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Published online by Cambridge University Press: 16 August 2005
Back in the early 1960s, when the curtain was falling on British colonial administration in Africa, the newly-created Ministry of Overseas Development decided to gather together for posterity the expertise and experience of authorities on tsetse and trypanosomiasis control. Weighing in at three and a half pounds, the resulting publication, ‘The African Trypanosomiases’ edited by Colonel Hugh Mulligan and published in 1969, has since been a baseline not only for investigators in the field but also for pure scientists working on related problems at the laboratory bench. The editors of the present volume were inspired by the enormous progress made in trypanosomiasis research over the last thirty years to produce ‘an update of Mulligan’ – so, how do the two books compare? Well, amazingly, their weights are exactly the same – but content and coverage are, as might be expected, very different.
The new editors have chosen to broaden the subject to include South American trypanosomiasis (Trypanosoma cruzi and Chagas'disease) and the non-tsetse transmitted animal trypanosomiases of African origin. And whereas Mulligan originally toyed with a subtitle of ‘The British Contribution’ for his book, the dazzling array of contributors to the new version is drawn from a truly international cast. Coverage of traditional topics (epidemiology, diagnosis, pathogenesis, chemotherapy, vector control) is now supplemented with consideration of the impact of the trypanosomiases on medicine and economics. There is little repetition between the two volumes. The introductory section on the biology of trypanosomes deals with topics unheard of in Mulligan's day – genome organization, genetics and communication in trypanosomatids, and treatment of systematics based on gene sequence phylogeny rather than morphology alone.
The overall emphasis, however, is unashamedly on disease, rather than on the causative parasites – indeed the only portrayal of a trypanosome in the book is the colourful scanning electron micrograph on the front cover. The editors tauntingly point out that over the last thirty years we have learned a great deal about the trypanosome's workings at the molecular level but, so far, little of practical benefit has come of it: new drugs for treatment of the trypanosomiases remain elusive and despite an explosion of interest in the mechanism of antigenic variation in African trypanosomes, vaccination remains a pipe-dream. In contrast, they say, vector studies have brought real practical benefit. Geographical information systems combined with satellite imagery can project the likely distribution of the tsetse fly and before long will predict outbreaks of disease; the highly successful Southern Cone Initiative, a cooperative venture on the part of the governments of the seven South American countries instituted in 1991 to eliminate Triatoma infestans the most important vector of T. cruzi, has brought about a sharp decline in the infection rates of children born since the programme began and some states are now certified free of transmission. With all due respect to the editors' remarks, however, the reader cannot fail to be impressed by the major contributions of molecular studies to diagnosis and our understanding of epidemiology made plain in this book.
The editors describe their publication as a textbook, but is this description apt? The didactic urge to make a good story, demanded by a textbook, and so evident in its forebear, is less noticeable here. Such treatment is perhaps unsuited to the age of the data base which is now upon us; information is all! The Trypanosomiases is, however, a very fine reference book which presents an invaluable cross section of its subject at the beginning of the 21st Century. It successfully integrates different aspects of the African trypanosomiasis problem so that the research worker primarily interested in, say, the trypanosome as parasite, is led on to read other chapters on, say, epidemiology and then vector control. This heuristic element is promoted by the succinct conclusions or summary sections with which most authors finish their chapter. It has to be admitted, however, that the excellent chapters on the American disease stand somewhat apart from those on African trypanosomiasis, and it is not strikingly obvious why they were included in the same book in the first place: the two diseases, their vectors and the causative trypanosomes are very different. The lessons to be learned from integration of the two are left for readers to work out for themselves.
The editors are to be warmly congratulated on persuading some 33 contributors to produce manuscripts, and the publishers for arranging such rapid publication of this important work (some references dated 2003 appear in bibliographies). One cannot help wondering if, in 30 years time, any editors will care to undertake another update!