Kenya to be declared sleeping sickness free
Coastweek.com
ECIAL REPORT BY XINHUA CORRESPONDENT Duncan Mboyah
February 29 - March 3, 2011
Over half a million people suffer from sleeping diseases and 65,000 of them die annually for lack of medical care
Human African Trypanosomiasis, also called Sleeping Sickness, is one of the world’s most neglected diseases, affecting over 500 children and other poor populations in remote rural areas of Africa .
In Kenya , efforts by Kenya Agricultural Research Institute (KARI) Trypanosomiasis Research Centre (TRC) are fast bearing fruit as only three cases have been reported within the infested areas since 2006.
The Centre Director Grace Murilla reveals that Kenya may be declared by the World Health Organization (WHO) sleeping sickness free anytime following a multi disciplinary research between veterinary, chemists, medical doctors and environmental scientists.
“We are currently observing wildlife and livestock with a view to finding the source of the parasite upon which the country will be declared epidemic free,” Murilla notes.
Murilla observes that the high incidences of sleeping sickness cases that were notorious in Lambwe Valley in Homa Bay County in the 1970s to 1980s has been managed by the use of simpler traps and targets that were installed in collaboration with the Kenya Wildlife Service (KWS) and the International Centre for Insect Physiology and Ecology (ICIPE).
“Since 1992, there has been no case of someone dying from sleeping sickness in this region yet the flies caused deaths of many people before that,” adds Murilla.
She however reveals that researchers have continued their surveillance along the Lake Victoria basin and also into Busia and Teso Counties that border Uganda as there has been some pockets of the problem reported in the areas.
She says studies conducted have reveals that tsetse flies found within the Lake Victoria basin, Busia and Teso have homogenous genetic makeup similar to the one found in Uganda .
Sleeping Sickness is caused by a parasite called the “trypanosome” and is carried to human beings and animals by the tsetse fly.
This parasite multiplies in the bloodstream and lymph nodes causing fever, weakness, sweating, pain in the joints, and stiffness.
Over time, it migrates to the brain causing seizures, madness and if left untreated, coma and death.
For reasons not known yet, sleeping sickness is only found in Africa even though tsetse flies are endemic in many parts of the world.
In Kenya , sleeping sickness caused by Trypanosoma brucei rhodesiense is confined to the Nyanza and Western Provinces tsetse belts.
Over the last two decades, the disease has exhibited great spatial variability in its spread and distribution.
The results showed that sleeping sickness has spread northwards affecting the western parts of Busia, Teso, and of Bungoma districts in the late 1990s.
Most of the sleeping sickness cases were reported between March and June.
The mainly affected age groups were from 20 to 49 years.
Sleeping sickness is highest in areas with low human population density, ranging from 0-340 people per square km and high livestock population, ranging from 5,000 to 10,000 cattle.
The results reveal a shift of sleeping sickness occurrence from the old foci into new foci occurring at low transmission levels and causing occasional epidemic outbreaks.
The study concludes that seasons influenced disease incidences with higher numbers of sleeping sickness cases being recorded during the wet seasons.
Gender and age determined the disease occurrence with most productive age groups being at higher risk. Areas with high livestock populations had low human population densities and had higher sleeping sickness cases.
“Positive engagements with Uganda authorities is bearing fruits and very soon this menace will be history,” she notes.
Murilla however notes that the tsetse fly remains the biggest problem for livestock in northern Kenya where it is blamed for 50 percent of camel deaths annually.
She observes that while tsetse flies within western Kenya causes sleeping sickness, the ones found in Ngurman in Kajiado County are the major killer of livestock in the region.
She says that attempts by her department and the Programme against African Trypanosomiasis (PATEC) in the past five years are fast making positive developments.
Murilla attributes the success to the climate change and land use systems adding that forests and bushes where tsetse flies use to hide have since been depleted.
She notes that most flies that are currently in the country are found with the national parks and game reserves.
Trypanosomiasis takes two forms, namely trypanasoma brucei gambience (T.b. gambience) which is mainly found in central and West Africa and trypanosoma brucei rhodesiense (T.b. rhodesience) which occurs in East and Southern Africa T.b gambiene type of the disease is considered more dangerous as it causes chronic infection and the symptoms may take months or even years to show by which time the disease is already at an advanced stage.
T.b rhodesiene that causes sleeping sickness is though as dangerous as the other strain has its symptoms emerging after a few weeks meaning that it can be treated.
Those infected by the former strain of the disease become carriers of the disease, and whenever they are bitten by a tsetse fly, the insect picks up the parasite and spread it to the next fly-bite victim.
It is estimated that 60 million people in Africa are exposed to the infective bite of the tsetse fly though only 7 percent of these can access medical care.
Over half a million people suffer from sleeping diseases and 65,000 of them die annually for lack of medical care.
In early 1960s, the disease was brought close to elimination, but then resurged dramatically as health systems broke down and control programmes were abandoned or weakened by political problems and wars in Africa .
At present, major epidemics are taking place in central Africa in the countries of Angola , the Republic of Congo , Uganda , the Democratic Republic of Congo, Sudan , Ethiopia , Malawi and Tanzania .
Death, in certain villages, may reach levels as high as 50 percent of the entire village, and infected individuals, having no access to health services, die in their villages due to the unavailability of care.
The cases reported each year are only a small fraction of the real number of infected individuals since only 3 to 4 million people are under surveillance out of 60 million considered at risk for the disease.
Murilla says that Sleeping Sickness is a curable disease as attempts to cure patients in the late stages have been partially successful with the use of drugs.
After joint international efforts, public awareness, and leadership, a commitment was made by Aventis Pharmaceutical Company of France in May, 2001 to donate a five year contribution of three specific drugs in the treatment of Sleeping Sickness - pentamidine (used for earlier stage treatment), melarsoprol, and eflornithine which has a global value of 12.5 million U.S. dollars.
Another 12.5 million dollars was donated to strengthen surveillance and control.
Other partners in this effort include Bristol-Myers Squibb, Bayer, The Bill and Melinda Gates Foundation, Medicins Sans Frontieres- Drugs for Neglected Diseases Initiative, and the governments of Belgium and France .
While drugs are now more available and progress has been made, thanks to the Global Alliance created by the World Health Organization, a long-term plan has not been developed, and the drugs are not necessarily available where they are needed.
Most victims still have to be identified and the drug administered while new drugs or more simple forms of the present drugs need to be created and researched.
Without a long-term commitment, the disease will not be controlled because much remains to be done to achieve complete elimination of Sleeping Sickness and to save thousands of lives from unnecessary death.
KARI TRC runs the only sleeping sickness hospital in the country in Busia town where medical personnel are tracing people in the villages and screening them.
Trypanosomiasis is one of the neglected diseases like leishemaniasis, schistosomiasis and onchocercasis.
Kenya is among 37 countries infested by tsetse flies putting 20 percent of the country’s livestock at risk of trypanosomiasis infection.
The eradication of tsetse flies and the diseases they spread will not only spur economic growth but also help our country achieving Vision 2030 by widening tourism circuits amongst flagship projects.
Article at: http://www.coastweek.com/xin_250211_06.htm
