Sample records for african trypanosomiasis sleeping

  1. Human African Trypanosomiasis Transmission, Kinshasa, Democratic Republic of Congo

    Diabakana, Philemon Mansinsa; Mesu, Victor Kande Betu Ku; Manzambi, Emile Zola; Ollivier, Gaelle; Asonganyi, Tazoacha; Cuny, Gerard; Grébaut, Pascal


    To investigate the epidemiology of human African trypanosomiasis (sleeping sickness) in Kinshasa, Democratic Republic of Congo, 2 entomologic surveys were conducted in 2005. Trypanosoma brucei gambiense and human-blood meals were found in tsetse fly midguts, which suggested active disease transmission. Vector control should be used to improve human African trypanosomiasis control efforts. PMID:17326955

  2. Spatial predictions of Rhodesian Human African Trypanosomiasis (sleeping sickness prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda.

    Nicola A Batchelor

    Full Text Available The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.

  3. African Trypanosomiasis Detection using Dempster-Shafer Theory

    Maseleno, Andino


    World Health Organization reports that African Trypanosomiasis affects mostly poor populations living in remote rural areas of Africa that can be fatal if properly not treated. This paper presents Dempster-Shafer Theory for the detection of African trypanosomiasis. Sustainable elimination of African trypanosomiasis as a public-health problem is feasible and requires continuous efforts and innovative approaches. In this research, we implement Dempster-Shafer theory for detecting African trypanosomiasis and displaying the result of detection process. We describe eleven symptoms as major symptoms which include fever, red urine, skin rash, paralysis, headache, bleeding around the bite, joint the paint, swollen lymph nodes, sleep disturbances, meningitis and arthritis. Dempster-Shafer theory to quantify the degree of belief, our approach uses Dempster-Shafer theory to combine beliefs under conditions of uncertainty and ignorance, and allows quantitative measurement of the belief and plausibility in our identificat...

  4. Orchitis as an unusual manifestation of human African trypanosomiasis.

    Ehrhardt, Stephan; Lippert, Ute; Burchard, Gerd D; Sudeck, Hinrich


    African trypanosomiasis is a re-emerging disease. We report the case of an African patient whose predominant symptom was infertility due to a granulomatous orchitis. The patient was afebrile and had not been in Africa for years. Lymphadenopathy and splenomegaly led us eventually to the diagnosis of sleeping sickness. After treatment with suramin his spermiogram returned to normal. Sleeping sickness evolves through clinically different stages and leads to death if left untreated. The disease may, however, present clinically extremely variable and may thus be difficult to diagnose. PMID:15936085

  5. African Trypanosomiasis Detection using Dempster-Shafer Theory


    World Health Organization reports that African Trypanosomiasis affects mostly poor populations living in remote rural areas of Africa that can be fatal if properly not treated. This paper presents Dempster-Shafer Theory for the detection of African trypanosomiasis. Sustainable elimination of African trypanosomiasis as a public-health problem is feasible and requires continuous efforts and innovative approaches. In this research, we implement Dempster-Shafer theory for detecting African trypan...

  6. Challenges towards the elimination of Human African Trypanosomiasis in the sleeping sickness focus of Campo in southern Cameroon.

    Simo, Gustave; Mbida Mbida, Jean Arthur; Ebo'o Eyenga, Vincent; Asonganyi, Tazoacha; Njiokou, Flobert; Grébaut, Pascal


    The sleeping sickness focus of Campo lies along the Atlantic coast and extends along the Ntem River, which constitutes the Cameroonian and Equatorial Guinean border. It is a hypo-endemic focus with the disease prevalence varying from 0.3 to 0.86% during the last few decades. Investigations on animal reservoirs revealed a prevalence of Trypanosoma brucei gambiense of 0.6% in wild animals and 4.83% in domestic animals of this focus. From 2001 to 2012, about 19 931 tsetse were collected in this focus and five tsetse species including Glossina palpalis palpalis, G. pallicera, G. nigrofusca, G. tabaniformis and G. caliginea were identified. The analysis of blood meals of these flies showed that they feed on human, pig, goat, sheep, and wild animals such as antelope, duiker, wild pig, turtle and snake. The percentage of blood meals taken on these hosts varies according to sampling periods. For instance, 6.8% of blood meals from pig were reported in 2004 and 22% in 2008. This variation is subjected to considerable evolutions because the Campo HAT focus is submitted to socio-economic mutations including the reopening of a new wood company, the construction of autonomous port at "Kribi" as well as the dam at "Memve ele". These activities will bring more that 3000 inhabitants around Campo and induce the deforestation for the implementation of farmlands as well as breeding of domestic animals. Such mutations have impacts on the transmission and the epidemiology of sleeping sickness due to the modification of the fauna composition, the nutritional behavior of tsetse, the zoophilic/anthropophilic index. To achieve the elimination goal in the sleeping sickness focus of Campo, we report in this paper the current epidemiological situation of the disease, the research findings of the last decades notably on the population genetics of trypanosomes, the modifications of nutritional behavior of tsetse, the prevalence of T. b. gambiense in humans, domestic and wild animals. An overview

  7. Immunology and immunopathology of African trypanosomiasis

    Philippe Vincendeau


    Full Text Available Major modifications of immune system have been observed in African trypanosomiasis. These immune reactions do not lead to protection and are also involved in immunopathology disorders. The major surface component (variable surface glycoprotein,VSG is associated with escape to immune reactions, cytokine network dysfunctions and autoantibody production. Most of our knowledge result from experimental trypanosomiasis. Innate resistance elements have been characterised. In infected mice, VSG preferentially stimulates a Th 1-cell subset. A response of gd and CD8 T cells to trypanosome antigens was observed in trypanotolerant cattle. An increase in CD5 B cells, responsible for most serum IgM and production of autoantibodies has been noted in infected cattle. Macrophages play important roles in trypanosomiasis, in synergy with antibodies (phagocytosis and by secreting various molecules (radicals, cytokines, prostaglandins,.... Trypanosomes are highly sensitive to TNF-alpha, reactive oxygen and nitrogen intermediates. TNF-alpha is also involved in cachexia. IFN-gamma acts as a parasite growth factor. These various elements contribute to immunosuppression. Trypanosomes have learnt to use immune mechanisms to its own profit. Recent data show the importance of alternative macrophage activation, including arginase induction. L-ornithine produced by host arginase is essential to parasite growth. All these data reflect the deep insight into the immune system realised by trypanosomes and might suggest interference therapeutic approaches.Modificações importantes no sistema imune são observadas na tripanosomíase Africana. Essas reações imunológicas não protegem e estão envolvidas em distúrbios imunopatológicos. O principal componente de superfície (glicoproteína variante de superfície, VSG está associado à evasão das respostas imune, às disfunções da rede de citocinas e à produção de autoanticorpos. Muitos de nossos conhecimentos resultam

  8. Challenges in Diagnosing Human African Trypanosomiasis: Evaluation of the MSF OCG project in Dingila, DRC

    Van Nieuwenhove, Simon


    Between late 2010 and the end of 2014 and under extremely difficult conditions, Médecins sans Frontières (MSF) carried out a project to combat Human African Trypanosomiasis (HAT), also known as sleeping sickness, in the Dingila, Ango and Zobia regions of Orientale Province in the Democratic Republic of Congo (DRC). HAT in DRC is caused by Trypanosoma brucei gambiense and is transmitted by the tsetse fly (Glossina genus) of the Palpalis group. Without effective treatment, virtually all f...

  9. Human African Trypanosomiasis in South Sudan: How Can We Prevent a New Epidemic?

    Ruiz-Postigo, José A; José R Franco; Mounir Lado; Pere P Simarro


    Human African trypanosomiasis (HAT) has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in Sou...

  10. The detection and treatment of human African trypanosomiasis

    Bouteille B


    Full Text Available Bernard Bouteille,1 Alain Buguet21Laboratory of Parasitology, Dupuytren University Hospital of Limoges, France; 2Polyclinic Marie-Louise Poto-Djembo, Pointe-Noire, CongoAbstract: Human African trypanosomiasis (HAT is caused by the injection of Trypanosoma brucei (T. b. gambiense or T. b. rhodesiense by Glossina, the tsetse fly. Three historical eras followed the exclusive clinical approach of the 19th century. At the turn of the century, the “initial research” era was initiated because of the dramatic spread of HAT throughout intertropical Africa, and scientists discovered the agent and its vector. Two entities, recurrent fever and sleeping sickness, were then considered a continuum between hemolymphatic stage 1 and meningoencephalitic stage 2. Treatments were developed. Soon after World War I, specific services and mobile teams were created, initiating the “epidemiological” era, during which populations were visited, screened, and treated. As a result, by 1960, annual new cases were rare. New mass screening and staging tools were then developed in a third, “modern” era, especially to counter a new epidemic wave. Currently, diagnosis still relies on microscopic detection of trypanosomes without (wet and thick blood films or with concentration techniques (capillary tube centrifugation, miniature anion-exchange centrifugation technique. Staging is a vital step.Stage 1 patients are treated on site with pentamidine or suramin. However, stage 2 patients are treated in specialized facilities, using drugs that are highly toxic and/or that require complex administration procedures (melarsoprol, eflornithine, or nifurtimox-eflornithine combination therapy. Suramin and melarsoprol are the only medications active against Rhodesian HAT. Staging still relies on cerebrospinal fluid examination for trypanosome detection and white blood cell counts: stage 1, absence of trypanosomes, white blood cell counts ≤ 5/µL; stage 2, presence of

  11. Therapeutic evaluation of Acacia nilotica (Linn stem bark extract in experimental African trypanosomiasis

    E O Ogbadoyi


    Full Text Available Summary: Chemotherapy of African trypanosomiasis still remains far from being satisfactory, being severely limited by a number of factors including unacceptable toxicity, increasing parasite resistance, high cost and unavailability. There is an urgent need for therapeutic agents that are effective, affordable and accessible to the rural poor in Africa who bear most of the disease burden. The objective of this study was to evaluate the therapeutic effects of Acacia nilotica in experimental Trypanosoma brucei brucei infection in mice.  Methanol extract of stem bark of the plant was investigated for its therapeutic effects in experimental African trypanosomiasis. Acute toxicity studies were also conducted. Crude extract of 70% v/v (Methanol/Water at a dose of 400mg kg-1 body weight per day completely cured the experimental T.b. brucei infection in mice, while doses of 50, 100, 200, 300, and 400mgkg-1 body weight per day of the partially purified extract completely cured the experimental infection in mice within two days.  Sub inoculation of blood and cerebrospinal fluid drawn from the cured mice into healthy mice failed to produce any infection within 28 days of post inoculation. Phytochemical analysis showed the presence of carbohydrates, saponin, tannin and cardiac glycoside. LD50 of the partially purified extract was found to be 2000mg/kg body weight, the extract being acutely toxic at a dose of 1600mgkg-1 body weight. It is concluded that methanol extract of stem bark of A. nilotica cures experimental T. b. brucei infection in mice.   Industrial relevance: The findings in this study provide very useful clue for biopharmaceutical industries and drug manufacturers for the development of phytotherapeutic agents from this plant, not only for therapeutic intervention in the control of African trypanosomiasis but also for the treatment of cancer. This is because of the strong link between Chemotherapy of human African trypanosomiasis (sleeping

  12. Identifying Transmission Cycles at the Human-Animal Interface: The Role of Animal Reservoirs in Maintaining Gambiense Human African Trypanosomiasis

    Sebastian Funk; Hiroshi Nishiura; Hans Heesterbeek; W. John Edmunds; Francesco Checchi


    Many infections can be transmitted between animals and humans. The epidemiological roles of different species can vary from important reservoirs to dead-end hosts. Here, we present a method to identify transmission cycles in different combinations of species from field data. We used this method to synthesise epidemiological and ecological data from Bipindi, Cameroon, a historical focus of gambiense Human African Trypanosomiasis (HAT, sleeping sickness), a disease that has often been considere...

  13. Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis.


    This report provides a review and analysis of the research landscape for three diseases - Chagas disease, human African trypanosomiasis and leishmaniasis - that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease reference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations. The diseases, which are caused by related protozoan parasites, are described in terms of their epidemiology and diseases burden, clinical forms and pathogenesis, HIV coinfection, diagnosis, drugs and drug resistance, vaccines, vector control, and health-care interventions. Priority areas for research are identified based on criteria such as public health relevance, benefit and impact on poor populations and equity, and feasibility. The priorities are found in the areas of diagnostics, drugs, vector control, asymptomatic infection, economic analysis of treatment and vector control methods, and in some specific issues such as surveillance methods or transmission-blocking vaccines for particular diseases. This report will be useful to researchers, policy and decision-makers, funding bodies, implementation organizations, and civil society. This is one of ten disease and thematic reference group reports that have come out of the TDR Think Tank, all of which have contributed to the development of the Global Report for Research on Infectious Diseases of Poverty, available at: PMID:23484340

  14. Bioluminescence Imaging to Detect Late Stage Infection of African Trypanosomiasis.

    Burrell-Saward, Hollie; Ward, Theresa H


    Human African trypanosomiasis (HAT) is a multi-stage disease that manifests in two stages; an early blood stage and a late stage when the parasite invades the central nervous system (CNS). In vivo study of the late stage has been limited as traditional methodologies require the removal of the brain to determine the presence of the parasites. Bioluminescence imaging is a non-invasive, highly sensitive form of optical imaging that enables the visualization of a luciferase-transfected pathogen in real-time. By using a transfected trypanosome strain that has the ability to produce late stage disease in mice we are able to study the kinetics of a CNS infection in a single animal throughout the course of infection, as well as observe the movement and dissemination of a systemic infection. Here we describe a robust protocol to study CNS infections using a bioluminescence model of African trypanosomiasis, providing real time non-invasive observations which can be further analyzed with optional downstream approaches. PMID:27284970

  15. Human African trypanosomiasis in South Sudan: how can we prevent a new epidemic?

    José A Ruiz-Postigo

    Full Text Available Human African trypanosomiasis (HAT has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in South Sudan. It is a review of the available data, interventions over time, and current reports on the status of HAT in South Sudan. Since 2006, control interventions and treatments providing services for sleeping sickness have been reduced. Access to HAT diagnosis and treatment has been considerably diminished. The current status of control activities for HAT in South Sudan could lead to a new outbreak of the disease unless 1 the remaining competent personnel are used to train younger staff to resume surveillance and treatment in the centers where HAT activities have stopped, and 2 control of HAT continues to be given priority even when the number of cases has been substantially reduced. Failure to implement an effective and sustainable system for HAT control and surveillance will increase the risk of a new epidemic. That would cause considerable suffering for the affected population and would be an impediment to the socioeconomic development of South Sudan.

  16. Determinants of Human African Trypanosomiasis Elimination via Paratransgenesis.

    Jennifer A Gilbert


    Full Text Available Human African trypanosomiasis (HAT, transmitted by tsetse flies, has historically infected hundreds of thousands of individuals annually in sub-Saharan Africa. Over the last decade, concerted control efforts have reduced reported cases to below 10,000 annually, bringing complete elimination within reach. A potential technology to eliminate HAT involves rendering the flies resistant to trypanosome infection. This approach can be achieved through the introduction of transgenic Sodalis symbiotic bacteria that have been modified to produce a trypanocide, and propagated via Wolbachia symbionts, which confer a reproductive advantage to the paratransgenic tsetse. However, the population dynamics of these symbionts within tsetse flies have not yet been evaluated. Specifically, the key factors that determine the effectiveness of paratransgenesis have yet to be quantified. To identify the impact of these determinants on T.b. gambiense and T.b. rhodesiense transmission, we developed a mathematical model of trypanosome transmission that incorporates tsetse and symbiont population dynamics. We found that fecundity and mortality penalties associated with Wolbachia or recombinant Sodalis colonization, probabilities of vertical transmission, and tsetse migration rates are fundamental to the feasibility of HAT elimination. For example, we determined that HAT elimination could be sustained over 25 years when Wolbachia colonization minimally impacted fecundity or mortality, and when the probability of recombinant Sodalis vertical transmission exceeded 99.9%. We also found that for a narrow range of recombinant Sodalis vertical transmission probability (99.9-90.6% for T.b. gambiense and 99.9-85.8% for T.b. rhodesiense, cumulative HAT incidence was reduced between 30% and 1% for T.b. gambiense and between 21% and 3% for T.b. rhodesiense, although elimination was not predicted. Our findings indicate that fitness and mortality penalties associated with paratransgenic

  17. Expression and role of CXCL10 during the encephalitic stage of experimental and clinical African trypanosomiasis

    Amin, Daniel N; Rottenberg, Martin E; Thomsen, Allan R; Mumba, Dieudonné; Fenger, Christina; Kristensson, Krister; Büscher, Philippe; Finsen, Bente; Masocha, Willias


    BACKGROUND: Human African trypanosomiasis, caused by Trypanosoma brucei, involves an early hemolymphatic stage followed by a late encephalitic stage. METHODS: We studied the expression of chemokines with use of microarray and enzyme-linked immunosorbent assay in T. brucei brucei-infected mice and...... in patients with human African trypanosomiasis and examined their role in controlling brain accumulation of T cells and parasites. RESULTS: The messenger RNAs (mRNAs) encoding CXCR3 ligands CXCL9 and CXCL10 demonstrated the greatest increases among chemokines in brain specimens of infected mice, as...... reduced accumulation of trypanosomes and T cells in the brain parenchyma but similar parasitemia levels, compared with wild-type mice. CXCL10 and IFN-gamma levels were increased in the cerebrospinal fluid of patients with late stage but not early stage human African trypanosomiasis. Levels of CXCL10 in...

  18. Spatial distribution of African Animal Trypanosomiasis in Suba and Teso districts in Western Kenya

    Jung'a Joseph O


    Full Text Available Abstract Background Studies on the epidemiology of African Animal Trypanosomiasis (AAT rarely consider the spatial dimension of disease prevalence. This problem is confounded by use of parasitological diagnostic methods of low sensitivity in field surveys. Here we report a study combining highly sensitive and species specific molecular diagnostic methods, and Geographical information system (GIS for spatial analysis of trypanosome infection patterns, to better understand its epidemiology. Blood samples from 44 and 59 animals randomly selected from Teso and Suba districts respectively were screened for trypanosomes using PCR diagnostic assays. Spatial distribution of the positive cases was mapped and average nearest neighbour analysis used to determine the spatial pattern of trypanosome cases detected. Findings Trypanosome prevalence of 41% and 29% in Suba and Teso districts respectively was observed. T. vivax infections were most prevalent in both areas. Higher proportions of T. brucei infections (12% were observed in Suba, a known sleeping sickness foci compared with 2% in Teso. Average nearest neighbour analysis showed the pattern of trypanosome infections as random. An overlay with tsetse maps showed cases lying outside the tsetse infested areas, mostly being cases of T. vivax which is known to be transmitted both biologically by tsetse and mechanically by biting flies. Conclusion These findings suggest a need to design control strategies that target not just the biological vector tsetse, but also the parasite in cattle in order to clear the possibly mechanically transmitted T. vivax infections. There is need to also review the accuracy of available tsetse maps.

  19. The FAO programme for the control of African animal trypanosomiasis and related development

    The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980

  20. Syndromic algorithms for detection of gambiense human african trypanosomiasis in South Sudan.

    Palmer, JJ; Surur, EI; Goch, GW; Mayen, MA; Lindner, AK; Pittet, A.; Kasparian, S; Checchi, F.; Whitty, CJ


    BACKGROUND Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to...

  1. Human African Trypanosomiasis in a Traveler: Diagnostic Pitfalls

    Meltzer, Eyal; Leshem, Eyal; Steinlauf, Shmuel; MICHAELI, SHULAMIT; Sidi, Yechezkel; Schwartz, Eli


    An Israeli traveler returning from Tanzania presented with a relapsing febrile illness. A diagnosis of Trypanosoma brucei rhodesiense infection was established by blood smear after nearly a month. Blood polymerase chain reaction failed to provide an early diagnosis of human African trypanososmiasis. Recognition of suggestive signs should prompt physicians to perform repeated tests before ruling out human African trypanososmiasis.

  2. Genome sequence of the tsetse fly (Glossina morsitans ): Vector of African trypanosomiasis

    Watanabe, Junichi


    Tsetse flies are the sole vectors of human African trypanosomiasis throughout sub-Saharan Africa. Both sexes of adult tsetse feed exclusively on blood and contribute to disease transmission. Notable differences between tsetse and other disease vectors include obligate microbial symbioses, viviparous reproduction, and lactation. Here, we describe the sequence and annotation of the 366-megabase Glossina morsitans morsitans genome. Analysis of the genome and the 12,308 predicted protein-encoding genes led to multiple discoveries, including chromosomal integrations of bacterial (Wolbachia) genome sequences, a family of lactation-specific proteins, reduced complement of host pathogen recognition proteins, and reduced olfaction/chemosensory associated genes. These genome data provide a foundation for research into trypanosomiasis prevention and yield important insights with broad implications for multiple aspects of tsetse biology.

  3. The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012.

    Ami Neuberger

    Full Text Available BACKGROUND: Although human African trypanosomiasis (HAT is uncommon among patients from non-endemic countries (NEC, there has been an increase in the number of cases reported in recent years. METHODS: A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases. RESULTS: Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P<0.001, the proportion of females was lower (10.0% vs. 23.9%, P<0.01], most cases were diagnosed in expatriates, missionaries and soldiers (74.3%, and Gambian trypanosomiasis accounted for 86/110, (78% of cases. In the post-colonial era most patients 91/125 (72.8% were short-term tourists to game parks in Eastern and South-Eastern Africa (mainly in Tanzania; Rhodesian trypanosomiasis accounted for 94/123 (76.4% of cases. Between 1995 and 2010 there has been a constant linear increase in the number of incoming tourists to Tanzania, and HAT cases occurred in small outbreaks rather than following a similar linear pattern. CONCLUSIONS: In recent decades HAT patients from NEC are older, and more likely to be tourists who acquired the disease while visiting game-parks in Eastern and South-Eastern Africa. While Rhodesian trypanosomiasis is relatively uncommon among Africans, it now accounts for most cases reported among patients from NEC. Returning febrile travellers without an alternative diagnosis should be evaluated for HAT. Cases among travellers may serve as sentinels for Rhodesian trypanosomiasis "hot

  4. Syndromic algorithms for detection of gambiense human African trypanosomiasis in South Sudan.

    Jennifer J Palmer

    Full Text Available BACKGROUND: Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. METHODOLOGY/PRINCIPAL FINDINGS: Symptom data from 462 patients (27 cases presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss, with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9-92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4-8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. CONCLUSIONS/SIGNIFICANCE: In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT

  5. Monitoring the use of nifurtimox-eflornithine combination therapy (NECT in the treatment of second stage gambiense human African trypanosomiasis

    Franco JR


    Full Text Available Jose R Franco,1 Pere P Simarro,1 Abdoulaye Diarra,2 Jose A Ruiz-Postigo,3 Mireille Samo,1 Jean G Jannin11World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland; 2World Health Organization, Regional Office for Africa, Brazzaville, Congo; 3World Health Organization, Communicable Disease Control, Control of Tropical Diseases and Zoonoses Regional Office for the Eastern Mediterranean, Cairo, EgyptAbstract: After inclusion of the nifurtimox-eflornithine combination therapy (NECT in the Model List of Essential Medicines for the treatment of second-stage gambiense human African trypanosomiasis (HAT, the World Health Organization, in collaboration with National Sleeping Sickness Control Programs and nongovernmental organizations set up a pharmacovigilance system to assess the safety and efficacy of NECT during its routine use. Data were collected for 1735 patients treated with NECT in nine disease endemic countries during 2010–2011. At least one adverse event (AE was described in 1043 patients (60.1% and a total of 3060 AE were reported. Serious adverse events (SAE were reported for 19 patients (1.1% of treated, leading to nine deaths (case fatality rate of 0.5%. The most frequent AE were gastrointestinal disorders (vomiting/nausea and abdominal pain, followed by headache, musculoskeletal pains, and vertigo. The most frequent SAE and cause of death were convulsions, fever, and coma that were considered as reactive encephalopathy. Two hundred and sixty-two children below 15 years old were treated. The characteristics of AE were similar to adults, but the major AE were less frequent in children with only one SAE and no deaths registered in this group. Gastrointestinal problems (vomiting and abdominal pain were more frequent than in adults, but musculoskeletal pains, vertigo, asthenia, neuropsychiatric troubles (headaches, seizures, tremors, hallucinations, insomnia were less

  6. LAMP for human African trypanosomiasis: a comparative study of detection formats.

    Sally L Wastling

    Full Text Available Loop-mediated isothermal amplification (LAMP is at the forefront of the search for innovative diagnostics for human African trypanosomiasis (HAT. Several simple endpoint detection methods have been developed for LAMP and here we compare four of these: (i visualization of turbidity; (ii addition of hydroxynaphthol blue before incubation; (iii addition of calcein with MnCl₂ before incubation and (iv addition of Quant-iT PicoGreen after incubation. These four methods were applied to four LAMP assays for the detection of human African trypanosomiasis, including two Trypanozoon specific and two Trypanosoma brucei rhodesiense specific reactions using DNA extracted from cryo-preserved procyclic form T. b. rhodesiense. A multi-observer study was performed to assess inter-observer reliability of two of these methods: hydroxynapthol blue and calcein with MnCl₂, using DNA prepared from blood samples stored on Whatman FTA cards. Results showed that hydroxynaphthol blue was the best of the compared methods for easy, inexpensive, accurate and reliable interpretation of LAMP assays for HAT. Hydroxynapthol blue generates a violet to sky blue colour change that was easy to see and was consistently interpreted by independent observers. Visible turbidity detection is not possible for all currently available HAT LAMP reactions; Quant-iT PicoGreen is expensive and addition of calcein with MnCl₂ adversely affects reaction sensitivity and was unpopular with several observers.

  7. Improving the diagnosis and control of trypanosomiasis and other vector-borne diseases of African livestock using immunoassay methods

    This publication contains the results presented by the participants of the Co-ordinated Research Programme (CRP) on improving the diagnosis and control of trypanosomiasis and other vector-borne diseases of African livestock using immunoassay methods. The CRP lasted from 1987 until 1992. The individual contributions have been indexed separately. Refs, figs and tabs

  8. Sleeping Sickness and Nagana Disease

    Steverding, Dietmar


    The hemoflagellate Trypanosoma brucei is the causative agent of human and animal African trypanosomiasis, also known as sleeping sickness and nagana disease, respectively. The infec-tious disease is transmitted by the bite of infected tsetse flies and afflicts mainly rural popula-tions in sub-Saharan Africa. The subspecies T. b. gambiense and T. b. rhodesiense are responsi-ble for the two forms of human African trypanosomiasis, the West and East African sleeping sickness, respectively. A thir...

  9. Human African trypanosomiasis prevention, treatment and control costs: a systematic review.

    Keating, Joseph; Yukich, Joshua O; Sutherland, C Simone; Woods, Geordie; Tediosi, Fabrizio


    The control and eventual elimination of human African trypanosomiasis (HAT) requires the expansion of current control and surveillance activities. A systematic review of the published literature on the costs of HAT prevention, treatment, and control, in addition to the economic burden, was conducted. All studies that contained primary or secondary data on costs of prevention, treatment and control were considered, resulting in the inclusion of 42 papers. The geographically focal nature of the disease and a lack of standardization in the cost data limit the usefulness of the available information for making generalizations across diverse settings. More recent information on the costs of treatment and control interventions for HAT is needed to provide accurate information for analyses and planning. The cost information contained herein can be used to inform rational decision making in control and elimination programs, and to assess potential synergies with existing vector-borne disease control programs, but programs would benefit significantly from new cost data collection. PMID:26056739

  10. Evaluation of the diagnostic accuracy of prototype rapid tests for human African trypanosomiasis.

    Jeremy M Sternberg


    Full Text Available Diagnosis of human African trypanosomiasis (HAT remains a challenge both for active screening, which is critical in control of the disease, and in the point-of-care scenario where early and accurate diagnosis is essential. Recently, the first field deployment of a lateral flow rapid diagnostic test (RDT for HAT, "SD BIOLINE HAT" has taken place. In this study, we evaluated the performance of "SD BIOLINE HAT" and two new prototype RDTs.The performance of "SD BIOLINE HAT" and 2 prototype RDTs was tested using archived plasma from 250 Trypanosoma brucei gambiense patients, and 250 endemic controls. As well as comparison of the sensitivity and specificity of each device, the performance of individual antigens was assessed and the hypothetical performance of novel antigen combinations extrapolated. Neither of the prototype devices were inferior in sensitivity or specificity to "SD BIOLINE HAT" (sensitivity 0.82±0.01, specificity 0.97±0.01, 95% CI at the 5% margins, while one of the devices (BBI had significantly superior sensitivity (0.88±0.03. Analysis of the performance of individual antigens was used to model new antigen combinations to be explored in development of the next generation of HAT RDTs. The modelling showed that an RDT using two recombinant antigens (rLiTat1.5 and rISG65 would give a performance similar to the best devices in this study, and would also offer the most robust performance under deteriorating field conditions.Both "SD BIOLINE HAT" and the prototype devices performed comparably well to one another and also to the published performance range of the card agglutination test for trypanosomiasis in sensitivity and specificity. The performance of individual antigens enabled us to predict that an all-recombinant antigen RDT can be developed with an accuracy equivalent to " SD BIOLINE HAT." Such an RDT would have advantages in simplified manufacture, lower unit cost and assured reproducibility.

  11. Trypanosomiasis in Red Sokoto and West African Dwarf Goats at Ikpa Abattoir, Nsukka, Enugu State, Nigeria

    Okafor Obioma Juliet


    Full Text Available Goat serves as a major investment to most homes in Nigeria, mainly for provision of animal protein and income. The output of this animal is disturbed by Tsetse infestation which is the primary vector of Trypanosome. A survey of Trypanosomiasis of goat in Ikpa abattoir Nsukka, Enugu State, Nigeria was carried out between September and October 2010. This was aimed at determining the species of Trypanosome prevalent in the area and their infection rates among breeds of goat. 106 goats were sampled, among which 15(14.1% were positive for Trypanosome infection. The infection rates among the goat breeds were; Sokoto red (10.4% and West African Dwarf Goat (50.0%. The species of Trypanosome encountered were Trypanosoma vivax(66.7% and Trypanosoma brucei (33.3%. In the infection by sex, this was common among female goats in the various breeds examined and this stood as follows; 9.4% in Sokoto red and 4.7% in West African Dwarf goat. Considering the overall infection rate of Trypanosome in the breeds of goat in the study area, this was relatively high when compared with similar results in related areas; chemo prophylactic and insect control measures should be put in place to rescue the area.

  12. Diagnosis of human trypanosomiasis, due to Trypanosoma brucei gambiense in central Africa, by the polymerase chain reaction

    Penchenier, Laurent; Simo, G.; Grébaut, Pascal; Nkinin, S.; Laveissière, Claude; Herder, Stéphane


    During a mass screening of sleeping sickness conducted in 1998 and 1999, and involving 27,932 persons in Cameroon and the Central African Republic, we tested the polymerase chain reaction (PCR) on whole blood for the diagnosis of human African trypanosomiasis due to #Trypanosoma brucei gambiense$. The 1858 samples obtained were from 4 groups : 155 infected patients, 1432 serological suspects detected by the card agglutination test for trypanosomiasis (CATT), 222 negative controls living in th...

  13. Development of multiplex serological assay for the detection of human African trypanosomiasis.

    Nzou, Samson Muuo; Fujii, Yoshito; Miura, Masashi; Mwau, Matilu; Mwangi, Anne Wanjiru; Itoh, Makoto; Salam, Md Abdus; Hamano, Shinjiro; Hirayama, Kenji; Kaneko, Satoshi


    Human African trypanosomiasis (HAT) is a disease caused by Kinetoplastid infection. Serological tests are useful for epidemiological surveillance. The aim of this study was to develop a multiplex serological assay for HAT to assess the diagnostic value of selected HAT antigens for sero-epidemiological surveillance. We cloned loci encoding eight antigens from Trypanosoma brucei gambiense, expressed the genes in bacterial systems, and purified the resulting proteins. Antigens were subjected to Luminex multiplex assays using sera from HAT and VL patients to assess the antigens' immunodiagnostic potential. Among T. b. gambiense antigens, the 64-kDa and 65-kDa invariant surface glycoproteins (ISGs) and flagellar calcium binding protein (FCaBP) had high sensitivity for sera from T. b. gambiense patients, yielding AUC values of 0.871, 0.737 and 0.858 respectively in receiver operating characteristics (ROC) analysis. The ISG64, ISG65, and FCaBP antigens were partially cross-reactive to sera from Trypanosoma brucei rhodesiense patients. The GM6 antigen was cross-reactive to sera from T. b. rhodesiense patients as well as to sera from VL patients. Furthermore, heterogeneous antibody responses to each individual HAT antigen were observed. Testing for multiple HAT antigens in the same panel allowed specific and sensitive detection. Our results demonstrate the utility of applying multiplex assays for development and evaluation of HAT antigens for use in sero-epidemiological surveillance. PMID:26519611

  14. Development of a nanoparticulate formulation of diminazene to treat African trypanosomiasis

    Kroubi, Maya; Betbeder, Didier [EA 4483, IFR 114 IMPRT, Faculte de Medecine, Pole recherche, Departement de Physiologie, 1 place de Verdun, 59045 Lille Cedex (France); Daulouede, Sylvie; Mossalayi, Djavad; Vincendeau, Philippe [Laboratoire de Parasitologie, Universite Victor Segalen Bordeaux 2, 146 rue Leo Saignat, 33076 Bordeaux Cedex (France); Karembe, Hamadi [CEVA Sante Animale, ZI la Ballastiere, BP 126, 33501 Libourne (France); Jallouli, Youssef [Faculte de Pharmacie, Universite de Lille 2, 3 rue du Professeur Laguesse, 59006 Lille (France); Howsam, Mike, E-mail: [Centre Universitaire de Mesure et d' Analyse, Faculte de Pharmacie, Universite de Lille 2, 3 rue du Professeur Laguesse, 59006 Lille (France)


    There is a real need to develop new therapeutic strategies for African trypanosomiasis infections. In our study, we developed a new drug delivery system of diminazene (DMZ), a trypanocidal drug registered for veterinary use. This drug candidate presents a limited efficacy, a poor affinity for brain tissue and instability. The development of colloidal formulations based on a porous cationic nanoparticle with an oily core ({sub 70}DGNP{sup +}), has potentially two advantages: stabilization of the drug and potential targeting of the parasite. We analyzed two processes of drug loading: in process (DMZ was added during the preparation of {sub 70}DGNP{sup +} at 80 deg. C) and post-loading (DMZ was mixed with a {sub 70}DGNP{sup +} solution at room temperature). Poor stability of the drug was observed using the in process technique. When using the post-loading technique over 80% drug entrapment efficiency was obtained at a ratio of DMZ:phospholipids (wt:wt) < 5%. Moreover, DMZ loaded into {sub 70}DGNP{sup +} was found to be protected against oxidation and was stable for at least six months at 4 deg. C. Finally, in vitro tests on T.b. brucei showed an increased efficacy of DMZ loaded in {sub 70}DGNP{sup +}.

  15. The molecular basis of livestock disease as illustrated by African trypanosomiasis

    African trypanosomes are protozoan parasites, most species of which are transmitted by tsetse flies. They reside in the mammalian bloodstream and evade the immune system by periodically switching the major protein on their surface - a phenomenon called antigenic variation, mediated by gene rearrangements in the trypanosome genome. The trypanosomes eventually enter the central nervous system and cause a fatal disease, commonly called ngana in domestic cattle and sleeping sickness in humans. Two sub-species of Trypanosoma brucei infect humans (T. b. rhodesiense and T. b. gambiense) and one sub-species does not survive in humans (T. b. brucei) because it is lysed by the human-specific serum protein, apolipoprotein L-I. Wild animals in Africa have other (less well understood) molecular mechanisms of suppressing the number of African trypanosomes in the blood, and some indigenous breeds of African cattle also display a partial 'trypanotolerance' whose genetic loci have recently been mapped. (author)

  16. Challenges facing the elimination of sleeping sickness in west and central Africa: sustainable control of animal trypanosomiasis as an indispensable approach to achieve the goal.

    Simo, Gustave; Rayaisse, Jean Baptiste


    African trypanosomiases are infectious diseases caused by trypanosomes. African animal trypanosomiasis (AAT) remains an important threat for livestock production in some affected areas whereas human African trypanosomiasis (HAT) is targeted for elimination in 2020. In West and Central Africa, it has been shown that the parasites causing these diseases can coexist in the same tsetse fly or the same animal. In such complex settings, the control of these diseases must be put in the general context of trypanosomiasis control or "one health" concept where the coordination of control operations will be beneficial for both diseases. In this context, implementing control activities on AAT will help to sustain HAT control. It will also have a positive impact on animal health and economic development of the regions. The training of inhabitants on how to implement and sustain vector control tools will enable a long-term sustainability of control operations that will lead to the elimination of HAT and AAT. PMID:26671582

  17. Cattle owners' perceptions of African bovine trypanosomiasis and its control in Busia and Kwale Districts of Kenya.

    Machila, Noreen; Wanyangu, Samuel W; McDermott, John; Welburn, Susan C; Maudlin, Ian; Eisler, Mark C


    A study using a structured questionnaire was conducted in Busia District, Western Kenya and Kwale District, Coastal Kenya to obtain qualitative and quantitative information from 256 cattle owners about their production systems, their perceptions of the diseases encountered in their cattle, the drugs used, and other measures adopted to control trypanosomiasis in cattle. The predominant production system was mixed crop-livestock with farmers owning 2-11 local cattle on holdings between 2 and 5 ha. Approximately 15% of disease episodes in cattle were perceived to be trypanosomiasis, although the farmers' ability to make diagnoses was limited in that over half of the diagnoses were inconsistent with the clinical signs described. Drugs were generally obtained from agro-veterinary shops, and the farmers themselves administered slightly more than half of these. One third of drug treatments given to sick cattle were trypanocides, but over half of these trypanocidal treatments were given to cattle believed to have diseases other than trypanosomiasis. PMID:12711100

  18. Molecular Evidence of a Trypanosoma brucei gambiense Sylvatic Cycle in the Human African Trypanosomiasis Foci of Equatorial Guinea

    Carlos eCordon-Obras


    Full Text Available Gambiense trypanosomiasis is considered an anthroponotic disease. Consequently, control programs are generally aimed at stopping transmission of Trypanosoma brucei gambiense (T. b. gambiense by detecting and treating human cases. However, the persistence of numerous foci despite efforts to eliminate this disease questions this strategy as unique tool to pursue the eradication. The role of animals as a reservoir of T. b. gambiense is still controversial, but could partly explain maintenance of the infection at hypo-endemic levels. In the present study, we evaluated the presence of T. b. gambiense in wild animals in Equatorial Guinea. The infection rate ranged from 0.8% in the insular focus of Luba to more than 12% in Mbini, a focus with a constant trickle of human cases. The parasite was detected in a wide range of animal species including four species never described previously as putative reservoirs. Our study comes to reinforce the hypothesis that animals may play a role in the persistence of T. b. gambiense transmission, being particularly relevant in low transmission settings. Under these conditions the integration of sustained vector control and medical interventions should be considered to achieve the elimination of Gambiense trypanosomiasis.

  19. Gene fusion analysis in the battle against the African endemic sleeping sickness.

    Philip Trimpalis

    Full Text Available The protozoan Trypanosoma brucei causes African Trypanosomiasis or sleeping sickness in humans, which can be lethal if untreated. Most available pharmacological treatments for the disease have severe side-effects. The purpose of this analysis was to detect novel protein-protein interactions (PPIs, vital for the parasite, which could lead to the development of drugs against this disease to block the specific interactions. In this work, the Domain Fusion Analysis (Rosetta Stone method was used to identify novel PPIs, by comparing T. brucei to 19 organisms covering all major lineages of the tree of life. Overall, 49 possible protein-protein interactions were detected, and classified based on (a statistical significance (BLAST e-value, domain length etc., (b their involvement in crucial metabolic pathways, and (c their evolutionary history, particularly focusing on whether a protein pair is split in T. brucei and fused in the human host. We also evaluated fusion events including hypothetical proteins, and suggest a possible molecular function or involvement in a certain biological process. This work has produced valuable results which could be further studied through structural biology or other experimental approaches so as to validate the protein-protein interactions proposed here. The evolutionary analysis of the proteins involved showed that, gene fusion or gene fission events can happen in all organisms, while some protein domains are more prone to fusion and fission events and present complex evolutionary patterns.

  20. Genetically Distinct Glossina fuscipes fuscipes Populations in the Lake Kyoga Region of Uganda and Its Relevance for Human African Trypanosomiasis

    Richard Echodu


    Full Text Available Tsetse flies (Glossina spp. are the sole vectors of Trypanosoma brucei—the agent of human (HAT and animal (AAT trypanosomiasis. Glossina fuscipes fuscipes (Gff is the main vector species in Uganda—the only country where the two forms of HAT disease (rhodesiense and gambiense occur, with gambiense limited to the northwest. Gff populations cluster in three genetically distinct groups in northern, southern, and western Uganda, respectively, with a contact zone present in central Uganda. Understanding the dynamics of this contact zone is epidemiologically important as the merger of the two diseases is a major health concern. We used mitochondrial and microsatellite DNA data from Gff samples in the contact zone to understand its spatial extent and temporal stability. We show that this zone is relatively narrow, extending through central Uganda along major rivers with south to north introgression but displaying no sex-biased dispersal. Lack of obvious vicariant barriers suggests that either environmental conditions or reciprocal competitive exclusion could explain the patterns of genetic differentiation observed. Lack of admixture between northern and southern populations may prevent the sympatry of the two forms of HAT disease, although continued control efforts are needed to prevent the recolonization of tsetse-free regions by neighboring populations.

  1. Seasonal Changes in Sleep Duration in African American and African College Students Living In Washington, D.C.

    Janna Volkov; Kelly J. Rohan; Yousufi, Samina M.; Minh-Chau Nguyen; Jackson, Michael A.; Thrower, Courtney M.; Stiller, John W.; Teodor T. Postolache


    Duration of nocturnal melatonin secretion, a marker of “biological night” that relates to sleep duration, is longer in winter than in summer in patients with seasonal affective disorder (SAD), but not in healthy controls. In this study of African and African American college students, we hypothesized that students who met criteria for winter SAD or subsyndromal SAD (S-SAD) would report sleeping longer in winter than in summer. In addition, based on our previous observation that Africans repor...

  2. Seasonal Changes in Sleep Duration in African American and African College Students Living In Washington, D.C.

    Janna Volkov


    Full Text Available Duration of nocturnal melatonin secretion, a marker of “biological night” that relates to sleep duration, is longer in winter than in summer in patients with seasonal affective disorder (SAD, but not in healthy controls. In this study of African and African American college students, we hypothesized that students who met criteria for winter SAD or subsyndromal SAD (S-SAD would report sleeping longer in winter than in summer. In addition, based on our previous observation that Africans report more “problems” with change in seasons than African Americans, we expected that the seasonal changes in sleep duration would be greater in African students than in African American students. Based on Seasonal Pattern Assessment Questionnaire (SPAQ responses, African American and African college students in Washington, D.C. (N = 575 were grouped into a winter SAD/S-SAD group or a no winter diagnosis group, and winter and summer sleep length were determined. We conducted a 2 (season × 2 (sex × 2 (ethnicity × 2 (winter diagnosis group ANCOVA on reported sleep duration, controlling for age. Contrary to our hypothesis, we found that African and African American students with winter SAD/S-SAD report sleeping longer in the summer than in the winter. No differences in seasonality of sleep were found between African and African American students. Students with winter SAD or S-SAD may need to sacrifice sleep duration in the winter, when their academic functioning/efficiency may be impaired by syndromal or subsyndromal depression, in order to meet seasonally increased academic demands.

  3. Overview of the Diagnostic Methods Used in the Field for Human African Trypanosomiasis: What Could Change in the Next Years?

    Julien Bonnet


    Full Text Available Sleeping sickness is a parasitic infection caused by two species of trypanosomes (Trypanosoma brucei gambiense and rhodesiense, transmitted by the tsetse fly. The disease eventually affects the central nervous system, resulting in severe neurological symptoms. Without treatment, death is inevitable. During the first stage of the disease, infected patients are mildly symptomatic and early detection of infection allows safer treatment (administered on an outpatient basis which can avoid death; routine screening of the exposed population is necessary, especially in areas of high endemicity. The current therapeutic treatment of this disease, especially in stage 2, can cause complications and requires a clinical surveillance for several days. A good stage diagnosis of the disease is the cornerstone for delivering the adequate treatment. The task faced by the medical personnel is further complicated by the lack of support from local health infrastructure, which is at best weak, but often nonexistent. Therefore it is crucial to look for new more efficient technics for the diagnosis of stage which are also best suited to use in the field, in areas not possessing high-level health facilities. This review, after an overview of the disease, summarizes the current diagnosis procedures and presents the advances in the field.

  4. Constraints in the Control of African Trypanosomiasis the Prevailing Factors in Kurmin Kaduna, Northern, Nigeria (Review Article

    Attahir Abubakar


    Full Text Available The aim of this review is to further highlight the prevailing factors in the control of African trypanosomosis in Nigeria. The effectiveness of trypanocides as a means of control is being curtailed by, wide spread drug resistance, lack of alternative drugs, multiple resistance, fake drugs,insufficient veterinary services, proliferation of quacks, high cost of trypanocides and the ability of the parasite to survive in cryptic foci poorly accessible to drugs. Trypanotolerance is a relative rather than absolute trait, severely affected by heavy challenge, malnutrition, stress, breed, age, season, and concurrent disease, Trypanotolerant breeds are poorly utilized and accepted because of their size, productivity and traction power compared with the large zebu breeds. Use of insecticide has been the most effective and reliable method of control but fear of emergence of resistance, cross resistance, environmental damage, accumulation in food chains with damaging effect on fertility etc constitute a major drawback on its use. Poor policies formulation and enforcement, human beliefs and behaviors, tsetse redistribution, mechanical transmitters and reservoire host has hindered effective control. The scanty inform ation on distribution, prevalence and economic impact of trypanosomosis in Nigeria, coupled with corruption, lack of community participation, inability to implement cost effective control strategies, these has resulted in the negative attitude of national governments and international funding organizations towards control of the disease, leading to collapse of many control projects. There is no control method that can be used alone; rather a combination of different control methods has proven effective due to the social, economical and cultural behaviors of Nigerians.

  5. A mixed methods study of a health worker training intervention to increase syndromic referral for gambiense human African trypanosomiasis in South Sudan.

    Jennifer J Palmer


    Full Text Available BACKGROUND: Active screening by mobile teams is considered the most effective method for detecting gambiense-type human African trypanosomiasis (HAT but constrained funding in many post-conflict countries limits this approach. Non-specialist health care workers (HCWs in peripheral health facilities could be trained to identify potential cases for testing based on symptoms. We tested a training intervention for HCWs in peripheral facilities in Nimule, South Sudan to increase knowledge of HAT symptomatology and the rate of syndromic referrals to a central screening and treatment centre. METHODOLOGY/PRINCIPAL FINDINGS: We trained 108 HCWs from 61/74 of the public, private and military peripheral health facilities in the county during six one-day workshops and assessed behaviour change using quantitative and qualitative methods. In four months prior to training, only 2/562 people passively screened for HAT were referred from a peripheral HCW (0 cases detected compared to 13/352 (2 cases detected in the four months after, a 6.5-fold increase in the referral rate observed by the hospital. Modest increases in absolute referrals received, however, concealed higher levels of referral activity in the periphery. HCWs in 71.4% of facilities followed-up had made referrals, incorporating new and pre-existing ideas about HAT case detection into referral practice. HCW knowledge scores of HAT symptoms improved across all demographic sub-groups. Of 71 HAT referrals made, two-thirds were from new referrers. Only 11 patients completed the referral, largely because of difficulties patients in remote areas faced accessing transportation. CONCLUSIONS/SIGNIFICANCE: The training increased knowledge and this led to more widespread appropriate HAT referrals from a low base. Many referrals were not completed, however. Increasing access to screening and/or diagnostic tests in the periphery will be needed for greater impact on case-detection in this context. These data

  6. Influence of Pastoralists' Sociocultural Activities on Tsetse-Trypanosome-Cattle Reservoir Interface: The Risk of Human African Trypanosomiasis in North-Central Nigeria.

    Alhaji, N B; Kabir, J


    The study investigated socio-cultural characteristics of pastoralists that influenced on the tsetse-trypanosome-cattle reservoir interface thereby predisposing them to HAT in Niger State, North-central Nigeria. It was a cross-sectional survey of adult pastoral herders, aged 30 years and above, and conducted between October 2012 and February 2013. A face-to-face structured questionnaire was administered on the pastoralists nested in 96 cattle herds with questions focused on pastoralists' socio-cultural activities and behavioral practices related to HAT risk. Descriptive and analytic statistics were used to describe the obtained data. A total of 384 pastoralists participated, with mean age of 49.6  ± 10.76 SD years. Male respondents constituted 86.7% of gender, while pastoralists of age group 40-49 years constituted 35.4% of respondents. About 59.4% of the pastoralists had knowledge about HAT and its symptoms and only 33.9% of them believed that cattle served as reservoir of HAT trypanosome. Knowledge/belief levels of the pastoralists about African trypanosomiasis occurrence in humans and animals were statistically significant. Males were four times more likely to be exposed to HAT (OR = 3.67; 95% CI: 1.42, 9.52); age group 60-69 was also four times more likely to be exposed (OR = 3.59; 95% CI: 1.56, 8.28); and nomadic pastoralists were two times more likely to be exposed to HAT (OR = 2.07; 95% CI: 1.37, 3.14). All cultural practices significantly influenced exposure to HAT with extensive husbandry system three times more likely to predisposed pastoralists to HAT (OR = 3.21; 95% CI: 1.65, 6.24). Socio-cultural characteristics of pastoralists influenced exposure to HAT risk and, therefore, there is a need to sensitize them to bring changes to their socio-cultural practices and perceptions to achieve effective and long term sustainable HAT control. Elimination strategies of parasites in animals and vectors should be considered to avoid reintroduction

  7. N-myristoyltransferase inhibitors as new leads to treat sleeping sickness

    Frearson, Julie A.; Brand, Stephen; McElroy, Stuart P.; Cleghorn, Laura A.T.; Smid, Ondrej; Stojanovski, Laste; Price, Helen P.; Guther, M. Lucia S.; Torrie, Leah S.; Robinson, David A.; Hallyburton, Irene; Mpamhanga, Chidochangu P.; Brannigan, James A.; Wilkinson, Anthony J.; Hodgkinson, Michael; Hui, Raymond; Qiu, Wei; Raimi, Olawale G.; van Aalten, Daan M.F.; Brenk, Ruth; Gilbert, Ian H.; Read, Kevin D.; Fairlamb, Alan H.; Ferguson, Michael A.J.; Smith, Deborah F.; Wyatt, Paul G. (York); (Toronto); (Dundee)


    African sleeping sickness or human African trypanosomiasis, caused by Trypanosoma brucei spp., is responsible for {approx}30,000 deaths each year. Available treatments for this disease are poor, with unacceptable efficacy and safety profiles, particularly in the late stage of the disease when the parasite has infected the central nervous system. Here we report the validation of a molecular target and the discovery of associated lead compounds with the potential to address this lack of suitable treatments. Inhibition of this target - T. brucei N-myristoyltransferase - leads to rapid killing of trypanosomes both in vitro and in vivo and cures trypanosomiasis in mice. These high-affinity inhibitors bind into the peptide substrate pocket of the enzyme and inhibit protein N-myristoylation in trypanosomes. The compounds identified have promising pharmaceutical properties and represent an opportunity to develop oral drugs to treat this devastating disease. Our studies validate T. brucei N-myristoyltransferase as a promising therapeutic target for human African trypanosomiasis.

  8. The Molecular Dynamics of Trypanosoma brucei UDP-Galactose 4′-Epimerase: A Drug Target for African Sleeping Sickness

    Friedman, Aaron J; Durrant, Jacob D.; Pierce, Levi C. T.; McCorvie, Thomas J; Timson, David J; McCammon, J. Andrew


    During the past century, several epidemics of human African trypanosomiasis, a deadly disease caused by the protist Trypanosoma brucei, have afflicted sub-Saharan Africa. Over 10 000 new victims are reported each year, with hundreds of thousands more at risk. As current drug treatments are either highly toxic or ineffective, novel trypanocides are urgently needed. The T. brucei galactose synthesis pathway is one potential therapeutic target. Although galactose is essential for T. brucei survi...

  9. Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES)

    Meng Yuan-Xiang; Chen Zhimin; Coverson Dorothy L; Din-Dzietham Rebecca; Bidulescu Aurelian; Buxbaum Sarah G; Gibbons Gary H; Welch Verna L


    Abstract Background Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA). Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI) and obesity and...

  10. Improving the Quality of Host Country Ethical Oversight of International Research: The Use of a Collaborative 'Pre-Review' Mechanism for a Study of Fexinidazole for Human African Trypanosomiasis.

    Coleman, Carl H; Ardiot, Chantal; Blesson, Séverine; Bonnin, Yves; Bompart, Francois; Colonna, Pierre; Dhai, Ames; Ecuru, Julius; Edielu, Andrew; Hervé, Christian; Hirsch, François; Kouyaté, Bocar; Mamzer-Bruneel, Marie-France; Maoundé, Dionko; Martinent, Eric; Ntsiba, Honoré; Pelé, Gérard; Quéva, Gilles; Reinmund, Marie-Christine; Sarr, Samba Cor; Sepou, Abdoulaye; Tarral, Antoine; Tetimian, Djetodjide; Valverde, Olaf; Van Nieuwenhove, Simon; Strub-Wourgaft, Nathalie


    Developing countries face numerous barriers to conducting effective and efficient ethics reviews of international collaborative research. In addition to potentially overlooking important scientific and ethical considerations, inadequate or insufficiently trained ethics committees may insist on unwarranted changes to protocols that can impair a study's scientific or ethical validity. Moreover, poorly functioning review systems can impose substantial delays on the commencement of research, which needlessly undermine the development of new interventions for urgent medical needs. In response to these concerns, the Drugs for Neglected Diseases Initiative (DNDi), an independent nonprofit organization founded by a coalition of public sector and international organizations, developed a mechanism to facilitate more effective and efficient host country ethics review for a study of the use of fexinidazole for the treatment of late stage African Trypanosomiasis (HAT). The project involved the implementation of a novel 'pre-review' process of ethical oversight, conducted by an ad hoc committee of ethics committee representatives from African and European countries, in collaboration with internationally recognized scientific experts. This article examines the process and outcomes of this collaborative process. PMID:25039421

  11. "It's Not All About My Baby's Sleep": A Qualitative Study of Factors Influencing Low-Income African American Mothers' Sleep Quality.

    Zambrano, Danielle N; Mindell, Jodi A; Reyes, Naomi R; Hart, Chantelle N; Herring, Sharon J


    Low-income African American mothers are at particular risk for poor postpartum sleep. This study sought to understand facilitators and barriers that exist to getting a good night's sleep among these high-risk mothers. Semistructured interviews with 18 low-income African Americans (3-6 months postpartum) were conducted. Most mothers described their own sleep quality to be poor, despite the fact that their babies' sleep improved substantially from the newborn period. Mothers kept themselves awake due to their own internal worry and anxiety, along with external factors that were largely independent of babies' sleep, including work and school commitments and the home environment. For the few mothers with good sleep quality, time management and family support were strong facilitators. Findings lay the groundwork for sleep improvement interventions. PMID:26488388

  12. Sleep Disturbance and Risk Behaviors among Inner-City African-American Adolescents

    Umlauf, Mary Grace; Bolland, John M.; Lian, Brad E.


    Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998–2005; N = 20,716; age range = 9.75–19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep...

  13. Estimates of the duration of the early and late stage of gambiense sleeping sickness

    Chandramohan Daniel; Haydon Daniel T; Filipe João AN; Checchi Francesco; Chappuis François


    Abstract Background The durations of untreated stage 1 (early stage, haemo-lymphatic) and stage 2 (late stage, meningo-encephalitic) human African trypanosomiasis (sleeping sickness) due to Trypanosoma brucei gambiense are poorly quantified, but key to predicting the impact of screening on transmission. Here, we outline a method to estimate these parameters. Methods We first model the duration of stage 1 through survival analysis of untreated serological suspects detected during Médecins Sans...

  14. Prevention and control of malaria and sleeping sickness in Africa : where are we and where are we going ?

    Corbel Vincent; Henry Marie-Claire


    Abstract The International Symposium on Malaria and Human African Trypanosomiasis: New Strategies for their Prevention & Control was held 7-8 October, 2010 in Cotonou, Benin with about 250 participants from 20 countries. This scientific event aimed at identifying the gaps and research priorities in the prevention and control of malaria and sleeping sickness in Africa and to promote exchange between North and South in the fields of medical entomology, epidemiology, immunology and parasitology....

  15. Cerebral trypanosomiasis and AIDS

    Antunes Apio Claudio Martins


    Full Text Available A 36 year-old black female, complaining of headache of one month's duration presented with nausea, vomiting, somnolence, short memory problems, loss of weight, and no fever history. Smoker, intravenous drugs abuser, promiscuous lifestyle. Physical examination: left homonimous hemianopsia, left hemiparesis, no papilledema, diffuse hyperreflexia, slowness of movements. Brain CT scan: tumor-like lesion in the splenium of the corpus calosum, measuring 3.5 x 1.4 cm, with heterogeneous enhancing pattern, sugesting a primary CNS tumor. Due to the possibility of CNS infection, a lumbar puncture disclosed an opening pressure of 380 mmH(20; 11 white cells (lymphocytes; glucose 18 mg/dl (serum glucose 73 mg/dl; proteins 139 mg/dl; presence of Trypanosoma parasites. Serum Elisa-HIV tests turned out to be positive. Treatment with benznidazole dramatically improved clinical and radiographic picture, but the patient died 6 weeks later because of respiratory failure. T. cruzi infection of the CNS is a rare disease, but we have an increasing number of cases in HIV immunecompromised patients. Diagnosis by direct observation of CSF is uncommon, and most of the cases are diagnosed by pathological examination. It is a highly lethal disease, even when properly diagnosed and treated. This article intends to include cerebral trypanosomiasis in the differential diagnosis of intracranial space-occupying lesions, especially in immunecompromised patients from endemic regions.

  16. Population genetics of Trypanosoma brucei circulating in Glossina palpalis palpalis and domestic animals of the Fontem sleeping sickness focus of Cameroon

    Simo, Gustave; Njitchouang, Guy Roger; Melachio, Tresor Tito Tanekou; Njiokou, Flobert; Cuny, Gerard; Tazoacha, Asonganyi


    Background: Human African Trypanosomiasis is still a public health threat in Cameroon. To assess Trypanosoma brucei strains circulating in the Fontem sleeping sickness focus, we conducted a genetic structure study using microsatellites to assess genotypes circulating in both tsetse flies and domestic animals. Method: For this study, pyramidal traps were set up and 2695 tsetse flies were collected and 1535 (57%) living flies were dissected and their mid- guts collected. Furthermore, blood samp...

  17. The Phosphoproteome of Bloodstream Form Trypanosoma brucei, Causative Agent of African Sleeping Sickness

    Nett, Isabelle R. E.; Martin, David M. A.; Miranda-Saavedra, Diego; Lamont, Douglas; Barber, Jonathan D.; Mehlert, Angela; Ferguson, Michael A. J.


    The protozoan parasite Trypanosoma brucei is the causative agent of human African sleeping sickness and related animal diseases, and it has over 170 predicted protein kinases. Protein phosphorylation is a key regulatory mechanism for cellular function that, thus far, has been studied in T.brucei principally through putative kinase mRNA knockdown and observation of the resulting phenotype. However, despite the relatively large kinome of this organism and the demonstrated essentiality of severa...

  18. The molecular dynamics of Trypanosoma brucei UDP-galactose 4'-epimerase:a drug target for African sleeping sickness

    Friedman, Aaron J; Durrant, Jacob D.; Pierce, Levi C. T.; McCorvie, Thomas J; Timson, David J; McCammon, J. Andrew


    During the past century, several epidemics of human African trypanosomiasis, a deadly disease caused by the protist Trypanosoma brucei, have afflicted sub-Saharan Africa. Over 10 000 new victims are reported each year, with hundreds of thousands more at risk. As current drug treatments are either highly toxic or ineffective, novel trypanocides are urgently needed. The T. brucei galactose synthesis pathway is one potential therapeutic target. Although galactose is essential for T. brucei survi...

  19. Sleep

    ... NICHD Research Information Clinical Trials Resources and Publications Sleep: Condition Information Skip sharing on social media links Share this: Page Content What is sleep? Sleep is a period of unconsciousness during which ...

  20. Interaction of sleep quality and psychosocial stress on obesity in African Americans: the Cardiovascular Health Epidemiology Study (CHES

    Meng Yuan-Xiang


    Full Text Available Abstract Background Compared with whites, sleep disturbance and sleep deprivation appear more prevalent in African Americans (AA. Long-term sleep deprivation may increase the risk of obesity through multiple metabolic and endocrine alterations. Previous studies have reported contradictory results on the association between habitual sleep duration and obesity. Accordingly, we aimed to assess whether sleep quality and duration are inversely associated with body mass index (BMI and obesity and test whether these associations are modified by psychosocial stress, known to influence sleep quality. Methods A sample of 1,515 AA residents of metropolitan Atlanta, aged 30-65 years, was recruited by a random-digit-dialing method in 2007-08. The outcome obesity was defined by BMI (kg/m2 continuously and categorically (BMI ≥ 30 versus BMI Results The mean (standard deviation age was 47.5 (17.0 years, and 1,096 (72% were women. GSQ score categorized into tertiles was associated with BMI. Among women, after multivariable adjustment that included age, gender, physical activity, smoking status, education, total family income, financial stress and history of hypertension, hypercholesterolemia, diabetes and myocardial infarction, obesity was associated with sleep quality as assessed by GSQ continuous score, [odds ratio, OR (95% C.I.: 1.08 (1.03 - 1.12], and with a worse sleep disturbance subcomponent score [OR (95% C.I.: 1.48 (1.16 - 1.89]. Among all participants, stress modified the association between obesity and sleep quality; there was an increased likelihood of obesity in the medium stress category, OR (95% C.I.: 1.09 (1.02 - 1.17. Conclusion Sleep quality was associated with obesity in women. The association of sleep quality with obesity was modified by perceived stress. Our results indicate the need for simultaneous assessment of sleep and stress.

  1. Neglected diseases in the news: a content analysis of recent international media coverage focussing on leishmaniasis and trypanosomiasis.

    Mangai Balasegaram

    Full Text Available BACKGROUND: Although the pharmaceutical industry's "neglect" of neglected tropical diseases (NTDs has been investigated, no study evaluating media coverage of NTDs has been published. Poor media coverage exacerbates the neglect. This study aimed to investigate, describe, and analyse international media coverage of "neglected diseases" in general and three specific NTDs--African trypanosomiasis, leishmaniasis, and Chagas disease--from 1 January 2003 to 1 June 2007. METHODS: Archives of 11 leading international, English-language media were searched. A content analysis was done, coding for media organisation, date, author, type of report, slant, themes, and "frames". Semi-structured interviews with journalists and key informants were conducted for further insight. PRINCIPAL FINDINGS: Only 113 articles in a 53-month time period met the inclusion criteria, with no strong trends or increases in coverage. Overall, the BBC had the highest coverage with 20 results, followed by the Financial Times and Agence France Presse. CNN had the least coverage with one result. The term "neglected diseases" had good media currency and "sleeping sickness" was far more widely used than trypanosomiasis. The disease most covered was leishmaniasis and the least covered was Chagas. Academic researchers were most commonly quoted as a main source, while the World Health Organization (WHO and pharmaceutical industry were the least quoted. Journalists generally agreed NTDs had not been adequately covered, but said a lack of real news development and the need to cater to domestic audiences were major obstacles for NTD reporting. All journalists said health agencies, particularly WHO, were not communicating adequately about the burden of NTDs. CONCLUSIONS: Public health agencies need to raise priority for NTD advocacy. Innovative strategies, such as reporting grants or creating a network of voices, may be needed.

  2. Population genetics of Glossina palpalis palpalis from central African sleeping sickness foci

    Solano Philippe


    Full Text Available Abstract Background Glossina palpalis palpalis (Diptera: Glossinidae is widespread in west Africa, and is the main vector of sleeping sickness in Cameroon as well as in the Bas Congo Province of the Democratic Republic of Congo. However, little is known on the structure of its populations. We investigated G. p. palpalis population genetic structure in five sleeping sickness foci (four in Cameroon, one in Democratic Republic of Congo using eight microsatellite DNA markers. Results A strong isolation by distance explains most of the population structure observed in our sampling sites of Cameroon and DRC. The populations here are composed of panmictic subpopulations occupying fairly wide zones with a very strong isolation by distance. Effective population sizes are probably between 20 and 300 individuals and if we assume densities between 120 and 2000 individuals per km2, dispersal distance between reproducing adults and their parents extends between 60 and 300 meters. Conclusions This first investigation of population genetic structure of G. p. palpalis in Central Africa has evidenced random mating subpopulations over fairly large areas and is thus at variance with that found in West African populations of G. p. palpalis. This study brings new information on the isolation by distance at a macrogeographic scale which in turn brings useful information on how to organise regional tsetse control. Future investigations should be directed at temporal sampling to have more accurate measures of demographic parameters in order to help vector control decision.

  3. Animal trypanosomiasis control in Uganda

    Uganda, with a population of about 17 million people, depends largely on the Agricultural Sector both for subsistence and export. Uganda livestock stands at 4 million cattle, 2.5 million goats, 0.7 million sheep and 0.5 million pigs. The life of these animals is being threatened by various tropical diseases. Animal trypanosomiasis is endemic in all the 34 districts of Uganda except the highland areas of the country. These are correspondingly areas of high tsetse fly infestation. For effective control of this disease, therefore, an integrated approach is adopted. The country has been divided into three zones of disease incidence, namely the high, medium and low risk zones. Each zone has a slightly different treatment regime with curative and prophylactic trypanocidals as short term control measures. The long term aim is to eradicate the tsetse fly, and therefore, the disease

  4. Transverse myelitis due to trypanosomiasis in a middle aged Tanzanian man

    Kibiki, G S; Murphy, D K


    We report the case of a middle aged Tanzanian man who developed a spinal cord syndrome over 6 weeks, along with a mild encephalopathy. Investigations ruled out the usual major causes of such a syndrome in our setting in northern Tanzania. Examination of his cerebrospinal fluid revealed trypanosomes, and he made a slow but dramatic improvement after a full course of suramine and melarsoprol. We postulate that he had a transverse myelitis due to African trypanosomiasis, a rare and barely recogn...

  5. Cryptic Diversity within the Major Trypanosomiasis Vector Glossina fuscipes Revealed by Molecular Markers

    Choi, Kwang-Shik; Darby, Alistair C.; Causse, Sandrine; Kapitano, Berisha; Hall, Martin J. R.; Steen, Keith; Lutumba, Pascal; Madinga, Joules; Torr, Steve J.; Okedi, Loyce M.; Lehane, Michael J.; Donnelly, Martin J.


    Background The tsetse fly Glossina fuscipes s.l. is responsible for the transmission of approximately 90% of cases of human African trypanosomiasis (HAT) or sleeping sickness. Three G. fuscipes subspecies have been described, primarily based upon subtle differences in the morphology of their genitalia. Here we describe a study conducted across the range of this important vector to determine whether molecular evidence generated from nuclear DNA (microsatellites and gene sequence information), mitochondrial DNA and symbiont DNA support the existence of these taxa as discrete taxonomic units. Principal Findings The nuclear ribosomal Internal transcribed spacer 1 (ITS1) provided support for the three subspecies. However nuclear and mitochondrial sequence data did not support the monophyly of the morphological subspecies G. f. fuscipes or G. f. quanzensis. Instead, the most strongly supported monophyletic group was comprised of flies sampled from Ethiopia. Maternally inherited loci (mtDNA and symbiont) also suggested monophyly of a group from Lake Victoria basin and Tanzania, but this group was not supported by nuclear loci, suggesting different histories of these markers. Microsatellite data confirmed strong structuring across the range of G. fuscipes s.l., and was useful for deriving the interrelationship of closely related populations. Conclusion/Significance We propose that the morphological classification alone is not used to classify populations of G. fuscipes for control purposes. The Ethiopian population, which is scheduled to be the target of a sterile insect release (SIT) programme, was notably discrete. From a programmatic perspective this may be both positive, given that it may reflect limited migration into the area or negative if the high levels of differentiation are also reflected in reproductive isolation between this population and the flies to be used in the release programme. PMID:21858237

  6. Sleeping sickness in travelers - do they really sleep?

    Karin Urech


    Full Text Available The number of imported Human African Trypanosomiasis (HAT cases in non-endemic countries has increased over the last years. The objective of this analysis is to describe the clinical presentation of HAT in Caucasian travelers. Literature was screened (MEDLINE, Pubmed using the terms "Human African Trypanosomiasis", "travelers" and "expatriates"; all European languages except Slavic ones were included. Publications without clinical description of patients were only included in the epidemiological analysis. Forty-five reports on Caucasians with T.b. rhodesiense and 15 with T.b. gambiense infections were included in the analysis of the clinical parameters. Both species have presented with fever (T.b. rhodesiense 97.8% and T.b. gambiense 93.3%, headache (50% each and a trypanosomal chancre (T.b. rhodesiense 84.4%, T.b. gambiense 46.7%. While sleeping disorders dominate the clinical presentation of HAT in endemic regions, there have been only rare reports in travelers: insomnia (T.b. rhodesiense 7.1%, T.b. gambiense 21.4%, diurnal somnolence (T.b. rhodesiense 4.8%, T.b. gambiense none. Surprisingly, jaundice has been seen in 24.2% of the Caucasian T.b. rhodesiense patients, but has never been described in HAT patients in endemic regions. These results contrast to the clinical presentation of T.b. gambiense and T.b. rhodesiense HAT in Africans in endemic regions, where the presentation of chronic T.b. gambiense and acute T.b. rhodesiense HAT is different. The analysis of 14 reports on T.b. gambiense HAT in Africans living in a non-endemic country shows that neurological symptoms such as somnolence (46.2%, motor deficit (64.3% and reflex anomalies (14.3% as well as psychiatric symptoms such as hallucinations (21.4% or depression (21.4% may dominate the clinical picture. Often, the diagnosis has been missed initially: some patients have even been hospitalized in psychiatric clinics. In travelers T.b. rhodesiense and gambiense present as acute illnesses

  7. The phosphoproteome of bloodstream form Trypanosoma brucei, causative agent of African sleeping sickness.

    Nett, Isabelle R E; Martin, David M A; Miranda-Saavedra, Diego; Lamont, Douglas; Barber, Jonathan D; Mehlert, Angela; Ferguson, Michael A J


    The protozoan parasite Trypanosoma brucei is the causative agent of human African sleeping sickness and related animal diseases, and it has over 170 predicted protein kinases. Protein phosphorylation is a key regulatory mechanism for cellular function that, thus far, has been studied in T.brucei principally through putative kinase mRNA knockdown and observation of the resulting phenotype. However, despite the relatively large kinome of this organism and the demonstrated essentiality of several T. brucei kinases, very few specific phosphorylation sites have been determined in this organism. Using a gel-free, phosphopeptide enrichment-based proteomics approach we performed the first large scale phosphorylation site analyses for T.brucei. Serine, threonine, and tyrosine phosphorylation sites were determined for a cytosolic protein fraction of the bloodstream form of the parasite, resulting in the identification of 491 phosphoproteins based on the identification of 852 unique phosphopeptides and 1204 phosphorylation sites. The phosphoproteins detected in this study are predicted from their genome annotations to participate in a wide variety of biological processes, including signal transduction, processing of DNA and RNA, protein synthesis, and degradation and to a minor extent in metabolic pathways. The analysis of phosphopeptides and phosphorylation sites was facilitated by in-house developed software, and this automated approach was validated by manual annotation of spectra of the kinase subset of proteins. Analysis of the cytosolic bloodstream form T. brucei kinome revealed the presence of 44 phosphorylated protein kinases in our data set that could be classified into the major eukaryotic protein kinase groups by applying a multilevel hidden Markov model library of the kinase catalytic domain. Identification of the kinase phosphorylation sites showed conserved phosphorylation sequence motifs in several kinase activation segments, supporting the view that

  8. Social factors affecting seasonal variation in bovine trypanosomiasis on the Jos Plateau, Nigeria


    Background African Animal Trypanosomiasis (AAT) is a widespread disease of livestock in Nigeria and presents a major constraint to rural economic development. The Jos Plateau was considered free from tsetse flies and the trypanosomes they transmit due to its high altitude and this trypanosomiasis free status attracted large numbers of cattle-keeping pastoralists to the area. The Jos Plateau now plays a major role in the national cattle industry in Nigeria, accommodating approximately 7% of the national herd, supporting 300,000 pastoralists and over one million cattle. During the past two decades tsetse flies have invaded the Jos Plateau and animal trypanosomiasis has become a significant problem for livestock keepers. Here we investigate the epidemiology of trypanosomiasis as a re-emerging disease on the Plateau, examining the social factors that influence prevalence and seasonal variation of bovine trypanosomiasis. Methods In 2008 a longitudinal two-stage cluster survey was undertaken on the Jos Plateau. Cattle were sampled in the dry, early wet and late wet seasons. Parasite identification was undertaken using species-specific polymerase chain reactions to determine the prevalence and distribution of bovine trypanosomiasis. Participatory rural appraisal was also conducted to determine knowledge, attitudes and practices concerning animal husbandry and disease control. Results Significant seasonal variation between the dry season and late wet season was recorded across the Jos Plateau, consistent with expected variation in tsetse populations. However, marked seasonal variations were also observed at village level to create 3 distinct groups: Group 1 in which 50% of villages followed the general pattern of low prevalence in the dry season and high prevalence in the wet season; Group 2 in which 16.7% of villages showed no seasonal variation and Group 3 in which 33.3% of villages showed greater disease prevalence in the dry season than in the wet season. Conclusions

  9. Exploring the link between nocturnal heart rate, sleep apnea and cardiovascular function in African and Caucasian men : the SABPA study / Y. van Rooyen.

    Van Rooyen, Yolandi


    Motivation: There is a rapid escalation in urbanization amongst South Africans and it is known that urbanized South Africans are subjected to lifestyle factors conducive to an increase in the risk for cardiovascular disease (CVD). Obstructive sleep apnea (OSA) has been described as an independent risk factor for CVD, especially hypertension. OSA has also been associated with insomnia, and plays a contributory role in the co-morbidity of this disorder. The mechanisms employed by OSA, which pro...

  10. Mapping sleeping sickness in Western Africa in a context of demographic transition and climate change

    Cecchi G.


    Full Text Available Human population growth, climate change and economic development are causing major environmental modifications in Western Africa, which will have important repercussions on the epidemiology of sleeping sickness. A new initiative, the Atlas of human African trypanosomiasis (HAT, aims at assembling and geo-referencing all epidemiological data derived from both active screening activities and passive surveillance. A geographic database enables to generate up-to-date disease maps at a range of scales and of unprecedented spatial accuracy. We present preliminary results for seven West African countries (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali and Togo and briefly discuss the relevance of the Atlas for future monitoring, control and research activities.

  11. The significance of migrant Fulani and human trypanosomiasis in Kainji Lake area of Nigeria.

    Adekolu-John, E O


    The transhumance-route followed by the Fulani around Lake Kainji area of Nigeria is presented. Between January and February 1977 130 Fulanis were interviewed at different locations. Most respondents were between 20-60 years of age. In addition to cattle rearing, farming is practised among the Fulanis interviewed at Kaiama and Olli. Those interviewed at Faku practised pastoral transhumance. Less than 15% of the respondents had previous knowledge of human sleeping sickness. Although examination of blood films (thin and thick) did not reveal any blood trypanosome, the transhumance pastoral mobility will be an important factor in any outbreak of human trypanosomiasis around Kainji Lake area in future. PMID:734753

  12. Tsetse and trypanosomiasis control in Zimbabwe

    Trypanosomiasis, a disease transmitted by tsetse flies, is a major constraint on Agricultural Production in Tropical Africa. In Zimbabwe where agriculture, and particularly stock raising, is of major economic and social significance, the control of the tsetse fly leading to its eradication is a task of national importance. Zimbabwe has achieved significant progress in tsetse and trypanosomiasis control with a total of 48,000 km2 being cleared of tsetse since 1980. The cleared areas have been consolidated by planned human settlement whose agricultural production has increased following introduction of cattle which provide much needed traction power. Tsetse flies are now confined to an area of 25,000 km2 along the Zambezi Valley. Several strategies are being used to control tsetse flies with the latest technique being the use of odour-baited insecticide-impregnated targets. When used at a density of 4/km2, targets have been found to be extremely effective against the species of tsetse flies found in Zimbabwe. The work undertaken in Zimbabwe as well as prospects for the future within the EEC-funded Regional Tsetse and Trypanosomiasis Control Programme will be discussed. (author)

  13. Prevention and control of malaria and sleeping sickness in Africa: Where are we and where are we going?

    Corbel Vincent


    Full Text Available Abstract The International Symposium on Malaria and Human African Trypanosomiasis: New Strategies for their Prevention & Control was held 7-8 October, 2010 in Cotonou, Benin with about 250 participants from 20 countries. This scientific event aimed at identifying the gaps and research priorities in the prevention and control of malaria and sleeping sickness in Africa and to promote exchange between North and South in the fields of medical entomology, epidemiology, immunology and parasitology. A broad range of influential partners from academia (scientists, stakeholders, public health workers and industry attempted the meeting and about 40 oral communications and 20 posters were presented by phD students and internationally-recognized scientists from the North and the South. Finally, a special award ceremony was held to recognize efforts in pioneer work conducted by staff involved in the diagnostic of the Sleeping illness in West Africa with partnership and assistance from WHO and Sanofi-Aventis group.

  14. International assistance to intervention policies and implementation of area-wide tsetse and animal trypanosomiasis programmes

    Full text: Tsetse-transmitted trypanosomiasis is a human and animal disease problem that directly and indirectly affects African livestock and agricultural output, rural socio-economic development, human health and welfare. The overall economic impact of African animal trypanosomiasis (AAT) is estimated at USD 4.75 billion per annum in benefits than could otherwise have been obtained in the agriculture and livestock sector. With regards to human African trypanosomiasis (HAT), an effective active surveillance programme would need to cover 70 percent of the people at risk, for which some USD 35 million per year would be needed, not including the cost of drugs needed for treating all detected cases. Efforts against the AAT problem require a prioritised approach as part of sustainable agriculture and rural development (SARD). As the spread of HAT over the past decades, was furthered by many socio-economic factors, such as political instability, wars and poverty, effective and sustainable intervention efforts against HAT require to be established as part of overall public health initiatives. A removal of the tsetse and trypanosomiasis (T and T) problem is expected to have a catalysing effect on rural development, on public health and on reducing poverty and food insecurity. A variety of agro-ecological settings (geo-climatic factors and trends, land-use patterns, livestock systems and crop agriculture practices) prevail in tsetse-infested sub-Saharan Africa and result in heterogeneous landscape scenarios in terms of HAT foci, AAT prevalence, farming, poverty and food security. Consequently, priority areas, where T and T intervention is most urgently needed and is expected to produce tangible and sustainable benefits, are to be selected not merely on the basis of the technical feasibility to alleviate or eliminate disease, but also and perhaps foremost on the need for emergency assistance - particularly regarding HAT - and the potential for sustainable public health and

  15. Sleeping sickness and its relationship with development and biodiversity conservation in the Luangwa Valley, Zambia.

    Anderson, Neil E; Mubanga, Joseph; Machila, Noreen; Atkinson, Peter M; Dzingirai, Vupenyu; Welburn, Susan C


    The Luangwa Valley has a long historical association with Human African Trypanosomiasis (HAT) and is a recognised geographical focus of this disease. It is also internationally acclaimed for its high biodiversity and contains many valuable habitats. Local inhabitants of the valley have developed sustainable land use systems in co-existence with wildlife over centuries, based on non-livestock keeping practices largely due to the threat from African Animal Trypanosomiasis. Historical epidemics of human sleeping sickness have influenced how and where communities have settled and have had a profound impact on development in the Valley. Historical attempts to control trypanosomiasis have also had a negative impact on conservation of biodiversity.Centralised control over wildlife utilisation has marginalised local communities from managing the wildlife resource. To some extent this has been reversed by the implementation of community based natural resource management programmes in the latter half of the 20(th) century and the Luangwa Valley provides some of the earliest examples of such programmes. More recently, there has been significant uncontrolled migration of people into the mid-Luangwa Valley driven by pressure on resources in the eastern plateau region, encouragement from local chiefs and economic development in the tourist centre of Mfuwe. This has brought changing land-use patterns, most notably agricultural development through livestock keeping and cotton production. These changes threaten to alter the endemically stable patterns of HAT transmission and could have significant impacts on ecosystem health and ecosystem services.In this paper we review the history of HAT in the context of conservation and development and consider the impacts current changes may have on this complex social-ecological system. We conclude that improved understanding is required to identify specific circumstances where win-win trade-offs can be achieved between the conservation of

  16. Association of genetic loci with sleep apnea in European Americans and African-Americans: the Candidate Gene Association Resource (CARe.

    Sanjay R Patel

    Full Text Available Although obstructive sleep apnea (OSA is known to have a strong familial basis, no genetic polymorphisms influencing apnea risk have been identified in cross-cohort analyses. We utilized the National Heart, Lung, and Blood Institute (NHLBI Candidate Gene Association Resource (CARe to identify sleep apnea susceptibility loci. Using a panel of 46,449 polymorphisms from roughly 2,100 candidate genes on a customized Illumina iSelect chip, we tested for association with the apnea hypopnea index (AHI as well as moderate to severe OSA (AHI≥15 in 3,551 participants of the Cleveland Family Study and two cohorts participating in the Sleep Heart Health Study.Among 647 African-Americans, rs11126184 in the pleckstrin (PLEK gene was associated with OSA while rs7030789 in the lysophosphatidic acid receptor 1 (LPAR1 gene was associated with AHI using a chip-wide significance threshold of p-value<2×10(-6. Among 2,904 individuals of European ancestry, rs1409986 in the prostaglandin E2 receptor (PTGER3 gene was significantly associated with OSA. Consistency of effects between rs7030789 and rs1409986 in LPAR1 and PTGER3 and apnea phenotypes were observed in independent clinic-based cohorts.Novel genetic loci for apnea phenotypes were identified through the use of customized gene chips and meta-analyses of cohort data with replication in clinic-based samples. The identified SNPs all lie in genes associated with inflammation suggesting inflammation may play a role in OSA pathogenesis.

  17. Interim strategies to control animal trypanosomiasis in two selected villages along the white volta river in the onchocerciasis free zone of Northern Ghana

    The onchocerciasis eradication campaign in the west African subregion was a remarkable success which made formally deserted lands now suitable for settlement. Recent tsetse and trypanosomiasis surveys along the White Volta river indicate that livestock development would virtually be impossible in these areas without some form of intervention to contain animal trypanosomiasis. Apparent fly densities are in the order of 5-10 flies/trap/day (biconica traps) with fly infection rate being in the order of 1-8.0%. Trypanosomiasis is particularly prevalent in small ruminants (12-30%) with several reported cases of abortion. In view of the sparse human population in some of these areas, large scale control programmes would not be advisable unless there is a clear land-use plan. In the interim, however, efforts could be made to control the disease at the village level. This paper outlines some village-based strategies that could be adopted by settlers in these areas. (author)

  18. Disease: H00357 [KEGG MEDICUS

    Full Text Available H00357 African trypanosomiasis; Sleeping sickness African trypanosomiasis is a parasitic conditi ... rucei [GN:tbr] Vector: Glossina pallidipes (tsetse fly ) ICD-10: B56 MeSH: D014353 MedlinePlus: 001362 ...

  19. Report of the workshop on strategic planning of area-wide tsetse and trypanosomiasis control in West Africa

    Tsetse-transmitted trypanosomiasis is a disease unique to Africa affecting both humans and animals. This disease occurs in about 10 million km2 in 37 sub-Saharan countries corresponding approximately to one-third of Africa's total land area, and threatens an estimated 50 million people, 48 million cattle and a countless population of other domestic animal species. Trypanosomiasis has a severe impact on African agriculture; estimated annual losses in cattle production alone are in the range of 1.0-1.2 billion dollars. To this, we have to add the indirect negative effects engendered by trypanosomiasis on total crop production. The disease influences where people decide to live, how they manage their livestock and the intensity of crop agriculture. The combined effects result in changes in land use, environment and affect human welfare and increase the vulnerability of agricultural activity. FAO has identified the reinforcement of agriculture as a key element in the fight against poverty and the improvement of food security in developing countries. The need to reduce poverty is particularly felt in tsetse infested areas of sub-Saharan Africa. In this region half of the population suffers from food insecurity. Approximately 85% of the poor are located in rural areas and more than 80% of the population depends on agricultural production for their livelihood. In order to respond to the need in the fight against tsetse and trypanosomiasis (T and T) in people as well as livestock, the Programme Against African Trypanosomiasis (PAAT) was endorsed in November 1997 by the FAO Conference. The Programme seeks to combine the forces of FAO, IAEA, OAU/IBAR and WHO in order to: promote and co-ordinate international alliances and efforts assisting in harmonised interventions against T and T; effectively combat the disease in Africa; and delineate the polity framework, strategies and guiding pest management principles. This workshop was primarily concerned with the development of

  20. Sleep and Women

    ... Sleep Debt Sleep Deprivation Sleep Disorders Sleep history Sleep hygiene sleep length Sleep Need Sleep talking Sleeping Pills ... culture Immune System military travel CDC Healthy Sleep Sleep hygiene sleep length Sleep Debt Sleep Deprivation Sleep Need ...

  1. Sleep Sleeping Patch


    The Sleep Sleeping Patch is a new kind of external patch based on modern sleep medicine research achievements, which uses the internationally advanced transdermal therapeutic system (TTS). The Sleep Sleeping Patch transmits natural sleep inducers such as peppermint and liquorice extracts and melatonin through the skin to induce sleep. Clinical research proves that the Sleep Sleeping Patch can effectively improve insomnia and the quality of sleep. Highly effective: With the modern TTS therapy,

  2. Tsetse and trypanosomiasis at the Ngulia Rhino sanctuary

    The conservation of black rhinoceros (Diceros bicornis) in Kenya involves the translocation of rhinoceros to protected sanctuaries, e.g. the recently enlarged 69 km2 sanctuary at Ngulia in Tsavo West National Park. As the black rhinoceros is known to be particularly susceptible to infection with Trypanosoma brucei, there is a strong possibility that the stress of translocation will induce health problems that would not normally occur in resident populations. Similarly, the movement of animals born in tsetse-free areas to tsetse-infested areas may result in trypanosomiasis problems because of loss of immune protection in the absence of challenge in early life. Finally, there is some concern over the possibility of facilitating genetic exchange in T. brucei through the artificial movement of animals over long distances into novel environments. To aid in the development of prudent management practices, we initiated baseline studies on tsetse distribution and trypanosomiasis at the Ngulia sanctuary. To date, we have completed a dry season survey of tsetse distribution over a 125 km2 area centred on the sanctuary and have characterized the nature of the trypanosomiasis challenge in different areas. Trypanosomiasis challenge at Ngulia involves a variety of Trypanosoma spp. Nevertheless, an unusual finding is the lack of diversity in Nannomonas parasites, with most belonging to the savannah group of T. congolense

  3. Fate of trypanocidal drugs in cattle (chemotherapy of trypanosomiasis). Kenya

    This document is the final report of a project to determine the fate of tryponocidal drugs in cattle. Drugs are still the primary agent in the struggle against trypanosomiasis although there is little data on their pharmacokinetics, residue levels, bioavailability rates, etc. This project aimed to provide such information for the three drugs Diminazene aceturate (Berenil), Isometamidium chloride (Samorin) and Homidium bromide (Ethidium). Figs and tabs

  4. Contribution to the Analysis Cost/Benefit of Scenarios to Control Tsetse and Trypanosomiasis in West Africa (Data Study Area in Benin)

    Trypanosomiasis and animal sleeping sickness is a major constraint for Africa south of Sahara. Nearly a century of struggle was not enough to contain tsetse infestations or reduce the impact of Trypanosomiasis in Africa. So that the socioeconomic development of third of the continent is severely compromised by the consequences of this debilitating often fatal disease that affects humans and animals. It is painful to note that the country's poorest continent through a crisis period (armed conflict, population movements) are most severely affected by the sleeping sickness making interventions of medical teams difficult and dangerous. Sixty (60) million men, women and children in 22 of 36 countries in sub-Saharan Africa live under the threat of sleeping sickness. About half a million men are affected by sleeping sickness. 45,000 new cases were recorded according to WHO in 1999. Forty four (44) million cattle besides other domestic animals are in infested areas of tsetse flies. The disease causes a loss of 3 million cattle a year, a loss of 26% milk yield, a 50% reduction in the number of herds in areas with high agricultural potential (PLTA, 1999). This report has been prepared to provide the International Atomic Energy Agency (IAEA) data on the various study area in Benin for a cost / benefit analysis of any program against tsetse flies and trypanosomiasis in Sudanian and Sudanian Sahel of West Africa. The study area located in Benin covers the departments of Alibori and Borgou. After presenting general information on Benin, this report focuses on: - The evolution of the human population in the study area, - The health situation, - The size and productivity of livestock, - The development achievements of major crops - Natural resources and soil quality. In conclusion, it was noted the positive impact of a regional program to fight against Tsetse and Trypanosomiasis based on the integrated use of different control methods non pollutant to the environment (traps and

  5. Prevalence and Types of Coinfections in Sleeping Sickness Patients in Kenya (2000/2009

    J. M. Kagira


    Full Text Available The occurrence of coinfections in human African trypanosomiasis (HAT patients was investigated using a retrospective data of hospital records at the National Sleeping Sickness Referral Hospital in Alupe, Kenya. A total of 31 patients, 19 males and 12 females, were diagnosed with HAT between the years 2000 and 2009. The observed co-infections included malaria (100%, helminthosis (64.5%, typhoid (22.5%, urinary tract infections (16.1%, HIV (12.9%, and tuberculosis (3.2%. The species of helminthes observed included Ancylostoma duodenale (38.7%, Ascaris lumbricoides (45.7%, Strongyloides stercoralis (9.7%, and Taenia spp. (3.2%. The patients were also infected with Entamoeba spp. (32.3% and Trichomonas hominis (22.6% protozoan parasites. The main clinical signs observed at the point of admission included headache (74.2%, fever (48.4%, sleep disorders (45.2%, and general body pain (41.9%. The HAT patients were treated with suramin (early stage, 9/31 and melarsoprol (late stage, 22/31. In conclusion, the study has shown that HAT patients have multiple co-infections which may influence the disease pathogenesis and complicate management of HAT.

  6. Immunodiagnosis of bovine trypanosomiasis in Anambra and Imo states, Nigeria, using enzyme-linked immunosorbent assay: zoonotic implications to human health

    M.C. Ezeani


    Full Text Available Background & objectives: The prevalence of trypanosomiasis was studied in cattle, being a major source of animal protein in Nigeria, thus, a very likely means of spread of Human African Trypano-somosis (HAT. Methods: Enzyme-linked immunosorbent assay (ELISA was used to diagnose bovine trypanosomiasis in 264 samples collected from adult cattle of mixed breeds, age and sex, in Anambra and Imo states, Nigeria. Results: Out of 264 samples analysed, 21 (7.96% were seropositive for Trypanosoma congolense while 20 (7.58% were seropositive for T. vivax and 8 (3.03% were seropositive for T. brucei infections in both the states. Interpretation & conclusion: The predominant species was found to be T. congolense. Mixed infection of three species, T. vivax, T. congolense and T. brucei was found to dominate other mixed infections in both the states. ELISA detected the infection of the three species of trypanosomes in the same group of animals. The usefulness of antigen capture ELISA in the diagnosis of human or animal trypanosomiasis was established, and the possibility of the spread of HAT caused by T. brucei gambiense and T.b. rhodesiense through cattle was expressed.

  7. Familial aggregation of Trypanosoma brucei gambiense trypanosomiasis in a very high incidence community in Zaire.

    Khonde, N; Pépin, J; Niyonsenga, T; De Wals, P


    Familial aggregation of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) was investigated in 3 adjacent villages of central Zaire where 318/1431 inhabitants had previously suffered from HAT. Neither spatial nor familial aggregation was detected when analysing the distribution of cases in the whole community using Poisson, negative binomial and pairwise odds ratio models. However, clustering of cases was observed when specific familial relationships were examined. The risk of HAT for a child was significantly increased if the mother had also had HAT, but it was not influenced by a past history of HAT in the father. Sisters and brothers of cases of HAT had a higher risk of HAT than siblings of individuals who had never had HAT, but no such association was documented for half-sisters and half-brothers. Among married couples, a past history of HAT in one spouse had no impact on the other spouse's risk of HAT. Indirect arguments suggested that familial clustering was a consequence of shared exposure, either sequential or simultaneous, rather than of genetic susceptibility. The existence of familial clustering should be kept in mind when implementing passive or active case-finding activities. PMID:9463655

  8. Seroprevalence of CANINE LEISHMANIASIS AND American trypanosomiasis in dogs from Grenada, West Indies

    Canine leishmaniasis and American trypanosomiasis (AT) are caused by related hemoflagellated parasites, Leishmania spp. and Trypanosoma cruzi, which share several common host species. Dogs are reservoirs for human infections with both pathogens. We determined the prevalence of antibodies to Leishman...

  9. Three-year changes of prothrombotic factors in a cohort of South Africans with a high clinical suspicion of obstructive sleep apnea.

    von Känel, Roland; Malan, Nico T; Hamer, Mark; Lambert, Gavin W; Schlaich, Markus; Reimann, Manja; Malan, Leoné


    A hypercoagulable state might be one important mechanism linking obstructive sleep apnea (OSA) with incident myocardial infarction and stroke. However, previous studies on prothrombotic factors in OSA are not uniform and cross-sectional. We longitudinally studied prothrombotic factors in relation to OSA risk, adjusting for baseline levels of prothrombotic factors, demographics, metabolic parameters, aspirin use, and life style factors. The Berlin Questionnaire and/or neck circumference were used to define high OSA risk in 329 South African teachers (48.0% male, 44.6% black) at baseline and at three-year follow-up. Von Willebrand factor (VWF), fibrinogen, D-dimer, plasminogen activator inhibitor-1, clot lysis time (CLT), and soluble urokinase-type plasminogen activator receptor (suPAR) were measured in plasma. At baseline 35.7% of participants had a high risk of OSA. At follow-up, persistently high OSA risk, persistently low OSA risk, OSA risk remission, and new-onset OSA risk were present in 26.1%, 53.2%, 9.4%, and 11.3% of participants, respectively. New-onset OSA risk was associated with a significant and longitudinal increase in VWF, fibrinogen, CLT, and suPAR relative to persistently low OSA risk; in VWF, fibrinogen, and suPAR relative to remitted OSA risk; and in VWF relative to persistently high OSA risk. Persistently high OSA risk was associated with an increase in CLT and suPAR relative to persistently low OSA risk and in D-dimer relative to remitted OSA risk. Remitted OSA risk was associated with D-dimer decrease relative to persistently low OSA risk. In OSA, hypercoagulability is a dynamic process with a most prominent three-year increase in individuals with new-onset OSA risk. PMID:26335891

  10. Analysis of a model of gambiense sleeping sickness in humans and cattle.

    Ndondo, A M; Munganga, J M W; Mwambakana, J N; Saad-Roy, C M; van den Driessche, P; Walo, R O


    Human African Trypanosomiasis (HAT) and Nagana in cattle, commonly called sleeping sickness, is caused by trypanosome protozoa transmitted by bites of infected tsetse flies. We present a deterministic model for the transmission of HAT caused by Trypanosoma brucei gambiense between human hosts, cattle hosts and tsetse flies. The model takes into account the growth of the tsetse fly, from its larval stage to the adult stage. Disease in the tsetse fly population is modeled by three compartments, and both the human and cattle populations are modeled by four compartments incorporating the two stages of HAT. We provide a rigorous derivation of the basic reproduction number [Formula: see text]. For [Formula: see text], the disease free equilibrium is globally asymptotically stable, thus HAT dies out; whereas (assuming no return to susceptibility) for [Formula: see text], HAT persists. Elasticity indices for [Formula: see text] with respect to different parameters are calculated with baseline parameter values appropriate for HAT in West Africa; indicating parameters that are important for control strategies to bring [Formula: see text] below 1. Numerical simulations with [Formula: see text] show values for the infected populations at the endemic equilibrium, and indicate that with certain parameter values, HAT could not persist in the human population in the absence of cattle. PMID:27296784

  11. Sleep Problems

    ... For Consumers Consumer Information by Audience For Women Sleep Problems Share Tweet Linkedin Pin it More sharing ... PDF 474KB) En Español Medicines to Help You Sleep Tips for Better Sleep Basic Facts about Sleep ...

  12. Sleep Disorders

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  13. Racial Differences in Sleep Architecture: The Role of Ethnic Discrimination

    Tomfohr, Lianne; Pung, Meredith A.; Edwards, Kate M; Dimsdale, Joel E.


    African Americans have been consistently shown to have less deep (slow wave sleep; SWS) and more light (Stages 1 and 2) sleep than Caucasian Americans. This paper explored whether discrimination, a stressor that uniquely impacts certain ethnic groups, contributes to differences in sleep architecture. The sleep of 164 African and Caucasian Americans was examined with laboratory based polysomnography (PSG). Experiences of perceived discrimination (The Scale of Ethnic Experience) and sociodemogr...

  14. A neglected aspect of the epidemiology of sleeping sickness: the propensity of the tsetse fly vector to enter houses.

    Glyn A Vale

    Full Text Available BACKGROUND: When taking a bloodmeal from humans, tsetse flies can transmit the trypanosomes responsible for sleeping sickness, or human African trypanosomiasis. While it is commonly assumed that humans must enter the normal woodland habitat of the tsetse in order to have much chance of contacting the flies, recent studies suggested that important contact can occur due to tsetse entering buildings. Hence, we need to know more about tsetse in buildings, and to understand why, when and how they enter such places. METHODOLOGY/PRINCIPAL FINDINGS: Buildings studied were single storied and comprised a large house with a thatched roof and smaller houses with roofs of metal or asbestos. Each building was unoccupied except for the few minutes of its inspection every two hours, so focusing on the responses of tsetse to the house itself, rather than to humans inside. The composition, and physiological condition of catches of tsetse flies, Glossina morsitans morsitans and G. pallidipes, in the houses and the diurnal and seasonal pattern of catches, were intermediate between these aspects of the catches from artificial refuges and a host-like trap. Several times more tsetse were caught in the large house, as against the smaller structures. Doors and windows seemed about equally effective as entry points. Many of the tsetse in houses were old enough to be potential vectors of sleeping sickness, and some of the flies alighted on the humans that inspected the houses. CONCLUSION/SIGNIFICANCE: Houses are attractive in themselves. Some of the tsetse attracted seem to be in a host-seeking phase of behavior and others appear to be looking for shelter from high temperatures outside. The risk of contracting sleeping sickness in houses varies according to house design.

  15. Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy.

    Inaki Tirados

    Full Text Available Gambian sleeping sickness (human African trypanosomiasis, HAT outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT.The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2. In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings.The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment, covering 80% of the population, is US$433,333 (WHO figures. One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised.

  16. Practical applications of geographical information systems in tsetse and trypanosomiasis control

    Three aspects of geographical information systems (GISs) in tsetse and trypanosomiasis control are addressed. First is their use in planning and managing control operations, second is the use of appropriate data management systems to capture data from the field and process them in a format that facilitates their geographical analysis, and third is the use of GISs to predict some of the data layers required for planning tsetse and trypanosomiasis control activities. In planning and managing trypanosomiasis interventions, GISs are applied at a range of levels. At the policy level, it can be used to integrate data such as tsetse and trypanosomiasis distributions, livestock densities and percentage cultivation to assist in allocating resources to tsetse and trypanosomiasis control. At the management level, it can be used to combine the same sorts of data in decision support models to help prioritize areas for control. At the operational level, it can be used to help plan, manage and monitor field operations. Much of the data required for these applications come directly from the field, particularly the distributions of livestock, vector and disease. The use of bespoke software such as the disease and vector integrated database (DAVID) greatly facilitates entry, display and analysis of field data, and their integration with other data within GISs. Collecting field data relevant to planning and managing tsetse and trypanosomiasis control operations is often very expensive and time consuming, therefore preventing exhaustive ground coverage. The use of GISs to combine environmental predictor variables, using multivariate statistical models, and to predict the distribution and abundance of tsetse, trypanosomiasis, cultivation and livestock is reviewed. Finally, opportunities are discussed for developing these applications in the future. It is recommended that stronger links be forged between the research workers and those in operational programmes. (author)

  17. Race and Financial Strain are Independent Correlates of Sleep in Midlife Women: The SWAN Sleep Study

    Hall, Martica H.; Matthews, Karen A.; Kravitz, Howard M.; Gold, Ellen B.; Buysse, Daniel J.; Bromberger, Joyce T.; Owens, Jane F.; Sowers, MaryFran


    Study Objectives: To examine racial differences in sleep in a large cohort of midlife women and to evaluate whether indices of socioeconomic status (SES) are associated with racial differences in sleep. Design: Cross-sectional study. Setting: Participants' homes. Participants: Caucasian (n = 171), African American (n = 138) and Chinese women (n = 59). Interventions: None. Measurements: Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Polysomnographically assessed sleep duration, continuity, architecture, and NREM electroencephalograhic (EEG) power were calculated over multiple nights. Sleep disordered breathing and periodic leg movements were measured on a separate night. Linear regression analysis was used to model the independent and synergistic effects of race and SES on sleep after adjusting for other factors that impact sleep in midlife women. Indices of SES were self-reported educational attainment and financial strain. Results: Sleep was worse in African American women than Caucasian participants as measured by self-report, visual sleep stage scoring, and NREM EEG power. Slow wave sleep differences were also observed between Chinese and Caucasian participants. Racial differences persisted after adjustment for indices of SES. Although educational attainment was unrelated to sleep, financial strain was associated with decreased sleep quality and lower sleep efficiency. Financial strain-by-race interactions were not statistically significant, suggesting that financial strain has additive effects on sleep, independent of race. Conclusions: Independent relationships between race and financial strain with sleep were observed despite statistical adjustment for other factors that might account for these relationships. Results do not suggest that assessed indices of SES moderate the race-sleep relationship, perhaps due to too few women of low SES in the study. Citation: Hall MH; Matthews KA; Kravitz HM; Gold EB; Buysse DJ; Bromberger JT; Owens JF

  18. Environments and trypanosomiasis risks for early herders in the later Holocene of the Lake Victoria basin, Kenya.

    Chritz, Kendra L; Marshall, Fiona B; Zagal, M Esperanza; Kirera, Francis; Cerling, Thure E


    Specialized pastoralism developed ∼3 kya among Pastoral Neolithic Elmenteitan herders in eastern Africa. During this time, a mosaic of hunters and herders using diverse economic strategies flourished in southern Kenya. It has been argued that the risk for trypanosomiasis (sleeping sickness), carried by tsetse flies in bushy environments, had a significant influence on pastoral diversification and migration out of eastern Africa toward southern Africa ∼2 kya. Elmenteitan levels at Gogo Falls (ca. 1.9-1.6 kya) preserve a unique faunal record, including wild mammalian herbivores, domestic cattle and caprines, fish, and birds. It has been suggested that a bushy/woodland habitat that harbored tsetse fly constrained production of domestic herds and resulted in subsistence diversification. Stable isotope analysis of herbivore tooth enamel (n = 86) from this site reveals, instead, extensive C4 grazing by both domesticates and the majority of wild herbivores. Integrated with other ecological proxies (pollen and leaf wax biomarkers), these data imply an abundance of C4 grasses in the Lake Victoria basin at this time, and thus little risk for tsetse-related barriers to specialized pastoralism. These data provide empirical evidence for the existence of a grassy corridor through which small groups of herders could have passed to reach southern Africa. PMID:25775535

  19. Sleep apnoea

    Jun, Jonathan C.; Swati Chopra; Schwartz, Alan R.


    Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of breathing (central sleep apnoea). In this Clinical Year in Review, we summarise high-impact research from the past year pertaining to management, diagnosis and cardio-metabolic consequences of sleep apnoea.

  20. Glycolysis in the African Trypanosome: Targeting Enzymes and Their Subcellular Compartments for Therapeutic Development

    James C. Morris; Morris, Meredith T.; Dodson, Heidi C.; Coley, April F.


    Subspecies of the African trypanosome, Trypanosoma brucei, which cause human African trypanosomiasis, are transmitted by the tsetse fly, with transmission-essential lifecycle stages occurring in both the insect vector and human host. During infection of the human host, the parasite is limited to using glycolysis of host sugar for ATP production. This dependence on glucose breakdown presents a series of targets for potential therapeutic development, many of which have been explored and validat...

  1. Sleep Quiz

    Skip Navigation Bar Home Current Issue Past Issues Sleep Quiz Past Issues / Summer 2007 Table of Contents ... on. Photo: iStock Take the National Center on Sleep Disorders Research Sleep Quiz TRUE OR FALSE ? _____1. ...

  2. [Sleep psychiatry].

    Chiba, Shigeru


    Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain (EEG), sleep-wake system, rapid eye movement (REM) sleep, and circadian rhythm system. Additionally, the advent of video-polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease (e. g., lifestyle-related disease) but psychiatric illness. According to The International Classification of Sleep Disorders (2005), sleep disorders are classified into 8 major categories: 1) insomnia, 2) sleep-related breathing disorders, 3) hypersomnias of central origin, 4) circadian rhythm sleep disorders, 5) parasomnias, 6) sleep-related movement disorders, 7) isolated symptoms, and 8) other sleep disorders. Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. Moreover, sleep disorders may exacerbate underlying psychiatric disorders when left untreated. Therefore, psychiatrists should pay attention to the intimate relationship between sleep disorders and psychiatric symptoms. Sleep psychiatry is an academic field focusing on interrelations between sleep medicine and psychiatry. This mini-review summarizes recent findings in sleep psychiatry. Future research on the bidirectional relation between sleep disturbance and psychiatric symptoms will shed light on the pathophysiological view of psychiatric disorders and sleep disorders. PMID:24050022

  3. Sleep Disorders

    Rahbek Kornum, Birgitte; Mignot, Emmanuel


    Mammalian sleep has evolved under the influence of the day-night cycle and in response to reproductive needs, food seeking, and predator avoidance, resulting in circadian (predictive) and homeostatic (reactive) regulation. A molecular clock characterized by transcription/translation feedback loops...... mediates circadian regulation of sleep. Misalignment with the rhythm of the sun results in circadian disorders and jet lag. The molecular basis of homeostatic sleep regulation is mostly unknown. A network of mutually inhibitory brain nuclei regulates sleep states and sleep-wake transitions. Abnormalities...... in these networks create sleep disorders, including rapid eye movement sleep behavior disorder, sleep walking, and narcolepsy. Physiological changes associated with sleep can be imbalanced, resulting in excess movements such as periodic leg movements during sleep or abnormal breathing in obstructive...

  4. African trypanosomiasis in the rat alters melatonin secretion and melatonin receptor binding in the suprachiasmatic nucleus

    Kristensson, Krister; Claustrat, Bruno; Mhlanga, Jama D.M.;


    Neurobiology, cytokines, circadian rhythm, infection, nervous system, pineal gland, trypanosoma brucei......Neurobiology, cytokines, circadian rhythm, infection, nervous system, pineal gland, trypanosoma brucei...

  5. Snoring and risk for obstructive sleep apnea among nigerians with heart failure: Prevalence and clinical correlates

    Adeseye A Akintunde


    Conclusion: Heart failure seems to be associated with snoring and a high risk for obstructive sleep apnea among Africans with heart failure. Assessment for sleep disordered breathing should be incorporated into their routine clinical workup.

  6. Variability of sleep duration is related to subjective sleep quality and subjective well-being: an actigraphy study.

    Sakari Lemola

    Full Text Available While there is a large body of evidence that poor subjective sleep quality is related to lower subjective well-being, studies on the relation of objective sleep measures and subjective well-being are fewer in number and less consistent in their findings. Using data of the Survey of Mid-Life in the United States (MIDUS, we investigated whether duration and quality of sleep, assessed by actigraphy, were related to subjective well-being and whether this relationship was mediated by subjective sleep quality. Three hundred and thirteen mainly white American individuals from the general population and 128 urban-dwelling African American individuals between 35 and 85 years of age were studied cross-sectionally. Sleep duration, variability of sleep duration, sleep onset latency, and time awake after sleep onset were assessed by actigraphy over a period of 7 days. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index, positive psychological well-being and symptoms of psychological distress were assessed with the Satisfaction with Life Scale and the Mood and Anxiety Symptom Questionnaire. In both white and African Americans high day-to-day variability in sleep duration was related to lower levels of subjective well-being controlling age, gender, educational and marital status, and BMI. By contrast, sleep duration, sleep onset latency, and time awake after sleep onset were not related to subjective well-being controlling covariates and other sleep variables. Moreover, the relationship between variability in sleep duration and well-being was partially mediated by subjective sleep quality. The findings show that great day-to-day variability in sleep duration--more than average sleep duration--is related to poor subjective sleep quality and poor subjective well-being.

  7. Healthy Sleep Habits

    ... Sleep Apnea Testing CPAP Healthy Sleep Habits Healthy Sleep Habits Your behaviors can have a major impact ... team at an AASM accredited sleep center. Quick Sleep Tips Follow these tips to establish healthy sleep ...

  8. Obstructive Sleep Apnea

    ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ...

  9. Sleeping sickness

    ... this page: // Sleeping sickness To use the sharing features on this page, please enable JavaScript. Sleeping sickness is an infection caused by germs carried ...

  10. Exercise & Sleep

    ... Feature: Back to School, the Healthy Way Exercise & Sleep Past Issues / Fall 2012 Table of Contents At ... healthy weight Build sturdy muscles, bones, and joints Sleep better at night More time in front of ...

  11. Sleep Apnea

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  12. Sleep apnoea

    Hensley, Michael; Ray, Cheryl


    Sleep apnoea is the popular term for obstructive sleep apnoea-hypopnoea syndrome (OSAHS). OSAHS is abnormal breathing during sleep that causes recurrent arousals, sleep fragmentation, daytime sleepiness, and nocturnal hypoxaemia. Apnoea may be "central", in which there is cessation of inspiratory effort, or "obstructive", in which inspiratory efforts continue but are ineffective because of upper airway obstruction.OSAHS affects up to 4% of men and 2% of women in the USA, with obesity being...

  13. An Actigraphy Study of Sleep and Pain in Midlife Women – The SWAN Sleep Study

    Kravitz, Howard M.; Zheng, Huiyong; Bromberger, Joyce T.; Buysse, Daniel J.; Owens, Jane; Hall, Martica H.


    Objective We examined whether women reporting nighttime pain would have more actigraphy-measured evidence for disturbed sleep and report feeling less rested compared to women without nighttime pain. Methods Up to 27 consecutive nights of actigraphy and sleep diary data were analyzed from each participant in this community-based study of 314 African-American (n=118), White (n=141), and Chinese (n=55) women, aged 48-58 years, who were pre-, peri- or post-menopausal and participating in the Study of Women's Health Across the Nation (SWAN) Sleep Study. Dependent variables were actigraphy-measured movement and fragmentation index, total sleep time, and sleep efficiency, and diary self-report of feeling rested after waking up. All outcomes were fit using linear mixed effect models to examine covariate-adjusted associations between the independent variable, nighttime pain severity, and sleep outcomes. Results Higher pain severity scores were associated with longer sleep duration but reduced sleep efficiency and feeling less rested. Women reporting nocturnal vasomotor symptoms had more sleep-related movement and sleep fragmentation, reduced sleep efficiency, and were less likely to feel rested after wakening, regardless of whether they reported pain. Conclusions Midlife women who report higher nighttime pain levels have more objective evidence for less efficient sleep, consistent with self-reported less restful sleep. Nocturnal vasomotor symptoms also can contribute to restlessness and wakefulness in midlife women. PMID:25706182

  14. The sterile insect technique and its role in integrated Trypanosomiasis control programmes

    In the paper an attempt is made to define the rationale for using the sterile insect technique (SIT) for tsetse fly eradication within the global concept of trypanosomiasis control. Against the background of past and present research and development, and particularly the success of integrated tsetse fly control campaigns in Burkina Faso and Nigeria, the paper identifies problems to be overcome before further major action programmes with an SIT component are undertaken. (author). 33 refs

  15. Why Sleep?

    Manoach, Dara S.; Stickgold, Robert


    We human beings spend about a third of our lives sleeping. That means that if you live to 90, you'll sleep for about 30 years – probably more time than you'll spend doing anything else. Sleep is really important since we cannot live without it and spend so much time doing it. Yet unlike the other basic biological drives such as eating and reproducing, we still don't understand exactly why we need to sleep. It used to be thought that sleep was mainly to rest and restore the body and the mind, ...

  16. Sleep and Chronic Disease

    ... message, please visit this page: About . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  17. Sleep Deprivation and Deficiency

    ... page from the NHLBI on Twitter. What Are Sleep Deprivation and Deficiency? Sleep deprivation (DEP-rih-VA- ... Rate This Content: NEXT >> Updated: February 22, 2012 Sleep Infographic Sleep Disorders & Insufficient Sleep: Improving Health through ...

  18. National Sleep Foundation

    ... Turkish Ukrainian Urdu Vietnamese Welsh Yiddish Choose a Sleep Topic Sleep Disorders View More Items ... Recommendations. More Join Now Become a Professional Member Footer Redirect Learn about how sleep impacts ...

  19. Sleep disorders - overview

    Insomnia; Narcolepsy; Hypersomina; Daytime sleepiness; Sleep rhythm; Sleep disruptive behaviors; Jet lag ... excessive daytime sleepiness) Problems sticking to a regular sleep schedule (sleep rhythm problem) Unusual behaviors during sleep ( ...

  20. Bromodomain Proteins Contribute to Maintenance of Bloodstream Form Stage Identity in the African Trypanosome.

    Schulz, Danae; Mugnier, Monica R; Paulsen, Eda-Margaret; Kim, Hee-Sook; Chung, Chun-wa W; Tough, David F; Rioja, Inmaculada; Prinjha, Rab K; Papavasiliou, F Nina; Debler, Erik W


    Trypanosoma brucei, the causative agent of African sleeping sickness, is transmitted to its mammalian host by the tsetse. In the fly, the parasite's surface is covered with invariant procyclin, while in the mammal it resides extracellularly in its bloodstream form (BF) and is densely covered with highly immunogenic Variant Surface Glycoprotein (VSG). In the BF, the parasite varies this highly immunogenic surface VSG using a repertoire of ~2500 distinct VSG genes. Recent reports in mammalian systems point to a role for histone acetyl-lysine recognizing bromodomain proteins in the maintenance of stem cell fate, leading us to hypothesize that bromodomain proteins may maintain the BF cell fate in trypanosomes. Using small-molecule inhibitors and genetic mutants for individual bromodomain proteins, we performed RNA-seq experiments that revealed changes in the transcriptome similar to those seen in cells differentiating from the BF to the insect stage. This was recapitulated at the protein level by the appearance of insect-stage proteins on the cell surface. Furthermore, bromodomain inhibition disrupts two major BF-specific immune evasion mechanisms that trypanosomes harness to evade mammalian host antibody responses. First, monoallelic expression of the antigenically varied VSG is disrupted. Second, rapid internalization of antibodies bound to VSG on the surface of the trypanosome is blocked. Thus, our studies reveal a role for trypanosome bromodomain proteins in maintaining bloodstream stage identity and immune evasion. Importantly, bromodomain inhibition leads to a decrease in virulence in a mouse model of infection, establishing these proteins as potential therapeutic drug targets for trypanosomiasis. Our 1.25Å resolution crystal structure of a trypanosome bromodomain in complex with I-BET151 reveals a novel binding mode of the inhibitor, which serves as a promising starting point for rational drug design. PMID:26646171

  1. Ethnic differences in electroencephalographic sleep patterns in adolescents

    Rao, Uma; Hammen, Constance L.; Poland, Russell E.


    The purpose of the study was to evaluate ethnic differences in polysomnography measures in adolescents. Ninety-six volunteers from four ethnic groups (13 African-American, 18 Asian-American, 19 Mexican-American, and 46 Non-Hispanic White) were recruited. The subjects were in good physical and psychological health, and were asymptomatic with respect to sleep/wake complaints or sleep disorders. Polysomnography measures were collected on three consecutive nights. African-Americans manifested low...

  2. The validation of an Ag-ELISA for the diagnosis of trypanosomiasis in cattle in Uganda and its use in assessing the efficacy of a control programme

    An antigen detection ELISA (Ag-ELISA) for the diagnosis of trypanosomiasis was established in UTRO. The Ag-ELISA was used to assess the efficacy on an integrated tsetse and trypanosomiasis control programme which started in June 1991. Cattle were screened for trypanosomiasis using parasitologial tests and the Ag-ELISA. Cattle in Masafu where no control was implemented were screened for comparison with areas where control had been applied. Six months from the onset of control there was a reduction in the prevalence of trypanosomiasis throughout the control area. Six months from the onset of control there was a reduction in the prevalence of trypanosomiasis through the control area. Six months later, prevalence of trypanosomiasis had started rising throughout the control area with the exception of Buteba, where 1% Deltamethrin (Spot-on) had been applied to cattle. In Buteba the presence of trypanosomiasis was only detectable by Ag-ELISA. In Masafu where there was no control, prevalence of trypanosomiasis remained high. The Ag-ELISA consistently showed the presence of greater levels of infection than was revealed by microscopic methods and its usefulness was confirmed both as a means of monitoring the effectiveness of the control campaign and in identifying individual animals with non-patent active infections. 6 refs, 7 figs, 1 tab

  3. Towards an early warning system for Rhodesian sleeping sickness in savannah areas: man-like traps for tsetse flies.

    Glyn A Vale

    Full Text Available BACKGROUND: In the savannahs of East and Southern Africa, tsetse flies (Glossina spp. transmit Trypanosoma brucei rhodesiense which causes Rhodesian sleeping sickness, the zoonotic form of human African trypanosomiasis. The flies feed mainly on wild and domestic animals and are usually repelled by humans. However, this innate aversion to humans can be undermined by environmental stresses on tsetse populations, so increasing disease risk. To monitor changes in risk, we need traps designed specifically to quantify the responsiveness of savannah tsetse to humans, but the traps currently available are designed to simulate other hosts. METHODOLOGY/PRINCIPAL FINDINGS: In Zimbabwe, two approaches were made towards developing a man-like trap for savannah tsetse: either modifying an ox-like trap or creating new designs. Tsetse catches from a standard ox-like trap used with and without artificial ox odor were reduced by two men standing nearby, by an average of 34% for Glossina morsitans morsitans and 56% for G. pallidipes, thus giving catches more like those made by hand-nets from men. Sampling by electrocuting devices suggested that the men stopped flies arriving near the trap and discouraged trap-entering responses. Most of human repellence was olfactory, as evidenced by the reduction in catches when the trap was used with the odor of hidden men. Geranyl acetone, known to occur in human odor, and dispensed at 0.2 mg/h, was about as repellent as human odor but not as powerfully repellent as wood smoke. New traps looking and smelling like men gave catches like those from men. CONCLUSION/SIGNIFICANCE: Catches from the completely new man-like traps seem too small to give reliable indices of human repellence. Better indications would be provided by comparing the catches of an ox-like trap either with or without artificial human odor. The chemistry and practical applications of the repellence of human odor and smoke deserve further study.

  4. Ethnicity, sleep, mood, and illumination in postmenopausal women

    Tuunainen Arja


    Full Text Available Abstract Background This study examined how ethnic differences in sleep and depression were related to environmental illumination and circadian rhythms. Methods In an ancillary study to the Women's Health Initiative, 459 postmenopausal women were recorded for one week in their homes, using wrist monitors. Sleep and illumination experience were estimated. Depression was self-rated with a brief adjective check list. Affective diagnoses were made using the SCID interview. Sleep disordered breathing was monitored with home pulse oximetry. Results Hispanic and African-American women slept less than European-American women, according to both objective recordings and their own sleep logs. Non-European-American women had more blood oxygen desaturations during sleep, which accounted for 26% of sleep duration variance associated with ethnicity. Hispanic women were much more depressed. Hispanic, African-American and Native-American women experienced less daily illumination. Less daily illumination experience was associated with poorer global functioning, longer but more disturbed sleep, and more depression. Conclusions Curtailed sleep and poor mood were related to ethnicity. Sleep disordered breathing was a factor in the curtailed sleep of minority women. Less illumination was experienced by non-European-American women, but illumination accounted for little of the contrasts between ethnic groups in sleep and mood. Social factors may be involved.

  5. Ethnicity, sleep, mood, and illumination in postmenopausal women

    Kripke, Daniel F; Jean-Louis, Girardin; Elliott, Jeffrey A; Klauber, Melville R; Rex, Katharine M; Tuunainen, Arja; Langer, Robert D


    Background This study examined how ethnic differences in sleep and depression were related to environmental illumination and circadian rhythms. Methods In an ancillary study to the Women's Health Initiative, 459 postmenopausal women were recorded for one week in their homes, using wrist monitors. Sleep and illumination experience were estimated. Depression was self-rated with a brief adjective check list. Affective diagnoses were made using the SCID interview. Sleep disordered breathing was monitored with home pulse oximetry. Results Hispanic and African-American women slept less than European-American women, according to both objective recordings and their own sleep logs. Non-European-American women had more blood oxygen desaturations during sleep, which accounted for 26% of sleep duration variance associated with ethnicity. Hispanic women were much more depressed. Hispanic, African-American and Native-American women experienced less daily illumination. Less daily illumination experience was associated with poorer global functioning, longer but more disturbed sleep, and more depression. Conclusions Curtailed sleep and poor mood were related to ethnicity. Sleep disordered breathing was a factor in the curtailed sleep of minority women. Less illumination was experienced by non-European-American women, but illumination accounted for little of the contrasts between ethnic groups in sleep and mood. Social factors may be involved. PMID:15070419

  6. Immunization against East Coast fever: Effect of chronic trypanosomiasis on the development of immunity

    Two experiments were carried out in which clean cattle, or cattle chronically infected with Trypanosoma congolense, were immunized by the infection and treatment method against East Coast fever (ECF, Theileria parva infection). Chronic trypanosomiasis did not prevent cattle from mounting and effective immunological response to ECF immunization and resisting subsequent lethal challenge. There appeared to be no difference in the level or quality of immunity between clean cattle and trypanosome infected cattle. Thus, T. congolense infection on its own does not appear to provide a constraint to ECF immunization in the field. (author). 17 refs, 2 tabs

  7. Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health

    Grant, Catherine; Anderson, Neil; Machila, Noreen


    Background This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided. Methods A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors. Principal Findings Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is

  8. Ancestral sleep.

    de la Iglesia, Horacio O; Moreno, Claudia; Lowden, Arne; Louzada, Fernando; Marqueze, Elaine; Levandovski, Rosa; Pilz, Luisa K; Valeggia, Claudia; Fernandez-Duque, Eduardo; Golombek, Diego A; Czeisler, Charles A; Skene, Debra J; Duffy, Jeanne F; Roenneberg, Till


    While we do not yet understand all the functions of sleep, its critical role for normal physiology and behaviour is evident. Its amount and temporal pattern depend on species and condition. Humans sleep about a third of the day with the longest, consolidated episode during the night. The change in lifestyle from hunter-gatherers via agricultural communities to densely populated industrialized centres has certainly affected sleep, and a major concern in the medical community is the impact of insufficient sleep on health [1,2]. One of the causal mechanisms leading to insufficient sleep is altered exposure to the natural light-dark cycle. This includes the wide availability of electric light, attenuated exposure to daylight within buildings, and evening use of light-emitting devices, all of which decrease the strength of natural light-dark signals that entrain circadian systems [3]. PMID:27046809

  9. Sex Steroid Hormone Profiles are Related to Sleep Measures from Polysomnography and the Pittsburgh Sleep Quality Index

    Sowers, Mary Fran; Zheng, Huiyong; Kravitz, Howard M.; Matthews, Karen; Bromberger, Joyce T.; Gold, Ellen B.; Owens, Jane; Consens, Flavia; Hall, Martica


    Study Objectives: To relate reproductive hormones (and the preceding 7-year rates of their change) to objectively and subjectively assessed sleep measures, independent of age, vasomotor symptom frequency, depressive symptoms, and body size. Design: A cross-sectional sleep substudy nested in the Study of Women's Health Across the Nation (SWAN), a longitudinal study of the menopausal transition. Setting: Community-based. Participants: 365 Caucasian, African American, and Chinese women. Measurements and Results: Sleep duration, continuity, and architecture were measured during two nights of in-home polysomnography (PSG) studies. Participants completed the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, sleep diaries for medication, vasomotor symptoms, lifestyle information and questionnaires for depressive symptoms. Blood collected annually in the years prior to sleep study was assayed for follicle stimulating hormone (FSH), estradiol (E2), and total testosterone (T). More rapid rate of FSH change was significantly associated with higher delta sleep percent, longer total sleep time (TST), but less favorable self-reported sleep quality (PSQI). Baseline E2 was modestly and negatively associated with sleep quality. Women in the lowest total testosterone quartile at baseline had more wake time after sleep onset (WASO) than women in the highest quartile. Lower E2/T ratio, an index reflecting the increasing androgenic environment with the menopause transition, was associated with less WASO. Conclusions: More rapid rate of FSH change was associated with longer sleep duration but poor sleep quality. Women with higher T or who were closer to the completion of the transition process (as indexed by a lower E2/T) had less sleep discontinuity (less WASO). Citation: Sowers MF; Zheng H; Kravitz HM; Matthews K; Bromberger JT; Gold EB; Owens J; Consens F; Hall M. Sex steroid hormone profiles are related to sleep measures From polysomnography and the pittsburgh sleep quality

  10. Sleep Quiz

    ... and mental conditions and stress. Insomnia is the perception that you don't get enough sleep because ... RLS) is a medical condition distinguished by tingling sensations in the legs--and sometimes the arms--while ...

  11. Pediatric sleep apnea

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  12. Sleeping during Pregnancy

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Sleeping During Pregnancy KidsHealth > For Parents > Sleeping During Pregnancy ... have trouble getting enough deep, uninterrupted sleep. Why Sleeping Can Be Difficult The first and most pressing ...

  13. Sleep and Newborns

    ... Story" 5 Things to Know About Zika & Pregnancy Sleep and Newborns KidsHealth > For Parents > Sleep and Newborns ... night it is. How Long Will My Newborn Sleep? A newborn may sleep up to 18 hours ...

  14. American Sleep Association

    ... Public Health Professionals Join ASA Press Room American Sleep Association Share What is Sleep ? Insight into the ... Forums Contact Us Login Join ASA – for FREE Sleep Blog ASA Charitable Work – Sleeping Children Around the ...

  15. Sleep Apnea Information Page

    ... Awards Enhancing Diversity Find People About NINDS NINDS Sleep Apnea Information Page Table of Contents (click to ... en Español Additional resources from MedlinePlus What is Sleep Apnea? Sleep apnea is a common sleep disorder ...

  16. Sleep and Aging

    ... version of this page please turn Javascript on. Sleep and Aging About Sleep We all look forward to a good night's ... health and quality of life. Two Types of Sleep There are two types of sleep: non-rapid ...

  17. Pediatric sleep apnea

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  18. Sleep Apnea (For Parents)

    ... 5 Things to Know About Zika & Pregnancy Obstructive Sleep Apnea KidsHealth > For Parents > Obstructive Sleep Apnea Print ... kids and teens can develop it, too. About Sleep Apnea Sleep apnea happens when a person stops ...

  19. Obstructive sleep apnea - adults

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  20. Circadian Rhythm Sleep Disorders

    ... psychiatric and other sleep disorders such as sleep apnea and individuals with a strong need for stable ... and circadian rhythm sleep disorder, free-running type. Prevalence • The prevalence of circadian rhythm sleep disorders in ...

  1. Sleep Talking (Somniloquy)

    ... Facts Causes and Risk Factors Diagnosis and Treatment Sleepwalking Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep ... area. Search radius: Email Print Parasomnias Confusional Arousals Sleepwalking Sleep Terrors Sleep Eating Disorder REM Sleep Behavior ...

  2. Isolated sleep paralysis

    ... from sleep. It is not associated with another sleep disorder. ... Sleep paralysis can be a symptom of narcolepsy . But if you do not have other symptoms of narcolepsy, there is usually no need to have sleep studies done.

  3. "Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity

    Patel Nirav P


    Full Text Available Abstract Background Little is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES and other factors upon sleep quality. Methods A cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation. Results Significant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35. In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively. Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71 protected against poor sleep. Conclusions A "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.

  4. Sleep aspnea


    2008057 A multi-center study on the association between sleep apnea and prevalence of hypertension. CHEN Baoyuan(陈宝元), et al. Dept Respir Med, Tianjin Med Univ General Hosp, Tianjin 300052. Chin J Tuberc Respir Dis, 2007;30(12):894-897. Objective To investigate the prevalence of hypertension among sleep apnea patients and the associated factors. Methods A total of 2297 patients (male 1310, female 211) from 20 teaching hospita

  5. Refreshing Sleep and Sleep Continuity Determine Perceived Sleep Quality

    Fichten, Catherine; Creti, Laura; Conrod, Kerry; Tran, Dieu-Ly; Grad, Roland; Jorgensen, Mary; Amsel, Rhonda; Rizzo, Dorrie; Baltzan, Marc; Pavilanis, Alan; Bailes, Sally


    Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and evaluated correlates and predictors of sleep quality. Across all six samples and both qualitative and quantitative methodologies, the daytime experience of feeling refreshed (nonrefreshed) in the morning and the nighttime experience of good (impaired) sleep continuity characterized perceived good and poor sleep. Our results clarify sleep quality as a construct and identify refreshing sleep and sleep continuity as potential clinical and research outcome measures. PMID:27413553

  6. The dispersal ecology of Rhodesian sleeping sickness following its introduction to a new area.

    Nicola A Wardrop

    Full Text Available Tsetse-transmitted human and animal trypanosomiasis are constraints to both human and animal health in sub-Saharan Africa, and although these diseases have been known for over a century, there is little recent evidence demonstrating how the parasites circulate in natural hosts and ecosystems. The spread of Rhodesian sleeping sickness (caused by Trypanosoma brucei rhodesiense within Uganda over the past 15 years has been linked to the movement of infected, untreated livestock (the predominant reservoir from endemic areas. However, despite an understanding of the environmental dependencies of sleeping sickness, little research has focused on the environmental factors controlling transmission establishment or the spatially heterogeneous dispersal of disease following a new introduction. In the current study, an annually stratified case-control study of Rhodesian sleeping sickness cases from Serere District, Uganda was used to allow the temporal assessment of correlations between the spatial distribution of sleeping sickness and landscape factors. Significant relationships were detected between Rhodesian sleeping sickness and selected factors, including elevation and the proportion of land which was "seasonally flooding grassland" or "woodlands and dense savannah." Temporal trends in these relationships were detected, illustrating the dispersal of Rhodesian sleeping sickness into more 'suitable' areas over time, with diminishing dependence on the point of introduction in concurrence with an increasing dependence on environmental and landscape factors. These results provide a novel insight into the ecology of Rhodesian sleeping sickness dispersal and may contribute towards the implementation of evidence-based control measures to prevent its further spread.

  7. Sleep in Othello

    Dimsdale, Joel E.


    Some of our best descriptions of sleep disorders come from literature. While Shakespeare is well known for his references to insomnia and sleep walking, his works also demonstrate a keen awareness of many other sleep disorders. This paper examines sleep themes in Shakespeare's play Othello. The play indicates Shakespeare's astute eye for sleep deprivation, sexual parasomnias, and effects of stress and drugs on sleep.

  8. Racial Differences in Sleep Architecture: The Role of Ethnic Discrimination

    Tomfohr, Lianne; Pung, Meredith A.; Edwards, Kate M.; Dimsdale, Joel E.


    African Americans have been consistently shown to have less deep (slow wave sleep; SWS) and more light (Stages 1 and 2) sleep than Caucasian Americans. This paper explored whether discrimination, a stressor that uniquely impacts certain ethnic groups, contributes to differences in sleep architecture. The sleep of 164 African and Caucasian Americans was examined with laboratory based polysomnography (PSG). Experiences of perceived discrimination (The Scale of Ethnic Experience) and sociodemographic factors were also assessed. After adjusting for age, body mass index (BMI), socioeconomic status (SES) and smoking status, African Americans slept approximately 4.5% more total sleep time (TST) in Stage 2 sleep and 4.7% less TST in SWS than Caucasian Americans (ps< .05). Perceived discrimination was a partial mediator of ethnic differences in sleep architecture. Individuals who reported experiencing more discrimination slept more time in Stage 2 and less time in SWS (ps< .05). Results suggest that the impact of stress related to ethnic group membership plays a part in explaining differences in sleep architecture. PMID:21925567

  9. Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

    Shaw, Alexandra P. M.; Tirados, Inaki; Mangwiro, Clement T. N.; Esterhuizen, Johan; Lehane, Michael J.; Torr, Stephen J.; Kovacic, Vanja


    Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were...

  10. Refreshing Sleep and Sleep Continuity Determine Perceived Sleep Quality

    Libman, Eva; Fichten, Catherine; Creti, Laura; Conrod, Kerry; Tran, Dieu-Ly; Grad, Roland; Jorgensen, Mary; Amsel, Rhonda; Rizzo, Dorrie; Baltzan, Marc; Pavilanis, Alan; Bailes, Sally


    Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and ev...

  11. Computer-Aided Drug Discovery Approaches against the Tropical Infectious Diseases Malaria, Tuberculosis, Trypanosomiasis, and Leishmaniasis.

    Njogu, Peter M; Guantai, Eric M; Pavadai, Elumalai; Chibale, Kelly


    Despite the tremendous improvement in overall global health heralded by the adoption of the Millennium Declaration in the year 2000, tropical infections remain a major health problem in the developing world. Recent estimates indicate that the major tropical infectious diseases, namely, malaria, tuberculosis, trypanosomiasis, and leishmaniasis, account for more than 2.2 million deaths and a loss of approximately 85 million disability-adjusted life years annually. The crucial role of chemotherapy in curtailing the deleterious health and economic impacts of these infections has invigorated the search for new drugs against tropical infectious diseases. The research efforts have involved increased application of computational technologies in mainstream drug discovery programs at the hit identification, hit-to-lead, and lead optimization stages. This review highlights various computer-aided drug discovery approaches that have been utilized in efforts to identify novel antimalarial, antitubercular, antitrypanosomal, and antileishmanial agents. The focus is largely on developments over the past 5 years (2010-2014). PMID:27622945

  12. Actigraphy-defined Measures of Sleep and Movement Across the Menstrual Cycle In Midlife Menstruating Women: SWAN Sleep Study

    Zheng, Huiyong; Harlow, Siobán D; Kravitz, Howard M; Bromberger, Joyce; Buysse, Daniel J; Matthews, Karen A; Gold, Ellen B; Owens, Jane F; Hall, Martica


    Objective To evaluate patterns in actigraphy-defined sleep measures across the menstrual cycle, testing the hypothesis that sleep would be more disrupted in the premenstrual period, i.e. in the 14 days prior to menses. Methods A community-based, longitudinal study of wrist actigraphy-derived sleep measures was conducted with 163 women (58 African-American, 78 White, and 27 Chinese) of late reproductive age (mean=51.5, SD=2.0 years) from the Study of Women's Health Across the Nation (SWAN) Sleep Study. Daily measures of sleep [sleep efficiency (%) and total sleep time (minutes)] and movement during sleep [mean activity score (counts)] were characterized using wrist actigraphy across a menstrual cycle or 35 days, whichever was shorter. Data were standardized to 28 days to account for the variation of unequal cycle lengths and divided into four weekly segments for analyses. Results Sleep efficiency percentage declined gradually across the menstrual cycle, but the decline became pronounced in fourth week, the premenstrual period. Compared with third week, sleep efficiency declined by 5% (p<0.0001) and mean total sleep time was 25 minutes less (p=0.0002) in fourth week. No significant mean differences were found when comparing the means of second week versus third week. The association of weekly segments with sleep efficiency or minutes of total sleep time was modified by sociodemographic and lifestyle factors, including body mass index (BMI), race, study site, financial strain, marital status, and smoking. Conclusions Sleep varied systematically across the menstrual cycle in women of late reproductive age, including a gradual decline in sleep efficiency across all weeks, with a more marked change premenstrually during the last week of the menstrual cycle. These sleep changes may be modifiable by altering lifestyle factors. PMID:24845393

  13. Neuroimmunologic aspects of sleep and sleep loss

    Rogers, N. L.; Szuba, M. P.; Staab, J. P.; Evans, D. L.; Dinges, D. F.


    The complex and intimate interactions between the sleep and immune systems have been the focus of study for several years. Immune factors, particularly the interleukins, regulate sleep and in turn are altered by sleep and sleep deprivation. The sleep-wake cycle likewise regulates normal functioning of the immune system. Although a large number of studies have focused on the relationship between the immune system and sleep, relatively few studies have examined the effects of sleep deprivation on immune parameters. Studies of sleep deprivation's effects are important for several reasons. First, in the 21st century, various societal pressures require humans to work longer and sleep less. Sleep deprivation is becoming an occupational hazard in many industries. Second, to garner a greater understanding of the regulatory effects of sleep on the immune system, one must understand the consequences of sleep deprivation on the immune system. Significant detrimental effects on immune functioning can be seen after a few days of total sleep deprivation or even several days of partial sleep deprivation. Interestingly, not all of the changes in immune physiology that occur as a result of sleep deprivation appear to be negative. Numerous medical disorders involving the immune system are associated with changes in the sleep-wake physiology--either being caused by sleep dysfunction or being exacerbated by sleep disruption. These disorders include infectious diseases, fibromyalgia, cancers, and major depressive disorder. In this article, we will describe the relationships between sleep physiology and the immune system, in states of health and disease. Interspersed will be proposals for future research that may illuminate the clinical relevance of the relationships between sleeping, sleep loss and immune function in humans. Copyright 2001 by W.B. Saunders Company.

  14. Genetics of Sleep and Sleep disorders

    Sehgal, Amita; Mignot, Emmanuel


    Sleep remains one of the least understood phenomena in biology – even its role in synaptic plasticity remains debatable. Since sleep was recognized to be regulated genetically, intense research has launched on two fronts: the development of model organisms for deciphering the molecular mechanisms of sleep and attempts to identify genetic underpinnings of human sleep disorders. In this Review, we describe how unbiased, high-throughput screens in model organisms are uncovering sleep regulatory ...

  15. Sleep in Neurodegenerative Diseases.

    Iranzo, Alex


    Disorders of sleep are an integral part of neurodegenerative diseases and include insomnia, sleep-wake cycle disruption, excessive daytime sleepiness that may be manifested as persistent somnolence or sudden onset of sleep episodes, obstructive and central sleep apnea, rapid eye movement sleep behavior disorder, and restless legs syndrome. The origin of these sleep disorders is multifactorial including degeneration of the brain areas that modulate sleep, the symptoms of the disease, and the effect of medications. Treatment of sleep disorders in patients with neurodegenerative diseases should be individualized and includes behavioral therapy, sleep hygiene, bright light therapy, melatonin, hypnotics, waking-promoting agents, and continuous positive airway pressure. PMID:26972029

  16. Diagnosing Sleep Disorders

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Diagnosing Sleep Disorders Past Issues / Summer 2015 Table of Contents Depending ... several possible tests when trying to diagnose a sleep disorder: Sleep history and sleep log If you believe ...

  17. What Is Sleep Apnea?

    ... move out of deep sleep and into light sleep. As a result, the quality of your sleep is poor, which makes you tired during the ... of silence followed by gasps. Wanting a better quality of life, Jim sought the advice of his doctor, who recommended a sleep study. As a result of the sleep study, ...

  18. Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda

    Coleman Paul G


    Full Text Available Abstract Background Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis, caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. Methods The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. Results Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater

  19. Benefiting Africans



    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September.This activity was launched by Hengyuanxiang,a leading Chinese wool manufacturer.

  20. Benefiting Africans


    Along with thriving Sino-African economic and trade ties,Chinese companies have attached greater importance to their social responsibility to Africans.More than 2,000 sweaters woven by Chinese mothers were sent to orphans and disabled children in Kenya and four other African countries in September. This activity was launched by Hengyuanxiang,aleading Chinese wool manufacturer.

  1. Pharmacokinetic studies on 14C-labelled phenanthridine and aromatic diamidine drugs used to control African trypanosomiasis in domestic animals

    For many years ethidium (homidium) bromide (3, 8-diamino-6-phenyl-5-ethyl phenanthridinium bromide) has been used curatively and for limited prophylaxis against Trypanosoma congolense and Trypanosoma vivax infections in ruminants in Africa and aromatic diamidine berenil (diminazeneaceturate, 4, 4'-(diazoamino) benzamidine) has been used as a curative drug against these parasites, but there is little published information about the pharmacokinetics of either drug. Reviewed here is the present knowledge and report results of recent experiments using 14C-labelled drugs to measure blood and tissue fluid levels and tissue residues of ethidium in uninfected and T. congolense-infected laboratory animals and bovines and berenil in laboratory animals. In the case of 14C-ethidium levels of radioactivity in blood and tissue fluids reached a maximum within 1 h of intramuscular injection (1 mg/kg) and then fell rapidly; after 96 h 80-90% of the radioactivity injected had been excreted, approximately one-third in urine and two-thirds in faeces. It is estimated that ca 3-4% of the radioactivity injected is present in tissues of animals sacrificed 9-10 d after administration of drug, the highest residues/unit wet weight of tissue being present in liver and kidney. In similar experiments with 14C-berenil (3.5 mg/kg) radioactivity in blood reached a peak within 30 min, fell rapidly over the next 5 h, but remained at a significant level for 4-6 d. Radioactivity in tissue fluids did not rise as rapidly or to such a high peak level as in blood, but after 2 h remained at approximately twice the level detected in blood for up to 7 d. At 7 d, in marked contrast to ethidium, only 65% of the administered radioactivity had been excreted (44% in urine and 21% in faeces), and in animals sacrificed at that time it was found that the majority (95%) of the residual drug was present in the liver. (author)

  2. Snoring and Sleep Apnea

    ... experience sleepless nights and fatigue. Medically – It disturbs sleeping patterns and deprives the snorer of adequate rest. It ... snacks for three hours before retiring. • Establish regular sleeping patterns. • Sleep on your side rather than your back. • ...

  3. Problems sleeping during pregnancy

    ... page: // Problems sleeping during pregnancy To use the sharing features on ... time sleeping well. Why is it hard to sleep during pregnancy? Your baby is growing bigger, which ...

  4. Sleep and your health

    ... this page: // Sleep and your health To use the sharing features ... in a number of ways. Why You Need Sleep Sleep gives your body and brain time to ...

  5. Medicines for sleep

    ... Medicines for sleep To use the sharing features on this page, ... Alcohol or illegal drug use Over-the-counter sleep medicines Most over-the-counter (OTC) sleeping pills ...

  6. Sleep Issues and Sundowning

    ... We will not sell or share your name. Sleep Issues and Sundowning Tweet Bookmark this page | Email | ... Sleep Changes Back to top Coping strategies for sleep issues and sundowning If the person is awake ...

  7. Sleep Apnea Detection

    ... Prenatal Baby Bathing & Skin Care Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Sleep > Sleep Apnea ...

  8. Sleep Medicine Textbook

    Bassetti, Claudio; Dogas, Zoran; Peigneux, Philippe


    The Sleep Medicine Textbook provides comprehensive, all-in-one educational material (550 pages) structured around the Catalogue of knowledge and skills for sleep medicine (Penzel et al. 2014, Journal of Sleep Research). Written by experts in the field and published by the ESRS, it provides an European approach to sleep medicine education, and represents the knowledge-base for the ESRS-endorsed sleep medicine examinations.The book is available at

  9. Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans

    Jung, Christopher M.; Melanson, Edward L.; Frydendall, Emily J; Perreault, Leigh; Eckel, Robert H; Wright, Kenneth P


    Sleep has been proposed to be a physiological adaptation to conserve energy, but little research has examined this proposed function of sleep in humans. We quantified effects of sleep, sleep deprivation and recovery sleep on whole-body total daily energy expenditure (EE) and on EE during the habitual day and nighttime. We also determined effects of sleep stage during baseline and recovery sleep on EE. Seven healthy participants aged 22 ± 5 years (mean ± s.d.) maintained ∼8 h per night sleep s...

  10. Sleep Disorders (PDQ)

    ... Professionals Questions to Ask about Your Treatment Research Sleep Disorders (PDQ®)–Patient Version General Information About Sleep Disorders Go to Health Professional Version Key Points Getting ...

  11. Sleep and sleep disorders in older adults.

    Crowley, Kate


    A common but significant change associated with aging is a profound disruption to the daily sleep-wake cycle. It has been estimated that as many as 50% of older adults complain about difficulty initiating or maintaining sleep. Poor sleep results in increased risk of significant morbidity and mortality. Moreover, in younger adults, compromised sleep has been shown to have a consistent effect on cognitive function, which may suggest that sleep problems contribute to the cognitive changes that accompany older age. The multifactorial nature of variables affecting sleep in old age cannot be overstated. Changes in sleep have been thought to reflect normal developmental processes, which can be further compromised by sleep disturbances secondary to medical or psychiatric diseases (e.g., chronic pain, dementia, depression), a primary sleep disorder that can itself be age-related (e.g., Sleep Disordered Breathing and Periodic Limb Movements During Sleep), or some combination of any of these factors. Given that changes in sleep quality and quantity in later life have implications for quality of life and level of functioning, it is imperative to distinguish the normal age-related sleep changes from those originating from pathological processes. PMID:21225347

  12. Income, Ethnicity and Sleep: Coping as a Moderator

    El-Sheikh, Mona; Kelly, Ryan J.; Sadeh, Avi; Buckhalt, Joseph A.


    Toward identifying variables that may protect children against sleep problems otherwise associated with ethnic minority status and economic adversity, support coping was examined as a moderator. Participants were 235 children (113 boys, 122 girls; M age = 11.33 years, SD =8.03 months); 64% European American and 36% African American. Children’s sleep duration (minutes) and continuity (efficiency) were assessed through actigraphs worn for one week. Mothers reported on the family’s monetary reso...

  13. Estudios sobre Trypanosomiasis americana en el Perú. Observaciones en el departamento de Ica

    Víctor M Ayulo Robles


    Full Text Available Hemos comprobado la presencia de Triatomas en las ciudades de Ica y Nazca. Los Triatomas encontrados en esas localidades son de la especie del Triatoma Infestans. Las observaciones del contenido intestinal de los Triatomas capturados en ambas ciudades reveló que ellos no se encuentran infestados; lo que hace sospechar que estos insectos procedan de la Ciudad de Arequipa. Los exámenes de sangre en fresco, gota gruesa y frotis coloreados por el método de Giemsa en 174 personas y 32 animales, así como las pruebas de Desviación del Complemento (Reacción de GUERREIRO Y MACHADO e intradermo-reacción en las 174 personas, fueron negativas; lo que demuestra que actualmente no existe la Enfermedad de Chagas en el Departamento de Ica. Dada la presencia de Triatomas en Ica y Nazca y la existencia de la Enfermedad de Chagas en Vitor, Sihuas y Quishuarani del Departamento de Arequipa no se excluye la posibilidad de que posteriormente se haga presente la Trypanosomiasis americana, también, en esas zonas.

  14. Animal trypanosomiasis in South America. Current status, partnership, and information technology.

    Dávila, A M; Silva, R A


    Animal trypanosome species of economical importance in South America include T. vivax and T. evansi. Both species are described in Brazil, Bolivia, Colombia, French Guyana, Peru, Suriname, and Venezuela. In Argentina and Guyana, only T. evansi and T. vivax are found, respectively. Our studies on T. vivax indicated that the parasite was spreading around 1.3 km per day in Bolivia. We found severe leukopenia in bovines from Pantanal (Brazil) and the Department of Santa Cruz (Bolivia). Because it can cause immunosuppression, the importance of trypanosomiasis control in ensuring success of vaccination campaigns against foot and mouth disease (FMD) in the Pantanal and Bolivia should be considered. The use of one needle for several animals during FMD campaigns in Brazil and Bolivia could also contribute to the spread of T. vivax. The anticipated losses due to T. vivax could exceed $160 million, assuming there are 11 million head of cattle in the Brazilian Pantanal and Bolivian lowlands. International collaboration among research institutes is needed to deal with these diseases and parasites. Previous efforts using information technologies resulted in the creation of two discussion lists (Tryplink and Trypan), the edition of the on-line version of Trypnews and Internet conferences. PMID:11193622

  15. Tsetse and trypanosomiasis control for the rural development of Buvuma island, Lake Victoria, Uganda

    Historically, the potentially highly agricultural productive areas of Uganda, bordering the shores of Lake Victoria, have been plagued by the presence of tsetse flies. While Glossina pallidipes was reported to be main vector in the area, evidence has accrued indicating that G. fuscipes fuscipes is in fact the main vector on the island. There is also evidence that the species has adopted a peridomestic behaviour in this, predominantly, farming and fishing community. Since 1987/88, intensive surveys were conducted and current monitoring work concentrates on strategic sites such as water collection points, fishing camps, ports of call and selected villages on the island (Bulopa-Walwanda, Lwenyanga, Kyanamu, Tome, Isiriba and Kachanga). Making use of 20-25 pyramidal traps impregnated with deltamethrin (400 mg/trap) for 20-22 days/month, the G. f. fuscipes population around reference villages was considerably reduced (90-95% after 7-9 months). Arrangements are underway to evaluate insecticides treatments of domestic livestock host animals and monitor trends in the transmission of trypanosomiasis. In collaboration with UTRO, Tororo, experimental rearing of G. F. fuscipes will be undertaken aiming at producing flies for mark-release-recapture studies and trials with sterile flies




    @@Sleep is the natural suspension of consciousness during which the powers of the body are restored Sleep recurs with remarkable periodicity in alliance with the geocosmic cycle and in compliance with the circadian rhythms of the body.

  17. Sleep physiology and sleep disorders in childhood

    El Shakankiry HM


    Full Text Available Hanan M El ShakankiryKing Fahd University Hospital, Al Dammam University, Al Khobar, Kingdom of Saudi ArabiaAbstract: Sleep has long been considered as a passive phenomenon, but it is now clear that it is a period of intense brain activity involving higher cortical functions. Overall, sleep affects every aspect of a child's development, particularly higher cognitive functions. Sleep concerns are ranked as the fifth leading concern of parents. Close to one third of all children suffer from sleep disorders, the prevalence of which is increased in certain pediatric populations, such as children with special needs, children with psychiatric or medical diagnoses and children with autism or pervasive developmental disorders. The paper reviews sleep physiology and the impact, classification, and management of sleep disorders in the pediatric age group.Keywords: sleep physiology, sleep disorders, childhood, epilepsy

  18. Sleep for cognitive enhancement

    Susanne Diekelmann


    Full Text Available Sleep is essential for effective cognitive functioning. Loosing even a few hours of sleep can have detrimental effects on a wide variety of cognitive processes such as attention, language, reasoning, decision making, learning and memory. While sleep is necessary to ensure normal healthy cognitive functioning, it can also enhance performance beyond the boundaries of the normal condition. This article discusses the enhancing potential of sleep, mainly focusing on the domain of learning and memory. Sleep is known to facilitate the consolidation of memories learned before sleep as well as the acquisition of new memories to be learned after sleep. According to a widely held model this beneficial effect of sleep relies on the neuronal reactivation of memories during sleep that is associated with sleep-specific brain oscillations (slow oscillations, spindles, ripples as well as a characteristic neurotransmitter milieu. Recent research indicates that memory processing during sleep can be boosted by (i cueing memory reactivation during sleep, (ii stimulating sleep-specific brain oscillations, and (iii targeting specific neurotransmitter systems pharmacologically. Olfactory and auditory cues can be used, for example, to increase reactivation of associated memories during post-learning sleep. Intensifying neocortical slow oscillations (the hallmark of slow wave sleep by electrical or auditory stimulation and modulating specific neurotransmitters such as noradrenaline and glutamate likewise facilitates memory processing during sleep. With this evidence in mind, this article concludes by discussing different methodological caveats and ethical issues that should be considered when thinking about using sleep for cognitive enhancement in everyday applications.

  19. Metabolic consequences of sleep and sleep loss

    Van Cauter, Eve; Spiegel, Karine; Tasali, Esra; Leproult, Rachel


    Reduced sleep duration and quality appear to be endemic in modern society. Curtailment of the bedtime period to minimum tolerability is thought to be efficient and harmless by many. It has been known for several decades that sleep is a major modulator of hormonal release, glucose regulation and cardiovascular function. In particular, slow wave sleep (SWS), thought to be the most restorative sleep stage, is associated with decreased heart rate, blood pressure, sympathetic nervous activity and ...

  20. Sleep apnea and sleep : diagnostic aspects

    Sahlin, Carin


    Background: Patients with sleep apnea have frequent apneas and hypopneas during sleep. Apneas can be either central or obstructive. The apnea-hypopnea index (AHI) is the mean number of apneas and hypopneas per hour of sleep. Aims: 1) To evaluate the effect of a mandibular advancement device on obstructive apneas and sleep; 2) to evaluate the influence of body position on central apnea frequency; 3) to investigate whether obstructive or central apnea is related to mortality in patients with st...

  1. Adolescents' Sleep Behaviors and Perceptions of Sleep

    Noland, Heather; Price, James H.; Dake, Joseph; Telljohann, Susan K.


    Background: Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents. This study extends our understanding of how adolescents perceive and deal with their sleep issues. Methods: General education classes were…

  2. Growth in Body Mass Index from Childhood into Adolescence: The Role of Sleep Duration and Quality

    El-Sheikh, Mona; Bagley, Erika J.; Keiley, Margaret K.; Erath, Stephen A.


    This study examined longitudinal relations between sleep and body mass index (BMI) from late childhood ([X-bar] age = 9.44 at T1) to early adolescence ([X-bar] age = 11.36 at T3) with a relatively large (n = 273 at T1) and diverse (35% African Americans) sample. Sleep was assessed with actigraphy-based sleep minutes and self-reported sleep…

  3. Snoring and risk for obstructive sleep apnea among nigerians with heart failure: Prevalence and clinical correlates

    Akintunde, Adeseye A


    Background: Heart failure is an important cause of morbidity and mortality in developing nations like Nigeria. Sleep apnea and snoring has recently been recognized to be a cardiovascular risk factor. Sleep apnea is yet to be well studied among Africans with heart failure. We aimed to determine the prevalence of snoring and high risk for obstructive sleep apnea among Nigerians with stable heart failure. Materials and Methods: We studied 103 subjects that included 62 patients with heart fail...

  4. Common variants in DRD2 are associated with sleep duration: the CARe consortium.

    Cade, Brian E; Gottlieb, Daniel J; Lauderdale, Diane S; Bennett, David A; Buchman, Aron S; Buxbaum, Sarah G; De Jager, Philip L; Evans, Daniel S; Fülöp, Tibor; Gharib, Sina A; Johnson, W Craig; Kim, Hyun; Larkin, Emma K; Lee, Seung Ku; Lim, Andrew S; Punjabi, Naresh M; Shin, Chol; Stone, Katie L; Tranah, Gregory J; Weng, Jia; Yaffe, Kristine; Zee, Phyllis C; Patel, Sanjay R; Zhu, Xiaofeng; Redline, Susan; Saxena, Richa


    Sleep duration is implicated in the etiologies of chronic diseases and premature mortality. However, the genetic basis for sleep duration is poorly defined. We sought to identify novel genetic components influencing sleep duration in a multi-ethnic sample. Meta-analyses were conducted of genetic associations with self-reported, habitual sleep duration from seven Candidate Gene Association Resource (CARe) cohorts of over 25 000 individuals of African, Asian, European and Hispanic American ancestry. All individuals were genotyped for ∼50 000 SNPs from 2000 candidate heart, lung, blood and sleep genes. African-Americans had additional genome-wide genotypes. Four cohorts provided replication. A SNP (rs17601612) in the dopamine D2 receptor gene (DRD2) was significantly associated with sleep duration (P = 9.8 × 10(-7)). Conditional analysis identified a second DRD2 signal with opposite effects on sleep duration. In exploratory analysis, suggestive association was observed for rs17601612 with polysomnographically determined sleep latency (P = 0.002). The lead DRD2 signal was recently identified in a schizophrenia GWAS, and a genetic risk score of 11 additional schizophrenia GWAS loci genotyped on the IBC array was also associated with longer sleep duration (P = 0.03). These findings support a role for DRD2 in influencing sleep duration. Our work motivates future pharmocogenetics research on alerting agents such as caffeine and modafinil that interact with the dopaminergic pathway and further investigation of genetic overlap between sleep and neuro-psychiatric traits. PMID:26464489

  5. Sleep and Infant Learning

    Tarullo, Amanda R.; Balsam, Peter D.; Fifer, William P.


    Human neonates spend the majority of their time sleeping. Despite the limited waking hours available for environmental exploration, the first few months of life are a time of rapid learning about the environment. The organization of neonate sleep differs qualitatively from adult sleep, and the unique characteristics of neonatal sleep may promote…

  6. Sleep medicine in Taiwan

    Chen, Ning-Hung; Hang, Liang-Wen; Lin, Chia-Mo


    The sleep medicine is a young medical science in Taiwan. It began from less than 10 sleep beds 20 years ago in four hospitals all over Taiwan. By the organization of sleep team in Chang Gung Memorial Hospital and the initiation of Taiwan Society of Sleep Medicine, sleep medicine becomes a popular medicine in the past decades. The setting of Sleep Society in 2002 is the milestone to promote the sleep medicine, educate the public and professionals, and control of the quality of clinical practic...

  7. Occupational Sleep Medicine.

    Cheng, Philip; Drake, Christopher


    Sleep and circadian rhythms significantly impact almost all aspects of human behavior and are therefore relevant to occupational sleep medicine, which is focused predominantly around workplace productivity, safety, and health. In this article, 5 main factors that influence occupational functioning are reviewed: (1) sleep deprivation, (2) disordered sleep, (3) circadian rhythms, (4) common medical illnesses that affect sleep and sleepiness, and (5) medications that affect sleep and sleepiness. Consequences of disturbed sleep and sleepiness are also reviewed, including cognitive, emotional, and psychomotor functioning and drowsy driving. PMID:26972034

  8. Sleep problems predict cortisol reactivity to stress in urban adolescents.

    Mrug, Sylvie; Tyson, Anna; Turan, Bulent; Granger, Douglas A


    This study examined the role of sleep problems and sleep duration on stress-related HPA axis reactivity among urban, low income adolescents. A total of 84 adolescents (M age 13.36 years; 50% male; 95% African American) and their parents provided information on adolescents' sleep problems and sleep quantity. Adolescents completed a standardized social stress test in the laboratory (the Trier Social Stress Test; TSST). Saliva samples collected before and after the TSST yielded measures of cortisol pre-test, 15 min post-test, and 55 min post-test, as well as overall cortisol secretion and its increase (AUCG and AUCI). More sleep problems and longer sleep duration predicted higher cortisol reactivity to the TSST, particularly among females. Self-reports of sleep were more consistently related to stress-related cortisol reactivity than parent reports. Sleep problems and longer sleep duration may place adolescents at risk for HPA axis hyper-reactivity to stress, contributing to academic, behavioral and health problems. PMID:26679739

  9. Isolated sleep paralysis elicited by sleep interruption.

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K


    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy. PMID:1621022

  10. Sleep disorders in children


    Sleep disorders may affect 20-30% of young children, and include excessive daytime sleepiness, problems getting to sleep (dysomnias), or undesirable phenomena during sleep (parasomnias), such as sleep terrors, and sleepwalking. Children with physical or learning disabilities are at increased risk of sleep disorders. Other risk factors include the child being the first born, having a difficult temperament or having had colic, and increased maternal responsiveness.

  11. Ostriches sleep like platypuses.

    John A Lesku

    Full Text Available Mammals and birds engage in two distinct states of sleep, slow wave sleep (SWS and rapid eye movement (REM sleep. SWS is characterized by slow, high amplitude brain waves, while REM sleep is characterized by fast, low amplitude waves, known as activation, occurring with rapid eye movements and reduced muscle tone. However, monotremes (platypuses and echidnas, the most basal (or 'ancient' group of living mammals, show only a single sleep state that combines elements of SWS and REM sleep, suggesting that these states became temporally segregated in the common ancestor to marsupial and eutherian mammals. Whether sleep in basal birds resembles that of monotremes or other mammals and birds is unknown. Here, we provide the first description of brain activity during sleep in ostriches (Struthio camelus, a member of the most basal group of living birds. We found that the brain activity of sleeping ostriches is unique. Episodes of REM sleep were delineated by rapid eye movements, reduced muscle tone, and head movements, similar to those observed in other birds and mammals engaged in REM sleep; however, during REM sleep in ostriches, forebrain activity would flip between REM sleep-like activation and SWS-like slow waves, the latter reminiscent of sleep in the platypus. Moreover, the amount of REM sleep in ostriches is greater than in any other bird, just as in platypuses, which have more REM sleep than other mammals. These findings reveal a recurring sequence of steps in the evolution of sleep in which SWS and REM sleep arose from a single heterogeneous state that became temporally segregated into two distinct states. This common trajectory suggests that forebrain activation during REM sleep is an evolutionarily new feature, presumably involved in performing new sleep functions not found in more basal animals.

  12. Sleep and Student Achievement

    Eric R Eide; Mark H. Showalter


    We explore the relationship between sleep and student performance on standardized tests. We model test scores as a nonlinear function of sleep, which allows us to compute the hours of sleep associated with maximum test scores. We refer to this as “optimal” hours of sleep. We also evaluate how the sleep and student performance relationship changes with age. We use the Panel Study of Income Dynamics-Child Development Supplement, which includes excellent control variables that are not usually av...

  13. Childhood epilepsy and sleep

    Al-Biltagi, Mohammed A


    Sleep and epilepsy are two well recognized conditions that interact with each other in a complex bi-directional way. Some types of epilepsies have increased activity during sleep disturbing it; while sleep deprivation aggravates epilepsy due to decreased seizure threshold. Epilepsy can deteriorate the sleep-related disorders and at the same time; the parasomnias can worsen the epilepsy. The secretion of sleep-related hormones can also be affected by the occurrence of seizures and supplementat...

  14. Application of ELISA for diagnosing and investigating the epidemiology of trypanosomiasis in buffaloes in north Vietnam

    An antigen-detection enzyme immunoassay (Ag-ELISA) based on a Trypanosoma evansi specific monoclonal antibody was used for the detection of circulating antigens in experimentally infected buffaloes and in buffaloes kept in different geographical regions of Vietnam. In experimental infections, circulating antigens were detected around 7 to 14 days after infection but the levels detected were considerably lower than those in sera collected from the field, suggesting that the parasite isolate used became highly adapted to mice thorough passage. In a study of field sera the agreement between the Ag-ELISA and parasitological methods for detecting infected cases was 80% and the apparent specificity of the test was 90%. In these and other studies the Ag-ELISA consistently detected many more infected cases than did the conventional parasitological methods. In most cases animals whose sera reacted in the Ag-ELISA also had trypanosome specific antibodies in their circulation. Treatment of infected animals with a trypanocidal drug in most cases resulted in a significant drop in trypanosome antigen levels but their status with respect to trypanosomal antibodies remained unchanged. Seroepidemiological surveys using Ag-ELISA and Ab-ELISA and base on an analysis of around 1000 sera collected from different regions of Vietnam demonstrated prevalence ranging between 17% and 50% with no apparent relationship to geographical region. However, prevalence of infection was generally higher in summer (rainy season), when fly activity is highest. It is concluded that serological methods based on Ag-ELISA and Ab-ELISA are valuable adjuncts to clinical and parasitological methods for diagnosing trypanosomiasis, studying the epidemiology of the disease and monitoring the effectiveness of control programmes. (author). 12 refs, 2 figs, 3 tabs

  15. Consultants' Group Meeting on Tsetse Genetics in Relation to Tsetse/Trypanosomiasis Control/Eradication

    The FAO and IAEA have long recognized the need for methods for insect and pest control based upon approaches other than simply the widespread use of insecticides. Through the past several years the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has expended a considerable amount of effort in the development of a SIT programme applicable to tsetse. Such programmes have proved to be a highly successful component of the integrated control of tsetse flies. However, the pilot programmes undertaken to date have been applied to areas of limited size and future integrated control programmes for tsetse must cover much larger regions. The Consultants' Group was cognisant of the continued need for improvements in the cost effectiveness in the mass production of tsetse, particularly for SIT programmes. The Consultants' Goup recognized also that FAO/IAEA plays an important leadership role in the development of new technologies for the control of insect pest populations, and in the transfer of such technologies to assist in the improvement of agricultural production, particularly in developing countries. In addition to research on the development of methods for insect control (emphasizing application of the Sterile Insect Technique), the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has established and implemented five 'Co-ordinated Research Programmes' on tsetse and has, from time to time, convened groups of consultants to discuss and make recommendations on specific subjects. At least two such meetings (in July 1975 and November 1987) focused on genetic methods of insect control. The recent, rapid developments in molecular biology have stimulated interest in the application of genetic techniques to the problem of tsetse and trypanosomiasis control in Africa.

  16. Relationships between Menopausal and Mood Symptoms and EEG Sleep Measures in a Multi-ethnic Sample of Middle-Aged Women: The SWAN Sleep Study

    Kravitz, Howard M.; Avery, Elizabeth; Sowers, MaryFran; Bromberger, Joyce T.; Owens, Jane F.; Matthews, Karen A.; Hall, Martica; Zheng, Huiyong; Gold, Ellen B.; Buysse, Daniel J.


    Study Objectives: Examine associations of vasomotor and mood symptoms with visually scored and computer-generated measures of EEG sleep. Design: Cross-sectional analysis. Setting: Community-based in-home polysomnography (PSG). Participants: 343 African American, Caucasian, and Chinese women; ages 48–58 years; pre-, peri- or post-menopausal; participating in the Study of Women's Health Across the Nation Sleep Study (SWAN Sleep Study). Interventions: None. Measurements and Results: Measures included PSG-assessed sleep duration, continuity, and architecture, delta sleep ratio (DSR) computed from automated counts of delta wave activity, daily diary-assessed vasomotor symptoms (VMS), questionnaires to collect mood (depression, anxiety) symptoms, medication, and lifestyle information, and menopausal status using bleeding criteria. Sleep outcomes were modeled using linear regression. Nocturnal VMS were associated with longer sleep time. Higher anxiety symptom scores were associated with longer sleep latency and lower sleep efficiency, but only in women reporting nocturnal VMS. Contrary to expectations, VMS and mood symptoms were unrelated to either DSR or REM latency. Conclusions: Vasomotor symptoms moderated associations of anxiety with EEG sleep measures of sleep latency and sleep efficiency and was associated with longer sleep duration in this multi-ethnic sample of midlife women. Citation: Kravitz HM; Avery E; Sowers MF; Bromberger JT; Owens JF; Matthews KA; Hall M; Zheng H; Gold EB; Buysse DJ. Relationships between menopausal and mood symptoms and Eeg sleep measures in a multi-ethnic sample of middle-aged women: the SWAN Sleep Study. SLEEP 2011;34(9):1221-1232. PMID:21886360

  17. Challenges of controlling sleeping sickness in areas of violent conflict: experience in the Democratic Republic of Congo

    Yun Oliver


    Full Text Available Abstract Background Human African trypanosomiasis (HAT, or sleeping sickness, is a fatal neglected tropical disease if left untreated. HAT primarily affects people living in rural sub-Saharan Africa, often in regions afflicted by violent conflict. Screening and treatment of HAT is complex and resource-intensive, and especially difficult in insecure, resource-constrained settings. The country with the highest endemicity of HAT is the Democratic Republic of Congo (DRC, which has a number of foci of high disease prevalence. We present here the challenges of carrying out HAT control programmes in general and in a conflict-affected region of DRC. We discuss the difficulties of measuring disease burden, medical care complexities, waning international support, and research and development barriers for HAT. Discussion In 2007, Médecins Sans Frontières (MSF began screening for HAT in the Haut-Uélé and Bas-Uélé districts of Orientale Province in northeastern DRC, an area of high prevalence affected by armed conflict. Through early 2009, HAT prevalence rate of 3.4% was found, reaching 10% in some villages. More than 46,000 patients were screened and 1,570 treated for HAT during this time. In March 2009, two treatment centres were forced to close due to insecurity, disrupting patient treatment, follow-up, and transmission-control efforts. One project was reopened in December 2009 when the security situation improved, and another in late 2010 based on concerns that population displacement might reactivate historic foci. In all of 2010, 770 patients were treated at these sites, despite a limited geographical range of action for the mobile teams. Summary In conflict settings where HAT is prevalent, targeted medical interventions are needed to provide care to the patients caught in these areas. Strategies of integrating care into existing health systems may be unfeasible since such infrastructure is often absent in resource-poor contexts. HAT care in

  18. Sleep locally, act globally.

    Rattenborg, Niels C; Lima, Steven L; Lesku, John A


    In most animals, sleep is considered a global brain and behavioral state. However, recent intracortical recordings have shown that aspects of non-rapid eye movement (NREM) sleep and wakefulness can occur simultaneously in different parts of the cortex in mammals, including humans. Paradoxically, however, NREM sleep still manifests as a global behavioral shutdown. In this review, the authors examine this paradox from an evolutionary perspective. On the basis of strategic modeling, they suggest that in animals with brains composed of heavily interconnected and functionally interdependent units, a global regulator of sleep maintains the behavioral shutdown that defines sleep and thereby ensures that local use-dependent functions are performed in a safe and efficient manner. This novel perspective has implications for understanding deficits in human cognitive performance resulting from sleep deprivation, sleep disorders such as sleepwalking, changes in consciousness that occur during sleep, and the function of sleep itself. PMID:22572533

  19. Patterns of sleep behaviour.

    Webb, W. B.


    Discussion of the electroencephalogram as the critical measurement procedure for sleep research, and survey of major findings that have emerged in the last decade on the presence of sleep within the twenty-four-hour cycle. Specifically, intrasleep processes, frequency of stage changes, sequence of stage events, sleep stage amounts, temporal patterns of sleep, and stability of intrasleep pattern in both man and lower animals are reviewed, along with some circadian aspects of sleep, temporal factors, and number of sleep episodes. It is felt that it is particularly critical to take the presence of sleep into account whenever performance is considered. When it is recognized that responsive performance is extremely limited during sleep, it is easy to visualize the extent to which performance is controlled by sleep itself.

  20. Are You Getting Enough Sleep?

    ... Past Emails CDC Features Are you getting enough sleep? Recommend on Facebook Tweet Share Compartir Sleep is ... sleep guidelines for different age groups. How much sleep do you need? Newborns 16-18 hours Preschool- ...

  1. All about Sleep (For Parents)

    ... Kids For Parents MORE ON THIS TOPIC Naps Sleepwalking Nightmares Night Terrors Sleep and Your 1- to ... Sleep Apnea Sleep Problems in Teens Separation Anxiety Sleepwalking Nightmares What Kids Say About: Sleep Time for ...

  2. [Sleep and dreams in pictures].

    Stoll, R T


    Human life is divided into two thirds wakefulness and one third sleep. A newborn child sleeps to strengthen, the adult for regeneration. At the end of life man sinks down into the sleep of death: Hypnos and Thanatos are twin sons of the Queen of Night. Myths from different cultures are influenced by the experience of sleep and its inner world of pictures, the dreams. Artists, painters and sculptors let their visions float steadily into new pictures, and creatures of sleep formed out of diverse materials. Devine sleep, sleep for new life, sleep of health, creative sleep, prophetic sleep, sleep for revelation and for decisions. PMID:7732243

  3. Are Inflammatory and Coagulation Biomarkers Related to Sleep Characteristics in Mid-Life Women?: Study of Women's Health Across the Nation Sleep Study

    Matthews, Karen A.; Zheng, Huiyong; Kravitz, Howard M.; Sowers, MaryFran; Bromberger, Joyce T.; Buysse, Daniel J.; Owens, Jane F.; Sanders, Mark; Hall, Martica


    Study Objectives: Inflammation and pro-coagulation biomarkers may be a link between sleep characteristics and risk for cardiometabolic disorders. We tested the hypothesis that worse sleep characteristics would be associated with C-reactive protein (CRP), fibrinogen, factor VIIc, and plasminogen activator inhibitor (PAI)-1 in a multi-ethnic subsample of mid-life women enrolled in the Study of Women's Health across the Nation. Design: Cross-sectional. Measurements and Results: African American, Chinese, and Caucasian women (N = 340) participated in 3 days of in-home polysomnographic (PSG) monitoring and had measures of inflammation and coagulation. Regression analyses revealed that each of the biomarkers were associated with indicators of sleep disordered breathing after adjusting for age, duration between sleep study and blood draw, site, menopausal status, ethnicity, residualized body mass index, smoking status, and medications that affect sleep or biomarkers. Among African American women, those who had higher levels of CRP had shorter PSG-sleep duration and those who had higher levels of fibrinogen had less efficient sleep in multivariate models. Conclusions: These results suggest that inflammation and pro-coagulation processes may be an important pathway connecting sleep disordered breathing and cardiometabolic disorders in women of these ethnic groups and that inflammation may be a particularly important pathway in African Americans. Citation: Matthews KA; Zheng H; Kravitz HM; Sowers M; Bromberger JT; Buysse DJ; Owens JF; Sanders M; Hall M. Are inflammatory and coagulation biomarkers related to sleep characteristics in mid-life women?: Study of Women's Health Across the Nation Sleep Study. SLEEP 2010;33(12):1649-1655. PMID:21120127

  4. Sleep as a Mediator in the Pathway Linking Environmental Factors to Hypertension: A Review of the Literature

    Oluwaseun A. Akinseye


    Full Text Available Environmental factors, such as noise exposure and air pollution, are associated with hypertension. These environmental factors also affect sleep quality. Given the growing evidence linking sleep quality with hypertension, the purpose of this review is to investigate the role of sleep as a key mediator in the association between hypertension and environmental factors. Through this narrative review of the extant literature, we highlight that poor sleep quality mediates the relationship between environmental factors and hypertension. The conceptual model proposed in this review offers opportunities to address healthcare disparities in hypertension among African Americans by highlighting the disparate impact that the predictors (environmental factors and mediator (sleep have on the African-American community. Understanding the impact of these factors is crucial since the main outcome variable (hypertension severely burdens the African-American community.

  5. Biochemical Regulation of Sleep and Sleep Biomarkers

    Clinton, James M.; Davis, Christopher J.; Zielinski, Mark R.; Jewett, Kathryn A.; Krueger, James M.


    Symptoms commonly associated with sleep loss and chronic inflammation include sleepiness, fatigue, poor cognition, enhanced sensitivity to pain and kindling stimuli, excess sleep and increases in circulating levels of tumor necrosis factor α (TNF) in humans and brain levels of interleukin-1 β (IL1) and TNF in animals. Cytokines including IL1 and TNF partake in non-rapid eye movement sleep (NREMS) regulation under physiological and inflammatory conditions. Administration of exogenous IL1 or TN...

  6. Sleep physiology and sleep disorders in childhood

    El Shakankiry HM


    Hanan M El ShakankiryKing Fahd University Hospital, Al Dammam University, Al Khobar, Kingdom of Saudi ArabiaAbstract: Sleep has long been considered as a passive phenomenon, but it is now clear that it is a period of intense brain activity involving higher cortical functions. Overall, sleep affects every aspect of a child's development, particularly higher cognitive functions. Sleep concerns are ranked as the fifth leading concern of parents. Close to one third of all children suffer ...

  7. Sleep strategies of night shift nurses on days off: which ones are most adaptive?

    Megan E Petrov


    Full Text Available Objectives: To determine the off-shift sleep strategies of bi-ethnic night shift nurses, the relationship between these sleep strategies and adaptation to shift work, and identify the participant-level characteristics associated with a given sleep strategy.Methods: African American and non-Hispanic White female, night shift nurses from an academic hospital were recruited to complete a survey on sleep-wake patterns (n = 213. Participants completed the Standard Shiftwork Index and the Biological Clocks Questionnaire to determine sleep strategies and adaptation to night shift work. In addition, chronotype was determined quantitatively with a modified version of the Munich ChronoType Questionnaire.Most participants worked approximately three consecutive 12-hour night shifts followed by several days off.Results: Five sleep strategies used on days off were identified: a Night Stay, b Nap Proxy, c Switch Sleeper, d No Sleep, and e Incomplete Switcher. Nap Proxy and No Sleep types were associated with poorer adaptation to night shift work. The Switch Sleeper and Incomplete Switcher types were identified as more adaptive strategies that were associated with less sleep disturbance, a later chronotype, and less cardiovascular problems.Conclusions: Behavioral sleep strategies are related to adaptation to a typical night-shift schedule among hospital nurses. Nurses are crucial to the safety and well-being of their patients. Therefore, adoption of more adaptive sleep strategies may reduce sleep/wake dysregulation in this population, and improve cardiovascular outcomes.

  8. Validation of the antigen ELISA in comparison with parasitological techniques for the diagnosis of bovine trypanosomiasis in Zimbabwe

    The antigen ELISA (Ag-ELISA) for the detection of trypanosomal infections was used to test sera from naturally infected cattle and the results were correlated with those obtained by buffy coat technique (BCT). Sera were obtained from cattle kept in a tsetse free area to determine test sensitivity and from a second tsetse free area to obtain baseline values for a group of animals which were later to be moved to an area of high tsetse challenge. The Ag-ELISA was apparently 98.4% specific. In the area of high tsetse challenge the buffy coat technique detected 75 (26.6%) infections while the antigen ELISA detected 110 (39.0%) infections. The ELISA failed to detect antigens in some parasitologically positive animals, but the two were complementary for the diagnosis of trypanosomiasis in individual animals. An unexpectedly high proportion of antigen positive animals (25.0%) was found in the second tsetse free area but these infections could be due to non cyclical transmission indicating that although tsetse eradication may remove the vector, sub-clinical trypanosomiasis may persist in the cattle population unless measures are taken to provide adequate trypanocidal drug therapy. (author). 2 refs, 6 figs, 1 tab

  9. Sleep Eduction: Treatment & Therapy

    ... Facts Causes and Risk Factors Diagnosis and Treatment Sleepwalking Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep Terrors Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment Sleep Eating Disorder Overview & Facts Symptoms & Risk Factors Diagnosis & Treatment REM ...

  10. Teenagers and sleep

    ... Teenagers and sleep To use the sharing features on this page, ... need. What Makes it Hard for Teens to Sleep? Several factors make it hard for teens to ...

  11. Sleep and Salivary Cortisol

    Garde, Anne Helene; Karlson, Bernt; Hansen, Åse Marie;


    The aim of the present chapter was to analyze whether measures of cortisol in saliva were associated with measures of sleep and to explore if divergent results were related to underlying differences in theoretic assumptions and methods. Measures of sleep quality included sleep duration, overall...... sleep quality, difficulty falling asleep, disturbed sleep, and sleep deprivation. Twenty-three papers were found to fulfill the inclusion criteria. Cortisol measures were grouped into single time points at different times during the day, deviations at different time periods during the day, reactivity...... sleep duration and single measures of salivary cortisol at awakening, which was observed in 3 studies. In these studies, sleep duration was also associated with low evening cortisol levels, steep diurnal deviation of cortisol and/or high area under the curve. Together these findings suggest that longer...

  12. Sleep and Aging: Insomnia

    ... page please turn Javascript on. Sleep and Aging Insomnia Insomnia is the most common sleep complaint at ... at greater risk for falling. Health Issues and Insomnia Disorders that cause pain or discomfort during the ...

  13. Sleep and Eating Disorders.

    Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M


    Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia. PMID:27553980

  14. Brain Basics: Understanding Sleep

    ... up. Some children experience bedwetting, night terrors, or sleepwalking during deep sleep. When we switch into REM ... stimulate some parts of the brain and can cause insomnia, or an inability to sleep. Many antidepressants ...

  15. Sleep and your health

    ... Practice of Sleep Medicine . 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 65. Carskadon MA, Dement WC. ... Practice of Sleep Medicine . 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 2. Centers for Disease Control ...

  16. Aging changes in sleep

    ... this page: // Aging changes in sleep To use the sharing features ... cycle is repeated several times during the night. AGING CHANGES With aging, sleep patterns tend to change. ...

  17. Sleep Loss and Inflammation

    Mullington, Janet M.; Simpson, Norah S.; Meier-Ewert, Hans K.; Haack, Monika


    Controlled, experimental studies on the effects of acute sleep loss in humans have shown that mediators of inflammation are altered by sleep loss. Elevations in these mediators have been found to occur in healthy, rigorously screened individuals undergoing experimental vigils of more than 24 hours, and have also been seen in response to various durations of sleep restricted to between 25 and 50% of a normal 8 hour sleep amount. While these altered profiles represent small changes, such sub-cl...

  18. Pediatric Sleep Surgery

    Cecille Gail Sulman


    Full Text Available Adenotonsillectomy is the most common surgery performed for sleep disordered breathing with good outcomes. Children with obesity, craniofacial disorders, and neurologic impairment are at risk for persistent sleep apnea after adenotonsillectomy. Techniques exist to address obstructive lesions of the palate, tongue base, or craniofacial skeleton in children with persistent sleep apnea. Children with obstructive sleep apnea have a higher rate of peri-operative complications.

  19. : REM sleep behavior disorder

    Arnulf, Isabelle


    Patients with REM sleep behavior disorder (RBD) enact violent dreams during REM sleep in the absence of normal muscle atonia. This disorder is highly frequent in patients with synucleinopathies (60%-100% of patients) and rare in patients with other neurodegenerative disorders. The disorder is detected by interview plus video and sleep monitoring. Abnormal movements expose the patients and bed partners to a high risk of injury and sleep disruption. The disorder is usually alleviated with melat...

  20. Sleep, vigilance, and thermosensitivity

    Romeijn, Nico; Raymann, Roy J E M; Møst, Els; Te Lindert, Bart; Van Der Meijden, Wisse P.; Fronczek, Rolf; Gomez-Herrero, German; Van Someren, Eus J. W.


    The regulation of sleep and wakefulness is well modeled with two underlying processes: a circadian and a homeostatic one. So far, the parameters and mechanisms of additional sleep-permissive and wake-promoting conditions have been largely overlooked. The present overview focuses on one of these conditions: the effect of skin temperature on the onset and maintenance of sleep, and alertness. Skin temperature is quite well suited to provide the brain with information on sleep-permissive and wake...

  1. Pediatric Sleep Surgery

    Cecille Gail Sulman


    Adenotonsillectomy is the most common surgery performed for sleep disordered breathing with good outcomes. Children with obesity, craniofacial disorders, and neurologic impairment are at risk for persistent sleep apnea after adenotonsillectomy. Techniques exist to address obstructive lesions of the palate, tongue base, or craniofacial skeleton in children with persistent sleep apnea. Children with obstructive sleep apnea have a higher rate of peri-operative complications.

  2. Sleep disorders and stroke

    Wallace, Douglas M; Ramos, Alberto R.; Rundek, Tatjana


    The purpose of this review is to highlight existing literature on the epidemiology, pathophysiology, and treatments of stroke sleep disorders. Stroke sleep disorders are associated with many intermediary vascular risk factors leading to stroke, but they may also influence these risk factors through direct or indirect mechanisms. Sleep disturbances may be further exacerbated by stroke or caused by stroke. Unrecognized and untreated sleep disorders may influence rehabilitation efforts and poor ...

  3. Sleep and Metabolism: An Overview

    Sunil Sharma


    Full Text Available Sleep and its disorders are increasingly becoming important in our sleep deprived society. Sleep is intricately connected to various hormonal and metabolic processes in the body and is important in maintaining metabolic homeostasis. Research shows that sleep deprivation and sleep disorders may have profound metabolic and cardiovascular implications. Sleep deprivation, sleep disordered breathing, and circadian misalignment are believed to cause metabolic dysregulation through myriad pathways involving sympathetic overstimulation, hormonal imbalance, and subclinical inflammation. This paper reviews sleep and metabolism, and how sleep deprivation and sleep disorders may be altering human metabolism.

  4. The Functions of Sleep

    Samson Z Assefa


    Full Text Available Sleep is a ubiquitous component of animal life including birds and mammals. The exact function of sleep has been one of the mysteries of biology. A considerable number of theories have been put forward to explain the reason(s for the necessity of sleep. To date, while a great deal is known about what happens when animals sleep, there is no definitive comprehensive explanation as to the reason that sleep is an inevitable part of animal functioning. It is well known that sleep is a homeostatically regulated body process, and that prolonged sleep deprivation is fatal in animals. In this paper, we present some of the theories as to the functions of sleep and provide a review of some hypotheses as to the overall physiologic function of sleep. To better understand the purpose for sleeping, we review the effects of sleep deprivation on physical, neurocognitive and psychic function. A better understanding of the purpose for sleeping will be a great advance in our understanding of the nature of the animal kingdom, including our own.

  5. Sleep and Your Preschooler

    ... Story" 5 Things to Know About Zika & Pregnancy Sleep and Your Preschooler KidsHealth > For Parents > Sleep and Your Preschooler Print A A A Text ... Preschoolers need about 11 to 12 hours of sleep each day, which can include a nap. There's ...

  6. Is Sleep Essential?

    Chiara Cirelli; Giulio Tononi


    No current hypothesis can explain why animals need to sleep. Yet, sleep is universal, tightly regulated, and cannot be deprived without deleterious consequences. This suggests that searching for a core function of sleep, particularly at the cellular level, is still a worthwhile exercise.

  7. Cancer and African Americans

    ... Population Profiles > Black/African American > Cancer Cancer and African Americans African Americans have the highest mortality rate ... 65MB] At a glance – Top Cancer Sites for African Americans (2008-2012) Cancer Incidence Rates per 100, ...

  8. Sleep and primary headaches.

    Aguggia, Marco; Cavallini, M; Divito, N; Ferrero, M; Lentini, A; Montano, V; Tinebra, M C; Saracco, M G; Valfrè, W


    The relationship between sleep and primary headaches has been known for over a century, particularly for headaches occurring during the night or early morning. Migraine, tension-tyre headache, and cluster headache may cause sleep fragmentation, insomnia, and hypersomnia, causing considerable social and economical costs and several familial problems. By contrast, sleep disorders may themselves trigger headache attacks. Finally, headaches and sleep disorders can also be symptoms of other underlying pathologies. Despite this background, there is still no clarity about the mechanism that links these two entities and their interdependence remains to be defined. Patients with primary headache should undergo a careful assessment of sleep habits. PMID:21533713

  9. Sleep as a support for social competence, peer relations, and cognitive functioning in preschool children.

    Vaughn, Brian E; Elmore-Staton, Lori; Shin, Nana; El-Sheikh, Mona


    Evidence that sleep influences social and cognitive adaptation for school-age children and adolescents is accumulating rapidly, but less research focuses on the role of sleep for adaptive functioning during early childhood. We addressed these questions using actigraphy to assess sleep duration, sleep quality, and variability in sleep schedules in relation to a range of social/emotional and cognitive measures, including receptive vocabulary, emotion understanding, peer acceptance, social skills, social engagement, and temperament. Children in a convenience sample (N = 62, 40 boys, mean age = 4.15 yrs, 67% European American) wore actigraphs for 4-7 days, with sleep and wake states determined using Sadeh's scoring algorithm. Older children spent less time in bed at night and ethnic minority children (mostly African Americans) slept less at night and had lower sleep efficiency than did European American ethnic status children. Bivariate relations (controlling for sex, age, and ethnicity) between sleep variables and child adaptation scores showed that sleep duration was positively associated with peer acceptance, social skills, social engagement, receptive vocabulary, and understanding of the causes of emotions. Fewer variables were associated with nighttime sleep quality and variability and these tended to be related to outcome variables suggestive of behavioral and emotional regulation. Results suggest that sleep parameters are broadly implicated in the adjustment of preschool age children. PMID:24527839

  10. Circadian rhythm sleep disorders

    Morgenthaler TI


    Full Text Available Bhanu P Kolla,1,2 R Robert Auger,1,2 Timothy I Morgenthaler11Mayo Center for Sleep Medicine, 2Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USAAbstract: Misalignment between endogenous circadian rhythms and the light/dark cycle can result in pathological disturbances in the form of erratic sleep timing (irregular sleep–wake rhythm, complete dissociation from the light/dark cycle (circadian rhythm sleep disorder, free-running type, delayed sleep timing (delayed sleep phase disorder, or advanced sleep timing (advanced sleep phase disorder. Whereas these four conditions are thought to involve predominantly intrinsic mechanisms, circadian dysrhythmias can also be induced by exogenous challenges, such as those imposed by extreme work schedules or rapid transmeridian travel, which overwhelm the ability of the master clock to entrain with commensurate rapidity, and in turn impair approximation to a desired sleep schedule, as evidenced by the shift work and jet lag sleep disorders. This review will focus on etiological underpinnings, clinical assessments, and evidence-based treatment options for circadian rhythm sleep disorders. Topics are subcategorized when applicable, and if sufficient data exist. The length of text associated with each disorder reflects the abundance of associated literature, complexity of management, overlap of methods for assessment and treatment, and the expected prevalence of each condition within general medical practice.Keywords: circadian rhythm sleep disorders, assessment, treatment

  11. Neuroimaging in sleep medicine.

    Dang-Vu, Thien Thanh; Desseilles, Martin; Petit, Dominique; Mazza, Stéphanie; Montplaisir, Jacques; Maquet, Pierre


    The development of neuroimaging techniques has made possible the characterization of cerebral function throughout the sleep-wake cycle in normal human subjects. Indeed, human brain activity during sleep is segregated within specific cortical and subcortical areas in relation to the sleep stage, sleep physiological events and previous waking activity. This approach has allowed sleep physiological theories developed from animal data to be confirmed, but has also introduced original concepts about the neurobiological mechanisms of sleep, dreams and memory in humans. In contrast, at present, few neuroimaging studies have been dedicated to human sleep disorders. The available work has brought interesting data that describe some aspects of the pathophysiology and neural consequences of disorders such as insomnia, sleep apnea and narcolepsy. However, the interpretation of many of these results is restricted by limited sample size and spatial/temporal resolution of the employed technique. The use of neuroimaging in sleep medicine is actually restrained by concerns resulting from the technical experimental settings and the characteristics of the diseases. Nevertheless, we predict that future studies, conducted with state of the art techniques on larger numbers of patients, will be able to address these issues and contribute significantly to the understanding of the neural basis of sleep pathologies. This may finally offer the opportunity to use neuroimaging, in addition to the clinical and electrophysiological assessments, as a helpful tool in the diagnosis, classification, treatment and monitoring of sleep disorders in humans. PMID:17470413

  12. Sleep and Sleep Problems: From Birth to 3

    Du Mond, Courtney; Mindell, Jodi A.


    Sleep is an important aspect of a child's early development and is essential to family well-being. During their first 3 years, infants and toddlers spend more than 50% of their lives sleeping. However, concerns about sleep and sleep problems are among the most common issues brought to the attention of pediatricians. Although sleep is one of the…

  13. Family Disorganization, Sleep Hygiene, and Adolescent Sleep Disturbance

    Billows, Michael; Gradisar, Michael; Dohnt, Hayley; Johnston, Anna; McCappin, Stephanie; Hudson, Jennifer


    The link between sleep hygiene and adolescent sleep is well documented, though evidence suggests contributions from other factors, particularly the family environment. The present study examined whether sleep hygiene mediated the relationship between family disorganization and self-reported sleep onset latency, total sleep time, and daytime…

  14. Sleep apnea and stroke.

    Culebras, Antonio


    Clinical evidence has established that sleep apnea is a risk factor for stroke. Patients with stroke have a high prevalence of sleep apnea that may have preceded or developed as a result of the stroke. Well-established concurrent stroke risk factors for stroke like hypertension and atrial fibrillation respond favorably to the successful treatment of sleep apnea. The gold standard diagnosis of sleep apnea is obtained in the sleep laboratory, but unattended polysomnography is gaining acceptance. Positive airway pressure (PAP) (continuous positive airway pressure [CPAP] or bilevel positive airway pressure [BiPAP]) applications are the gold-standard treatment of sleep apnea. Suggestive evidence indicates that stroke occurrence or recurrence may be reduced with treatment of sleep apnea. PMID:25407131

  15. Dreaming without REM sleep.

    Oudiette, Delphine; Dealberto, Marie-José; Uguccioni, Ginevra; Golmard, Jean-Louis; Merino-Andreu, Milagros; Tafti, Mehdi; Garma, Lucile; Schwartz, Sophie; Arnulf, Isabelle


    To test whether mental activities collected from non-REM sleep are influenced by REM sleep, we suppressed REM sleep using clomipramine 50mg (an antidepressant) or placebo in the evening, in a double blind cross-over design, in 11 healthy young men. Subjects were awakened every hour and asked about their mental activity. The marked (81%, range 39-98%) REM-sleep suppression induced by clomipramine did not substantially affect any aspects of dream recall (report length, complexity, bizarreness, pleasantness and self-perception of dream or thought-like mentation). Since long, complex and bizarre dreams persist even after suppressing REM sleep either partially or totally, it suggests that the generation of mental activity during sleep is independent of sleep stage. PMID:22647346

  16. Dietary Macronutrients and Sleep.

    Lindseth, Glenda; Murray, Ashley


    This study examined the effects of macronutrient diets on sleep quantity and quality. Using a repeated-measures, randomized crossover study design, 36 young adults served as their own control, and consumed high protein, carbohydrate, fat, and control diets. Treatment orders were counterbalanced across the dietary groups. Following consumption of the study diets, sleep measures were examined for within-subject differences. Fatty acid intakes and serum lipids were further analyzed for differences. Sleep actigraphs indicated wake times and wake minutes (after sleep onset) were significantly different when comparing consumption of macronutrient diets and a control diet. Post hoc testing indicated high carbohydrate intakes were associated with significantly shorter (p Sleep Quality Index© post hoc results indicated high fat intake was associated with significantly better (p sleep in comparison with the other diets. These results highlight the effects that dietary manipulations may have on sleep. PMID:27170039

  17. Subjectively and Objectively Measured Sleep With and Without Posttraumatic Stress Disorder and Trauma Exposure

    Kobayashi, Ihori; Huntley, Edward; Lavela, Joseph; Mellman, Thomas A.


    Study Objectives: Although reports of sleep disturbances are common among individuals with posttraumatic stress disorder (PTSD), results of polysomnographic (PSG) studies have inconsistently documented abnormalities and have therefore suggested “sleep state misperception.” The authors' study objectives were to compare sleep parameters measured objectively and subjectively in the laboratory and at home in civilians with and without trauma exposure and PTSD. Design: Cross-sectional study. Setting: PSG recordings in a sleep laboratory and actigraphic recordings in participants' homes. Participants: One hundred three urban-residing African Americans with and without trauma exposure and PTSD who participated in a larger study. Interventions: N/A. Measurements: Sleep parameters (total sleep time [TST], sleep onset latency [SOL], and wake after sleep onset [WASO]) were assessed using laboratory PSG and home actigraphy. A sleep diary was completed in the morning after PSG and actigraphy recordings. Habitual TST, SOL, and WASO were assessed using a sleep questionnaire. The Clinician Administered PTSD Scale was administered to assess participants' trauma exposure and PTSD diagnostic status. Results: Participants, regardless of their trauma exposure/PTSD status, underestimated WASO in the diary and questionnaire relative to actigraphy and overestimated SOL in the diary relative to PSG. Among participants with current PTSD, TST diary estimates did not differ from the actigraphy measure in contrast with those without current PTSD who overestimated TST. No other significant group differences in discrepancies between subjective and objective sleep measures were found. Conclusions: Discrepancies between subjectively and objectively measured sleep parameters were not associated with trauma exposure or PTSD. This challenges prior assertions that individuals with PTSD overreport their sleep disturbances. Citation: Kobayashi I; Huntley E; Lavela J; Mellman TA. Subjectively and

  18. Associations between children's intelligence and academic achievement: the role of sleep.

    Erath, Stephen A; Tu, Kelly M; Buckhalt, Joseph A; El-Sheikh, Mona


    Sleep problems (long wake episodes, low sleep efficiency) were examined as moderators of the relation between children's intelligence and academic achievement. The sample was comprised of 280 children (55% boys; 63% European Americans, 37% African Americans; mean age = 10.40 years, SD = 0.65). Sleep was assessed during seven consecutive nights of actigraphy. Children's performance on standardized tests of intelligence (Brief Intellectual Ability index of the Woodcock-Johnson III) and academic achievement (Alabama Reading and Math Test) were obtained. Age, sex, ethnicity, income-to-needs ratio, single parent status, standardized body mass index, chronic illness and pubertal development were controlled in analyses. Higher intelligence was strongly associated with higher academic achievement across a wide range of sleep quality. However, the association between intelligence and academic achievement was slightly attenuated among children with more long wake episodes or lower sleep efficiency compared with children with higher-quality sleep. PMID:25683475

  19. Sleep from an islamic perspective

    Ahmed S BaHammam


    Full Text Available Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allβh (God and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh, Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry.

  20. Sleep from an Islamic perspective.

    Bahammam, Ahmed S


    Sleep medicine is a relatively new scientific specialty. Sleep is an important topic in Islamic literature, and the Quran and Hadith discuss types of sleep, the importance of sleep, and good sleep practices. Islam considers sleep as one of the signs of the greatness of Allνh (God) and encourages followers to explore this important sign. The Quran describes different types of sleep, and these correspond with sleep stages identified by modern science. The Quran discusses the beneficial effects of sleep and emphasizes the importance of maintaining a pattern of light and darkness. A mid-day nap is an important practice for Muslims, and the Prophet Muhammad peace be upon him (pbuh) promoted naps as beneficial. In accordance with the practice and instructions of Muhammad (pbuh), Muslims have certain sleep habits and these sleep habits correspond to some of the sleep hygiene rules identified by modern science. Details during sleep include sleep position, like encouraging sleep on the right side and discouraging sleep in the prone position. Dream interpretation is an established science in the Islamic literature and Islamic scholars have made significant contributions to theories of dream interpretation. We suggest that sleep scientists examine religious literature in general and Islamic literature in particular, to understand the views, behaviors, and practices of ancient people about the sleep and sleep disorders. Such studies may help to answer some unresolved questions in sleep science or lead to new areas of inquiry. PMID:21977062

  1. Sleep Hygiene and Sleep Quality in Italian and American Adolescents

    LeBourgeois, Monique K.; Giannotti, Flavia; CORTESI, FLAVIA; Wolfson, Amy; Harsh, John


    This study investigated cross-cultural differences in adolescent sleep hygiene and sleep quality. Participants were 1348 students (655 males; 693 females) aged 12–17 years from public school systems in Rome, Italy (n = 776) and Southern Mississippi (n = 572). Participants completed the Adolescent Sleep-Wake Scale and the Adolescent Sleep Hygiene Scale. Reported sleep hygiene and sleep quality were significantly better for Italian than American adolescents. A moderate linear relationship was o...

  2. Association Between Sleep Hygiene and Sleep Quality in Medical Students

    Brick, Cameron A.; Seely, Darbi L.; Palermo, Tonya M.


    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among...

  3. African American College Students: Literacy of Depression and Help Seeking

    Stansbury, Kim L.; Wimsatt, Maureen; Simpson, Gaynell Marie; Martin, Fayetta; Nelson, Nancy


    Depression is a serious public health concern in the United States affecting almost 18.8 million adults. It is a common mental disorder in college students, with estimates of 1 in 4 "experiencing an episode by age 24." African American college students are at an elevated risk for depression due to racism, stress, sleep deprivation, and lack of…

  4. African dance

    Mumberson, Stephen


    The RE Open will be shown at the Mall Gallery London and the international section was judged by major practitioners and educators, print dealers and collectors, President of RE and Keeper of the Ashmolean Museum Dr Bren Unwin, John Purcell, Deborah Roslund, Colin Harrison, Dave Ferry, and Mark Hampson. Piece selected "African Dance" print.

  5. Pathology of sleep, hormones and depression

    Steiger, A.; Dresler, M.; Kluge, M.; Schussler, P.


    In patients with depression, characteristic changes of sleep electroencephalogram and nocturnal hormone secretion occur including rapid eye movement (REM) sleep disinhibition, reduced non-REM sleep and impaired sleep continuity. Neuropeptides are common regulators of the sleep electroencephalogram (

  6. Sleep-Route: Routing through Sleeping Sensors

    Sarkar, Chayan; Rao, Vijay S.; Prasad, R. Venkatesha


    In this article, we propose an energy-efficient data gathering scheme for wireless sensor network called Sleep-Route, which splits the sensor nodes into two sets - active and dormant (low-power sleep). Only the active set of sensor nodes participate in data collection. The sensing values of the dormant sensor nodes are predicted with the help of an active sensor node. Virtual Sensing Framework (VSF) provides the mechanism to predict the sensing values by exploiting the data correlation among ...

  7. Sleep disorders in the elderly

    ... this page: // Sleep disorders in the elderly To use the sharing features on this page, please enable JavaScript. Sleep disorders in the elderly involve any disrupted sleep ...

  8. Irregular sleep-wake syndrome

    Sleep-wake syndrome - irregular ... routine during the day. The amount of total sleep time is normal, but the body clock loses ... have a different condition, such as shift work sleep disorder or jet lag syndrome.

  9. American Academy of Sleep Medicine

    ... help you share AASM sleep duration recommendations Senate Finance Committee considers revisions to Stark Law These papers ... announcement: After 38 years of jointly publishing the journal SLEEP with the Sleep Research Society, the AASM ...

  10. Sleep and Irritable Bowel Syndrome

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