[Return of African sleeping sickness]. / Schlafkrankheit--reisemedizinisch wieder relevant. Auch Safari-Urlauber sind in Gefahr.

At present there is a steady rise in African sleeping sickness (trypanosomiasis) transmitted by the Tsetse fly, and which if left untreated, is fatal. Thanks to more than so years of neglect by research, our therapeutic repertoire is limited to medications with a high level of toxicity. Both WHO and international aid organizations are pushing hard for the development of new, more efficient drugs that can be readily applied in the field.

[Onchocerciasis]. / 18 Millionen sind mit der Tropenkrankheit Onchozerkose infiziert. Mit Doxycyclin die Flussblindheit bekämpfen.

Onchocerciasis, which is caused by filarial nematodes, affects roughly 18 million people in tropical Africa and is a major cause of morbidity, with a serious sociomedical impact. Although the present onchocerciasis control strategy comprising antifilarial chemotherapy and vector control is successful, it is associated with logistic problems due to the prolonged treatment duration. Furthermore, fears of drug resistance are on the increase. New approaches involving the use of antibiotics aimed at endobacteria living in symbiosis with filariae appear promising. Recent trials with tetracycline indicate a significant impact on worm viability.

Applied field research for comprehensive helminth infection control.

The Institute for Tropical Medicine at University of Tübingen has established 30 years ago in Togo a Research Centre and Onchocerciasis Reference Laboratory (ORL). Onchocerca volvulus infection control and of other neglected tropical diseases has been the focus of activities, and those were performed together with the National Institute of Hygiene in Togo, the Medical Faculty at University of Lomé, national disease control programs and district and regional hospitals. The ORL contributed significantly to the assessment of ivermectin as the prime choice for onchocerciasis treatment, and 24 years of repeated annual treatment with ivermectin has progressively reduced disease prevalence and notably the level of ocular and dermal manifestations of onchocerciasis in the endemic population. The ORL has shown that large parts of the rural population in Togo is concurrently infected with intestinal and intravascular protozoan and helminth parasites, notably school children. The application of repeated treatments with albendazole and praziquantel against Schistosoma spp. and instestinal helminthes for several years has reduced infection intensities by more than 80%. Longitudinal investigations of the cellular immune responses in adults and children have found that parasite co-infections will generate prominent pro-inflammatory responses, and a single or few interventions will not suffice to eliminate co-infections and not establish an appropriately balanced immunity.