Tsetse flies are vectors of human and animal African trypanosomiasis. In spite of many decades of chemotherapy and vector control, the disease has not been eradicated. Tsetse flies are vectors of parasitic diseases, namely, sleeping sickness or Human African Trypanosomiasis (HAT) in humans and nagana or Animal African Trypanosomiasis (AAT) in cattle.
Human African Trypanosomiasis
Human African Trypanosomiasis is a disease characterised by two phases, one with rather unspecific symptoms such as bouts of fever, headaches, weakness or lymphadenopathy, and a second one with severe neurological symptoms including disruption of the sleeping pattern, hence the historical name of the disease, sleeping sickness. It is due to a parasitic protist called Trypanosoma brucei, with only two subspecies being responsible for human infections: T. b. gambiense (98% of the cases) and T. b. rhodesiense. Under the microscope, this extracellular parasite exhibits a long motile flagellum that is attached to the cell body. It performs multiple functions such as motility, morphogenesis and adhesion to specific tissues. The parasite possesses a typical eukaryotic nucleus (35 Mo) and a single mitochondrion whose large genome is condensed in a structure called the kinetoplast. The parasite escapes the host immune response thanks to a sophisticated process of antigenic variation.

Trypanosomes in mammalian hosts
After landing on skin, the tsetse fly does not find immediately blood vessels for feeding. Rather, it probes by scratching and dilacerating tissues. During this process, the fly injects saliva and, if it contains trypanosomes, these are delivered in the skin. Recent development in imaging techniques allowed researchers to visualise parasite progression in mouse models. Trypanosomes are mostly present in the skin, including in cases where they were not detected in the blood. They are highly motile, possibly to escape phagocytic cells. Moreover, skin trypanosomes have been shown to infect naïve tsetse flies, demonstrating their role in parasite transmission. Analysis of skin biopsies from human patients coming from endemic areas for human African trypanosomiasis revealed the presence of trypanosomes, suggesting that the same phenomenon could occur in humans.