Human African trypanosomiasis in non-endemic areas: review on pathogenesis, clinical manifestation and therapy of cases published in the last 20 years
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Human African trypanosomiasis (HAT), also known as African sleeping sickness, is caused by the parasitic protozoan Trypanosoma brucei and is transmitted by tsetse flies. Both the parasites and the flies are endemic only to sub-Saharan Africa. If left untreated, the disease is lethal. While most reported cases are from endemic regions, cases have been reported in non-endemic areas, such as North America and Europe. These cases may be due to travellers, ex-patriots or military personnel returning from abroad or may be due to immigrants from endemic areas. In this paper, non-endemic cases reported over the past 20 are reviewed. Physicians in non-endemic areas should be made aware of the signs and symptoms of this disease, as well as methods of diagnosis and treatment.