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Two forms of a zoonotic disease unique to Uganda

By Vision Reporter

Added 6th December 2014 09:37 PM

On Independence Day this year, President Yoweri Museveni expressed concern that diseases like Ebola, Marburg and other zoonotic diseases were becoming increasingly widespread.

Two forms of a zoonotic disease unique to Uganda

On Independence Day this year, President Yoweri Museveni expressed concern that diseases like Ebola, Marburg and other zoonotic diseases were becoming increasingly widespread.

By Gladys Kalibbala

On Independence Day this year, President Yoweri Museveni expressed concern that diseases like Ebola, Marburg and other zoonotic diseases were becoming increasingly widespread.

Already, the Ebola virus has killed more than 6,000 people, mostly in West Africa, in the latest epidemic – the worst, since the discovery of the disease in 1976.

Zoonotic diseases are known to be very aggressive and contagious, passed on from animals to humans, and vice versa.

Museveni cautioned communities which eat bats, monkeys and other primates to stop doing so immediately and turn to livestock that “we have in plenty”.

Meanwhile, reports from health experts reveal that about 73% of new emerging diseases in humans have originated from animals.

Unfortunately, such information rarely gets to especially remote communities because of lack of proper sensitization. Maybe that is why sleeping sickness – nagana in animals and trypanosomiasis in humans – transmitted by tse-tse flies, has been killing Ugandans for decades, and still is.

In order to make an impact, the Coordinating Office For Control of Trypanosomiasis in Uganda (COCTU), the ministry of agriculture, health and other partners saw it fit to introduce an annual awareness day in the fight against the disease.

The launch of a community awareness campaign by the state minister of animal industry Bright Rwamirama took place in Dokolo district in October.

Agapitus Kato shows drugs used in tsetse flies traps to control tsetse flies. (photo credit: Gladys Kalibbala)

Sleeping sickness, also known as Human African Trypanosomiasis (HAT), is infectious and is caused by a parasite known as Trypanosome which is transmitted by infected tsetse flies.

Health experts explain that the disease, which is as deadly as malaria and mainly affects remote rural areas, contributes a lot to the entrenched cycle of poverty, ill health and stigma.

Two rare types

For some time health experts were worried about the narrowing gap between two types of sleeping sickness – from the eastern region to the northern part of the country.

The distance between the two types reduced to about 100km from 150km registered about a decade back. This proximity inspired a lot of concern among researchers, with fears that the two types of sleeping sickness would merge.

Unfortunately, Uganda is the only country with two forms of the disease: T.b. Gambiense said to be the chronic form is found in the West Nile region, and T.b. Rhodesiense, the acute form, is based in the southeastern region.

While Gambiense form is found in seven districts, Rhodesiense is present in 33 districts. 

Here, Kato shows tsetse fly traps. (photo credit: Gladys Kalibbala)

Dr. Charles Wamboga, the coordinator for National Sleeping Sickness Control Programme at the ministry of health, explains that each form of the disease is treated with a different drug, and so disaster may occur when the two forms meet.

He warns that an estimated over 10 million people are at risk of getting the disease, with 2,123,000 getting gambiense while 7,877,000 for rhodesiense.

“In 2012, we diagnosed 99 cases which were treated while in the last 13 years 7,562 have been treated.”

Wamboga adds that T.b. Rhodesiense (acute and severe) kills within six months of infection if not treated while T.b. Gambiense (chronic) kills within two to three years.

Although experts explain that the presence of a single tsetse fly means an epidemic, it has been confirmed that all the eleven sub-counties of Dokolo district are highly infested with tsetse flies.

The LC5 chairman of the district, JB Okello-Okello told minister Rwamirama that Kwera, Agwata, Kanga and all the other sub-counties are infested with tsetse flies.

Dokolo district has so far registered 22 cases of sleeping sickness this year where two patients are currently admitted at Dokolo Health Centre 4.

Among these 22 cases reported, one died after reporting late for treatment.

Rwamirama appealed to the community to stop self-medication and seek medical care from doctors whenever they feel feverish.

“The nagana and sleeping sickness records for 2014 indicate that there is a major problem in some districts of Teso and Lango sub-regions. The malaria-like symptoms must be tested by qualified health personnel to rule out sleeping sickness,” the minister advised.

He explained that the sensitization and awareness launched should enable communities to understand the disease better.

“Eliminate sleeping sickness from the human population and Nagana from livestock by using available tools and methods to control tsetse flies.”

Inadequate funding

Minister Rwamirama hands over a Certificate to Dr Abbas Kakembo in recognition for his efforts in the fight against tsetse flies. This took place at the Dokolo launch. (photo credit: Gladys Kalibbala)

An office to guide the community and offer information about tsetse flies was opened at the district offices while those who have been key in the fight of this disease received certificates.

In the meantime, reports from the Ministry of Agriculture indicate that in Uganda about 70% of the land surface is infested with tsetse flies.

Prof Charles Waisswa, the executive director of COCTU explained that they face challenges of inadequate funding for procurement and deployment of traps.

“Incidents of re-infestation of treated areas after successful control of the flies from neighbouring untreated areas should be addressed soon,” he said.

In response, Rwamirama explained how the tsetse fly is trans-boundary in nature. “Government is working with neighbouring countries like South Sudan, Kenya and DRC Congo to see that we work together in the control of tsetse flies.”

The minister said the awareness day will be an annual event in the infested districts to help improve the control of tsetse flies.

“Government has reduced taxes on veterinary drugs so farmers should embrace spraying of their animals more often.”

As more tsetse fly traps are fixed in the wilderness, animals are also sprayed with pour-on drugs which not only kill flies but also eliminate ticks as well.


The fight against two unique forms of a zoonotic disease

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