Cameroon remains vigilant against sleeping sickness

Campo-In Campo, a humid forest town in southern Cameroon, daily life revolves around fishing and farming. Some vector borne diseases, despite having declined sharply, still persist-including sleeping sickness, also known as human African trypanosomiasis. Caused by a parasite transmitted by the bite of the tsetse fly, the disease can affect the nervous system and become fatal if left untreated.

Philippe, 21, a fisherman at Campo Beach, was affected by the disease, which he initially ignored. He first experienced extreme fatigue, fever and general discomfort. Like many others, he did not seek medical care right away.

"At first, I thought it was a common illness. I tried treating myself at home, but it didn't work. After several weeks without improvement, I went to the hospital, where tests confirmed it was sleeping sickness," he explains.

Once diagnosed at the Campo District Medical Centre, Philippe received treatment and his condition gradually improved. He was later able to return to work. "I feel much better now. I'm glad I was treated in time," he says.

This situation remains common because the early symptoms of sleeping sickness resemble those of other frequent infections, particularly malaria. This similarity can delay consultation and diagnosis, even though treatment is more effective when started early. To reduce these delays, health authorities, with the support of the World Health Organization (WHO), are strengthening surveillance, screening and the training of health workers.

"Today, we have very few cases, but that doesn't mean the disease is gone," explains Dr Marie Françoise Ngo Sol, epidemiologist with the National Programme for the Control of Human African Trypanosomiasis.

"Our priority is to remain vigilant, because every early consultation and every case detected in time brings us closer to eliminating the disease," she says.

WHO supports this approach. For Dr Étienne Nnomzo'o, Neglected Tropical Diseases Programme Officer at the WHO Cameroon Country Office, the progress made is real and must be sustained.

"Cameroon has made significant progress toward eliminating sleeping sickness as a public health problem. To consolidate these gains, continuous surveillance, rapid diagnosis and sustained access to treatment are essential," he says.

In rural areas such as Campo, communities remain the most exposed, particularly fishermen and farmers living near rivers, where the tsetse fly is present. Because early symptoms can be confused with those of other diseases, nearby health facilities play a crucial role-yet consultations often happen late.

"Most patients come to us after trying malaria treatments without success," explains Dr Arthur Elemva Nkoumba, medical officer in charge of the Campo District Medical Centre.

"This means cases sometimes arrive late. In this context, the introduction of fexinidazole, an oral treatment, has simplified care for both patients and health workers."

For health authorities, these figures show that the disease has declined sharply, but sustained effort is still required. Screening, surveillance and access to treatment must continue.

"We are at a very low level, which is a major achievement," says Dr Ngo Sol. "But this is also a phase where we must stay alert. Even a single undetected case can slow progress."

On the ground, community health workers play a vital role in maintaining vigilance, particularly in areas where the disease has become rare. In Campo Centre, Ingrid Djowe, a community health worker for more than fifteen years, supports families daily by raising awareness of sleeping sickness symptoms and referring suspected cases to health facilities.

"When there are almost no more cases, some people think the disease no longer exists," she explains. "Our job is to keep talking to communities, explain the signs in simple terms and encourage people to get checked when symptoms persist."

Involved in screening campaigns and community mobilization, she highlights the importance of trust. "Because we live in the community, families listen to us. Acting early prevents the disease from getting worse and protects everyone."

Philippe's experience clearly illustrates the importance of acting without delay. Today, he has returned to fishing and regained a normal life. Reflecting on what he went through, he now shares a simple message with others: "When symptoms last, you need to seek care quickly. The sooner you go to the hospital, the faster you recover."

As Cameroon moves closer to eliminating sleeping sickness as a public health problem, the example of Campo highlights a simple reality: even when cases become rare, collective vigilance remains essential to secure gains and prevent the disease from returning.