Africa-Press – Malawi. Five people have been successfully treated for sleeping sickness in Malawi using a newly approved all-oral treatment, marking a milestone in the fight against the neglected tropical disease.
This follows health authorities’ approval of the drug Fexinidazole Winthrop in December 2024.
The medication was introduced after successful clinical trials conducted in Malawi and Uganda. The trials were funded by medical research organisation Drugs for Neglected Diseases initiative.
Sleeping sickness, or human African trypanosomiasis, is a parasitic disease transmitted by the bite of tsetse flies. These insects are commonly found in areas surrounding game reserves.
Previously, treatment for the advanced stage of the disease required an intravenous drug, which involved hospitalisation and came with severe side effects.
“At first, we were using injectable treatment which had side effects and sometimes we would lose patients because of these side effects,” said Alfred Chalira, focal person for sleeping sickness in Malawi.
According to Chalira, cases in the country saw a notable rise in 2019 and 2020, reaching 91 and 90, respectively, a sharp contrast to the years since 2012, when figures across endemic areas had remained below 40.
“The increase [was due] to a combination of factors, including adverse weather conditions during that period, which may have contributed to a surge in tsetse flies breeding and a subsequent rise in bites,” Chalira said.
In 2024, the number of cases dropped significantly, with only 14 recorded throughout the year. So far this year, from January to June, six cases have been reported.
While five of the patients were successfully treated with the new drug, one sought medical attention late and died. Chalira noted that while this indicates a downward trend, there were several months remaining in the year, such that continued vigilance was necessary.
Commenting on the issue, Dr Peter Nambala, an expert on sleeping sickness disease from the Malawi Liverpool Welcome Programme, said although the oral drug puts Malawi on track when it comes to control, elimination, on the other hand, cannot be easily achieved.
“Rhodesiense sleeping sickness is endemic in Malawi and other countries in East and Southern Africa. This type is currently not possible to fully eliminate because its transmission involves wild animals and humans through the bite of an infected tsetse fly,” Nambala said.
He further said it would not be feasible to treat all animals with a drug that kills the parasites which cause the disease. Health and Rights Education Programme Executive Director Maziko Matemba welcomed the treatment change, describing it as a breakthrough considering the drug’s efficacy.
“We hope that this will help in alleviating the suffering of patients and we urge the government to look at these positive findings on oral treatment and provide policy guidance and inclusion into our health systems,” he said.
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