THE incrimination of the trypanosome as the cause of sleeping sickness and the discovery of the transmission of the parasite by the tsetse fly was the result of studies carried out in Uganda by Castellani, Bruce, Nabarro and others.' While there is no question of the importance of their elucidation of the relation between the disease, the parasite and the vector, by clinical, laboratory, and fi...

A traveler to East Africa developed fever, an eschar on his forearm and thrombocytopenia shortly after returning home to Chennai, India. Trypanosoma brucei rhodesiense infection was diagnosed on examination of his peripheral smear. He made a full recovery after receiving a course of suramin.

In a study of 269 sleeping sickness patients treated with Mel-B, 14 (5.2%) died during treatment. With total dosages of at least 30 ml (1.08 g), 1.4% relapsed and another 6.4% died, mostly of unknown causes, within three years of treatment, giving a success rate of 92.1% over the three years. Mel-B was used to treat 55 relapses after suramin therapy with 1.8% deaths during treatment, 3.6% relap...

To the Editor: The past 2 decades have heralded notable success in efforts to control sleeping sickness (human African trypanosomiasis [HAT]) in Africa. HAT is a neglected tropical disease with major public health and economic effects in sub-Saharan Africa, and its effects on livestock productivity and development are considered major constraints to alleviating poverty in this region (1,2). Bec...

n engl j med 368;11 nejm.org march 14, 2013 1069 thereby reduce the duration of mechanical ventilation. Many, but not all, of these strategies were mentioned in our article. We also agree with the suggestion to avoid benzodiazepines, as has been recommended in the recent Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit...