• DNDi - Best Science for the Most Neglected 20 Years
  • Our work
    • Diseases
      • Sleeping sickness
      • Visceral leishmaniasis
      • Cutaneous leishmaniasis
      • Chagas disease
      • Filaria: river blindness
      • Mycetoma
      • Paediatric HIV
      • Cryptococcal meningitis
      • Hepatitis C
      • Dengue
      • COVID-19
      • Antimicrobial resistance
    • Research & development
      • R&D portfolio & list of projects
      • Drug discovery
      • Translational research
      • Clinical trials
      • Registration & access
      • Treatments delivered
    • Advocacy
      • Open and collaborative R&D
      • Transparency of R&D costs
      • Pro-access policies and IP
      • Children’s health
      • Gender equity
      • Climate change
      • AI and new technologies
  • Networks & partners
    • Partnerships
      • Our partners
      • Partnering with us
    • Global networks
      • Chagas Platform
      • Dengue Alliance
      • HAT Platform
      • HELP Helminth Elimination Platform
      • LEAP Platform
      • redeLEISH Network
    • DNDi worldwide
      • DNDi Switzerland
      • DNDi DRC
      • DNDi Eastern Africa
      • DNDi Japan
      • DNDi Latin America
      • DNDi North America
      • DNDi South Asia
      • DNDi South-East Asia
      • DNDi Southern Africa
  • News & resources
    • News & stories
      • News
      • Stories
      • Statements
      • Viewpoints
      • Social media
      • eNews Newsletter
    • Press
      • Press releases
      • In the media
    • Resources
      • Scientific articles
      • Our publications
      • Videos
    • Events
  • About us
    • About
      • Who we are
      • How we work
      • Our strategy
      • Our donors
      • Annual reports
    • Our people
      • Our leadership
      • Our governance
      • Contact us
    • Work with us
      • Working at DNDi
      • Job opportunities
      • Requests for proposal
  • Donate
DNDi - Best Science for the Most Neglected 20 Years
  • DNDi - Best Science for the Most Neglected 20 Years
  • Our work
    • Diseases
      • Sleeping sickness
      • Visceral leishmaniasis
      • Cutaneous leishmaniasis
      • Chagas disease
      • Filaria: river blindness
      • Mycetoma
      • Paediatric HIV
      • Cryptococcal meningitis
      • Hepatitis C
      • Dengue
      • COVID-19
      • Antimicrobial resistance
    • Research & development
      • R&D portfolio & list of projects
      • Drug discovery
      • Translational research
      • Clinical trials
      • Registration & access
      • Treatments delivered
    • Advocacy
      • Open and collaborative R&D
      • Transparency of R&D costs
      • Pro-access policies and IP
      • Children’s health
      • Gender equity
      • Climate change
      • AI and new technologies
  • Networks & partners
    • Partnerships
      • Our partners
      • Partnering with us
    • Global networks
      • Chagas Platform
      • Dengue Alliance
      • HAT Platform
      • HELP Helminth Elimination Platform
      • LEAP Platform
      • redeLEISH Network
    • DNDi worldwide
      • DNDi Switzerland
      • DNDi DRC
      • DNDi Eastern Africa
      • DNDi Japan
      • DNDi Latin America
      • DNDi North America
      • DNDi South Asia
      • DNDi South-East Asia
      • DNDi Southern Africa
  • News & resources
    • News & stories
      • News
      • Stories
      • Statements
      • Viewpoints
      • Social media
      • eNews Newsletter
    • Press
      • Press releases
      • In the media
    • Resources
      • Scientific articles
      • Our publications
      • Videos
    • Events
  • About us
    • About
      • Who we are
      • How we work
      • Our strategy
      • Our donors
      • Annual reports
    • Our people
      • Our leadership
      • Our governance
      • Contact us
    • Work with us
      • Working at DNDi
      • Job opportunities
      • Requests for proposal
  • Donate
Home > Diseases
sleeping sickness icon

Sleeping sickness

Symptoms, transmission, and current treatments for sleeping sickness

Home > Diseases
sleeping sickness icon

Sleeping sickness

Symptoms, transmission, and current treatments for sleeping sickness

  • Overview
  • Facts
  • Projects & achievements
  • Target product profiles

What is sleeping sickness?  

Sleeping sickness, or human African trypanosomiasis, is a life-threatening disease caused by related parasite strains, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, transmitted by the tsetse fly.

People with early stage sleeping sickness often are not diagnosed. If not treated, the parasite crosses the blood-brain barrier and invades the central nervous system causing advanced stage sleeping sickness. During this stage, people develop neuropsychiatric symptoms such as sleep disruption, confusion, lethargy, and convulsions. If left untreated, sleeping sickness is usually fatal.

What is the impact of sleeping sickness?

  • 3 million people live in areas at moderate to very high risk
  • 20% of infections are in children
  • Fewer than 600 cases of the T.b. gambiense strain diagnosed in 2020, down from over 38,000 in 1998.
  • Historically, deadly epidemics followed periods where disease seemed controlled
  • Tsetse flies are present in 36 African countries
    • gambiense sleeping sickness (83% of cases) has been reported in 15 countries in western and central Africa since 2000
    • rhodesiense sleeping sickness has been reported in 7 countries in eastern and southern Africa since 2000
    • 70% of sleeping sickness cases in 2020 were reported in DRC
Geographical distribution of sleeping sickness (2019-2020)

Source: Franco JR, et al. (2022) The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020. PLOS Neglected Tropical Diseases 16(1): e0010047.

What are current treatments for sleeping sickness? 

For decades, treatment for sleeping sickness was complex, difficult to administer, and even toxic. The only treatment available was melarsoprol – a drug developed in the 1940s. Derived from arsenic, it was so toxic that it killed one in 20 patients.

In 2009, DNDi and partners introduced NECT, a safer combination treatment consisting of pills and 14 intravenous infusions. NECT was provided free of charge by the World Health Organization (WHO) in all 13 countries with recent sleeping sickness cases thanks to drug donations from Sanofi and Bayer.

However, NECT still required administration by trained staff in specialized hospitals, presenting serious challenges for patients and health systems in resource-constrained settings. DNDi continued efforts to develop simpler treatments with entirely new medicines that could be provided at the primary health care level.

At the end of 2018, the European Medicines Agency issued a positive scientific opinion on the use of fexinidazole for the treatment of both stages of T.b. gambiense sleeping sickness. Developed by DNDi and partners, the first ever all-oral treatment was soon approved for use in the Democratic Republic of the Congo and other affected countries. The simple oral cure is now provided free of charge by Sanofi to the WHO for distribution to all affected countries.

What new treatments for sleeping sickness are needed?

WHO has set the target of eliminating sleeping sickness as a public health problem by 2020 and interruption of transmission (zero cases) by 2030. In order to maintain the current low levels of disease and reach the elimination target, a safe, effective, short-course oral treatment suitable for use in remote settings is needed.

What sleeping sickness treatments are we working on? 

We aim to deliver new oral treatments to cure sleeping sickness to support the sustainable elimination of the disease. In addition to developing the first all-oral treatment for sleeping sickness, we are working on acoziborole, a new single-dose oral drug that could be a critical tool for sustainable elimination.

Find out about our work developing treatments for sleeping sickness

How do you get sleeping sickness?

  • Insect bites: the parasites that cause sleeping sickness can be transmitted by the bite of infected tsetse flies
  • Mother-to-child transmission
  • Sexual contact

What are the symptoms of sleeping sickness?

Early Stage

  • non-specific symptoms such as fever and weakness
  • a person can be infected for months or even years without major signs or symptoms of the disease

Advanced Stage

  • neurological and psychiatric symptoms such as confusion, lethargy, and convulsions
  • if left untreated, usually fatal

How is sleeping sickness diagnosed? 

Diagnosing sleeping sickness involves invasive tests to confirm a positive result by the rapid diagnostic tests used for community screening. Diagnosis requires confirming the presence of the parasite in any body fluid, usually in the blood and lymph system through a microscope. Painful lumbar punctures are used to detect the parasite in spinal fluid, which indicates the advanced stage of the disease.

The new treatment fexinidazole could potentially reduce the number of lumbar punctures because it can be used to treat both stages of gambiense sleeping sickness.

More information

  • WHO factsheet

Last updated: March 2022

Making medical history for neglected patients

We develop urgently needed treatments for neglected patients and ensure they’re affordable, available, and adapted to the communities who need them

Young boy sitting on a hospital bed being examined by a nurse

Chagas disease

Causes heart and vital organ damage, after people are bitten by blood-sucking bugs

We delivered the first-ever treatment for children; now we’re searching for new drug candidates and working to boost access to care

Healthcare workers in a hospital

COVID-19

Devasting and deadly to many, there’s too little research to help the most vulnerable

We’re accelerating research by coordinating clinical trials in low-resource settings and bringing together partners

Patient medical examination

Cryptococcal meningitis

Without treatment, deadly for thousands of people with advanced HIV

We’re working to improve access to life-saving treatments and developing an easier-to-use formulation

Girl with skin lesions on her nose

Cutaneous leishmaniasis

Leaves disfiguring, life-long scars that lead to severe social stigma

We’re working to develop safer, shorter treatments for this disabling disease

Dengue

Rapidly spreading climate-sensitive disease with no specific treatment

We’re building a global partnership with dengue-endemic countries to develop a first treatment

Father walking in rural village with a cane and holding his son's hand

Filaria: river blindness

Lead to unbearable itching, disfiguring skin lesions, and even blindness

We’re working to develop a safe, effective, and affordable drug for the prevention and treatment of this debilitating disease

Young man standing in the street

Hepatitis C

Millions are left without treatment even though effective drugs exist

We’ve delivered a treatment as simple, safe, and effective as the best drugs available today – at a fraction of the cost 

Woman standing in front of her door house in a rural village in Sudan

Mycetoma

Often ends in amputation​, after people get infected from stepping on a thorn

We’re conducting the world’s first trial for an alternative to current treatments, which are toxic and ineffective

Mother holding her baby in her arms smiling

Paediatric HIV

Without treatment, half of children die before their second birthday

We’ve developed a strawberry-flavoured treatment to meet the needs of children long neglected by the global HIV response

Doctor diagnosing a man in a village with his hands on the man's neck

Sleeping sickness

Transmitted by the bite of a tsetse fly and causes severe neurological disorders

We delivered a revolutionary new drug to replace toxic treatments, and have ongoing trials to eliminate this disease

Girl looking over a fence

Visceral leishmaniasis

Is one of the world’s biggest parasitic killers, spread by the bites of sandflies

We’re working to develop a new generation of treatments to replace drugs that are painful, ineffective, and cause side effects

Chagas disease

COVID-19

Cryptococcal meningitis

Cutaneous leishmaniasis

Dengue

Filaria: river blindness

Hepatitis C

Mycetoma

Paediatric HIV

Sleeping sickness

Visceral leishmaniasis

VIEW ALL DISEASES

Stay connected

Get our latest news, personal stories, research articles, and job opportunities. 

DNDi - Best Science for the Most Neglected 20 Years
Facebook-f
Twitter
Instagram
Linkedin-in
Youtube
International non-profit developing safe, effective, and affordable treatments for the most neglected patients.

Learn more

  • Diseases
  • Neglected tropical diseases
  • R&D portfolio
  • Policy advocacy

Get in touch

  • Our offices
  • Contact us
  • Integrity Line

Support us

  • Donate
  • Subscribe to eNews

Work with us

  • Join research networks
  • Jobs
  • RFPs
  • Terms of Use   
  •   Acceptable Use Policy   
  •   Privacy Policy   
  •   Cookie Policy   
  •   Our policies   

  • Except for images, films and trademarks which are subject to DNDi’s Terms of Use, content on this site is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 3.0 Switzerland License   
We use cookies to track our audience and improve our content. By clicking 'Accept All', you are agreeing to our use of cookies. Click on 'Customize' to accept only some cookies.
Customize
REJECT ACCEPT ALL
Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
CookieDurationDescription
cookielawinfo-checkbox-advertisement1 yearSet by the GDPR Cookie Consent plugin, this cookie is used to record the user consent for the cookies in the "Advertisement" category .
cookielawinfo-checkbox-analytics11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional11 monthsThe cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
CookieLawInfoConsent1 yearRecords the default button state of the corresponding category & the status of CCPA. It works only in coordination with the primary cookie.
PHPSESSIDsessionThis cookie is native to PHP applications. The cookie is used to store and identify a users' unique session ID for the purpose of managing user session on the website. The cookie is a session cookies and is deleted when all the browser windows are closed.
viewed_cookie_policy11 monthsThe cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
Functional
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.
CookieDurationDescription
elementorneverThis cookie is used by the website's WordPress theme. It allows the website owner to implement or change the website's content in real-time.
Analytics
Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.
CookieDurationDescription
_ga2 yearsThe _ga cookie, installed by Google Analytics, calculates visitor, session and campaign data and also keeps track of site usage for the site's analytics report. The cookie stores information anonymously and assigns a randomly generated number to recognize unique visitors.
_ga_16Q5RH3XRG2 yearsThis cookie is installed by Google Analytics.
_gat_UA-10302561-11 minuteA variation of the _gat cookie set by Google Analytics and Google Tag Manager to allow website owners to track visitor behaviour and measure site performance. The pattern element in the name contains the unique identity number of the account or website it relates to.
_gid1 dayInstalled by Google Analytics, _gid cookie stores information on how visitors use a website, while also creating an analytics report of the website's performance. Some of the data that are collected include the number of visitors, their source, and the pages they visit anonymously.
_hjAbsoluteSessionInProgress30 minutesHotjar sets this cookie to detect the first pageview session of a user. This is a True/False flag set by the cookie.
_hjFirstSeen30 minutesHotjar sets this cookie to identify a new user’s first session. It stores a true/false value, indicating whether it was the first time Hotjar saw this user.
_hjIncludedInPageviewSample2 minutesHotjar sets this cookie to know whether a user is included in the data sampling defined by the site's pageview limit.
_hjIncludedInSessionSample2 minutesHotjar sets this cookie to know whether a user is included in the data sampling defined by the site's daily session limit.
_hjSession_112884430 minutesHotjar sets this cookie.
_hjSessionUser_11288441 yearHotjar sets this cookie.
CONSENT2 yearsYouTube sets this cookie via embedded youtube-videos and registers anonymous statistical data.
Targeting
Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.
SAVE & ACCEPT
Powered by CookieYes Logo