Advances and challenges in the diagnosis of human and animal african trypanosomiases

Human African trypanosomiasis (HAT) is a life-threatening vector-borne disease caused by parasites of the Trypanosoma brucei spp. HAT incidence has declined in recent years thanks to sustained control efforts, and 10 countries have already achieved elimination of the disease as a public health problem. However, it remains a concern in several endemic foci, particularly in West and Central Africa (gambiense HAT), and sporadic T. b. rhodesiense cases continue to be reported in parts of East and southern Africa. Animal African trypanosomiasis (AAT) also affects a wide range of domestic and wild mammals, causing substantial livestock morbidity and mortality and leading to major economic losses that hinder socioeconomic development across affected regions. Early and accurate diagnosis is essential for effective management and control of both HAT and AAT. However, diagnosis remains challenging, particularly in the current context of declining HAT prevalence, where infections often present with low parasitaemia in West and Central Africa. In addition, the diversity of trypanosome species infecting animals highlights the need for highly sensitive and species-specific diagnostic tools to support accurate detection and surveillance, especially as animal populations may contribute to maintenance and transmission of human-infective trypanosomes. This review summarizes the main diagnostic approaches currently used to detect African trypanosomes.