E156 Micro-Paper · Africa Clinical Trials

Trypanosomiasis Last Mile

Human African trypanosomiasis is approaching elimination, but the last-mile chal...

Africa Trials
23,873
US Trials
45
Total Africa
23,873
Nations
54
Africa hosts 23,873 trials across 54 nations with extreme geographic concentration.
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Trypanosomiasis Last Mile by Country Egypt: 11752 Algeria: N/A Morocco: 162 Tunisia: 540 Senegal: N/A Ghana: 261 Nigeria: 379 Cameroon: N/A DRC: N/A Ethiopia: 302 Kenya: 788 Uganda: 809 Tanzania: 460 Rwanda: N/A South Africa: 3654 Egy 11752 Sou 3654 Uga 809 Ken 788 Tun 540 162 11752
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Regional Comparison Africa US Europe 0 20 40
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Research Profile Volume Growth Phase3 Complete Diversity
Enrollment Distribution Africa Reference 500 1000
Growth 2010-2026 Before After Africa 0 0 US 0 0 Europe 0 0
Why It Matters

Human African trypanosomiasis is approaching elimination, but the last-mile challenge requires sustained trial investment in diagnostics and treatment for the most remote populations.

In the burden-versus-investment landscape of African health research, does the distribution of trypanosomiasis trials across African nations reveal a systematic research gap? This cross-sectional audit evaluated 23,873 African and 190,644 United States interventional trials registered on ClinicalTrials.gov through April 2026. Investigators computed the Kaplan-Meier cumulative registration curve as the primary estimand using registry metadata for each nation. Africa registered 0 relevant trials compared to 45 in the United States, revealing an 45-fold absolute gap in research volume. Temporal analysis showed 17.1-fold growth in African trial registrations from 2000-2005 to 2021-2025, though the gap with high-income regions persisted. These results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa. Interpretation is limited by reliance on ClinicalTrials.gov alone, which may undercount locally registered African studies.
Question

In the burden-versus-investment landscape of African health research, does the distribution of trypanosomiasis trials across African nations reveal a systematic research gap?

Dataset

This cross-sectional audit evaluated 23,873 African and 190,644 United States interventional trials registered on ClinicalTrials.

Method

gov through April 2026.

Primary Result

Investigators computed the Kaplan-Meier cumulative registration curve as the primary estimand using registry metadata for each nation.

Robustness

Africa registered 0 relevant trials compared to 45 in the United States, revealing an 45-fold absolute gap in research volume.

Interpretation

Temporal analysis showed 17.

Boundary

1-fold growth in African trial registrations from 2000-2005 to 2021-2025, though the gap with high-income regions persisted.

Extra

These results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa.

Extra

Interpretation is limited by reliance on ClinicalTrials.

Extra

gov alone, which may undercount locally registered African studies.