Chad eliminates sleeping sickness as a public health problem

In a historic achievement, Chad has become the first country and the 51st globally to eliminate a neglected tropical disease (NTD) in 2024 – the Gambiense form of human African trypanosomiasis (HAT), also known as sleeping sickness. This announcement by the World Health Organization (WHO) marks a significant victory in the ongoing battle against these debilitating diseases that primarily affect low-income populations.

HAT is caused by protozoan parasites that are spread through infected tsetse flies. According to WHO, the disease is usually fatal if left untreated. For centuries, sleeping sickness has devastated communities in sub-Saharan Africa. If left untreated, the disease progresses slowly, causing fatigue, headaches and, in severe cases, coma.

There are two forms of HAT, determined by the subspecies of parasite: Trypanosoma brucei gambiensewhich is 92 percent of the reported cases and Trypanosoma brucei rhodesienseaccounts for the remaining 8 percent.

Read more: Togo is the first country in Africa to eliminate sleeping sickness

Prior to 2002, Chad suffered from severe sleep apnea, Particularly in Mandol areaHowever, a dedicated national effort, in collaboration with the World Health Organization and other partners, launched a multi-pronged attack on the disease.

The strategy focused on two key areas:

• Early diagnosis and treatment
• Tsetse Fly Control

Early diagnosis and treatment included improving access to healthcare in remote areas, allowing for faster identification of cases. Additionally, the introduction of new, more effective, and easier-to-administer drugs for HAT treatment significantly improved patient outcomes.

Dealing with the insect vector tsetse was crucial to breaking the infection cycle. Chad implemented a targeted program using specially designed traps and insecticides to attract and kill tsetse flies.

These combined efforts have produced impressive results. The number of cases has fallen dramatically, with no new infections reported in recent years. However, elimination requires rigorous verification.

WHO carefully reviewed data on case surveillance, diagnostic testing, and vector control measures. Following a thorough evaluation, Chad was officially declared to have eliminated Gambiense sleeping sickness as a public health problem in April 2024.

This achievement is a testament to Chad's unwavering commitment to public health and its strong collaboration with international organisations. It is an inspiration for other countries battling NTDs. The success story also highlights the importance of targeted interventions, improved diagnostics and community participation in tackling these neglected diseases.

Read more: Tsetse fly genes provide clues to controlling sleeping sickness

While celebrating this milestone, vigilance remains crucial. Continued surveillance and control measures are necessary to prevent the re-emergence of sleeping sickness. Additionally, Chad can now turn its attention to eliminating other NTDs prevalent in the country.

The global fight against NTDs continues, with the goal of eliminating at least 100 of these diseases by 2030. Chad’s success story paves the way to a future free from the burden of neglected tropical diseases, and offers a ray of hope for the millions of people living with these debilitating conditions.

To date, WHO has validated the elimination of the gambiense form of HAT in seven countries: Togo (2020), Benin (2021), Ivory Coast (2021), Uganda (2022), Equatorial Guinea (2022), Ghana (2023) and Chad (2024). Additionally, the rhodesiense form of the disease has been eliminated as a public health problem in Rwanda.