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Chapter 75 – Human African Trypanosomiasis

Christian Burri,
Reto Brun

HISTORICAL BACKGROUND

David Livingstone (1813–1873) had been convinced in the mid-nineteenth century that the tsetse fly was responsible for the transmission of ‘nagana', a disease that affected cattle in central Africa. This is clearly recorded in his classic Missionary Travels, first published in 1857. It seems probable that Livingstone had in fact associated the bite of Glossina palpalis with ‘nagana’ as early as 1847. It was not until 1894, however, that the causative role of Trypanosoma (later designated T. brucei) was delineated in nagana, and this resulted from the brilliant work of David Bruce (Figure 75.1) in Zululand, where he had been posted from military duty in Natal. Shortly before this, animal trypanosomes had been visualized, and in 1878 Timothy Lewis had first indicated that trypanosomes could cause infection in mammals.

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A febrile illness associated with cervical lymphadenopathy and lethargy had been clearly …