradores están expuestos al riesgo de padecer y enfrentar esta enfermedad. Objetivo: Realizar una actualización clínica y epidemiológica de la entidad para alertar sobre la posibilidad de la aparición en áreas endémicas y la presencia de casos importados en Cuba. Métodos: Se realizó una revisión bibliográfica en la base de datos Medline/PubMed y en artículos relevantes relacionados con el tema, de los últimos años; también hemos tomado como referencia las notas descriptivas de tripanosomiasis africana de la OMS en el 2020, así como textos clásicos de medicina interna y la plataforma búsqueda ClinicalKey. Información, análisis y síntesis: Se hizo una detallada exposición de la enfermedad y la conducta terapéutica; una breve reseña de los casos importados y del país de procedencia, además del peligro que presenta la aparición de casos importados para Cuba. Conclusiones: La enfermedad es una entidad potencialmente mortal, endémica en países donde existe colaboración cubana. Es necesario tener presente el diagnóstico de esta enfermedad para un abordaje terapéutico adecuado(AU)

Introduction: Human African trypanosomiasis is produced by protozoa of the genus Trypanosoma and transmitted mainly by the bite of the tsetse fly. There have been several epidemics in Africa in the last century, but as the number of new reported trypanosomiasis cases has decreased, the WHO roadmap for neglected tropical diseases had targeted their elimination as a public health problem by 2020. Many of the countries where Cuba provides internationalist collaboration are endemic, so the collaborators are exposed to the risk of suffering and facing this disease. Objectives: To carry out a clinical and epidemiological update of the entity and warn about the possibility of the appearance in endemic areas and the presence of imported cases in Cuba. Methods: a bibliographic review was carried out in the Medline / Pub Med database and in relevant articles related to the subject, from recent years; we have taken the 2020 WHO African Trypanosomiasis descriptive notes as a reference, as well as classic internal medicine texts and the ClinicalKey search platform. Information, Analysis and Synthesis: A detailed exposition of the disease and the therapeutic behavior was made; a brief review of imported cases and the country of origin, in addition to the danger posed by the appearance of imported cases for Cuba. Conclusions: This is a potentially fatal entity, endemic in countries where there is Cuban collaboration. It is necessary to bear in mind the diagnosis of this disease for an adequate therapeutic approach(AU)

Contemporary and emerging strategies for eliminating human African trypanosomiasis due to Trypanosoma brucei gambiense: review.

OBJECTIVES: To review current and emerging tools for Gambiense HAT control and elimination, and propose strategies that integrate these tools with epidemiological evidence. METHODS: We reviewed the scientific literature to identify contemporary and emerging tools and strategies for controlling and eliminating Gambiense HAT. Through an iterative process involving key stakeholders, we then developed comprehensive scenarios leading to elimination, considering both established and new tools for diagnosis, case treatment and vector control. RESULTS: Core components of all scenarios include detecting and treating cases with established or emerging techniques. Relatively more intensive scenarios incorporate vector control. New tools considered include tiny targets for tsetse fly control, use of rapid diagnostic tests and oral treatment with fexinidazole or oxaboroles. Scenarios consider the time when critical new tools are expected to become ready for deployment by national control programmes. Based on a review of the latest epidemiological data, we estimate the various interventions to cover 1,380,600 km(2) and 56,986,000 people. CONCLUSIONS: A number of new tools will fill critical gaps in the current armamentarium for diagnosing and treating Gambiense HAT. Deploying these tools in endemic areas will facilitate the comprehensive and sustainable control of the disease considerably and contribute to the ultimate goal of elimination.