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The epidemiology of trypanosomiasis in Rumphi district, Malawi: a ten year retrospective study
Ist Teil von
Malawi medical journal, 2013-11, Vol.21 (1)
Ort / Verlag
Malawi: College of Medicine, University of Malawi and Medical Association of Malawi
Erscheinungsjahr
2013
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
Background Human African Trypanosomiasis (HAT) is caused by two species
of the tsetse fly vectored protozoan hemoflagellates belonging to
Trypanosma brucei, namely T.b gambiense which predominates in Western
Africa and follows a chronic disease course and T.b rhodensiense which
is more prevalent in Southern and Eastern Africa, Malawi included, and
follows a more acute and aggressive disease course. Previous studies in
the Democratic Republic of Congo, Angola, Uganda and Sudan have
demonstrated that the prevalence rates of T.b rhodensiense infection
have reached epidemic proportions. Objectives To describe the
epidemiology of Trypanosomiasis in Rumphi District over the past ten
years. Methodology A total of 163 records from January 2000 to December
2006 were retrospectively studied. Results There were more males than
females (121 vs. 40) with the 20 - 29 years age bracket having
the highest number of cases (26.3%, n=160). Stage 2 HAT was the
commonest stage at presentation (58.2%, n=158) with the patients in the
same being 3.5 times more likely to die than those with stage 1 HAT.
Case fatality rates for late and early stage disease were 21.5% (n =
92) and 7.2% (n = 66) respectively with 84.6% having been cured
(n=162). Convulsions were associated with fatal disease outcome and the
majority of cases (97.2%, n=103) lived within 5 kilometres of the Vwaza
game reserve boundary. Conclusion More men have been infected than
women, with a high involvement in the 20 - 29 age brackets. A
dramatic increase with active case finding indicates a high
under-detection of the disease with late stage HAT being predominant at
presentation. Though it has been found that cases with late stage
disease have an increased likelihood of dying compared to those in
early stage HAT, the high proportion of successful treatment indicates
that the disease still carries a high degree of favourable outcome with
treatment. It has also been demonstrated in this study that more than
95% of trypanosomiasis cases live within 5 km of game reserve boundary.
Disease interventions should be implemented in areas within 5km of
marshland game reserve boundary as priority areas.