Sleeping Sickness Surveillance In The Abraka Sleeping Sickness Focus, Nigeria

Abstract

Humans are the main reservoir hosts for gambiense sleeping sickness. They are therefore essential for the sustainance of its endemicity and reemergence of epidemics in many disease foci within sub- Saharan Africa. To investigate the epidemiological and clinical significance of reservoir hosts in the Abraka Sleeping Sickness Focus (ASSF), this survey was conducted between 8th April and May 11th 2002 in seven endemic villages with an overall population of 13,683. Pretested structured questionnaires were administered following informed consent on 2437 participants (1061 males and 1376 females) to assess knowledge and beliefs about the disease. Card Agglutination Test for Trypanosomes (CATT) screening was performed using whole blood on 1568 (11.6%) subjects of the overall population. Study participants were aged between less than 1 year and over 61 years. Confirmation of sleeping sickness (ss) was by the detection of trypanosomes in blood, body fluids and biopsy tissues. Thirteen (0.8%) seropositive subjects were parasitologically confirmed and treated with melasoprol at the Baptist Medical Centre (BMC) Eku. One (0.06%) patient died during the course of treatment. Forty-two (0.3%) subjects dropped out from the study while 128 (0.9%) seropositive and aparasitaemic subjects are currently being followed up. Five hundred and twenty (21.3%) of the 2,437 subjects interviewed reported having heard about the disease, while only 316 (12.9) had correct knowledge about the vector for the disease. Three hundred and sixty six (15.0%) believe those with the disease should remain in hiding, 422 (17.3%) believe the disease is a taboo while only 592 (25.3%) believe the disease is treatable by orthodox means. Our result provides data on active case detection and suggests the need for the formulation of health policies aimed at promoting compatibility of beliefs and knowledge about sleeping sickness with appropriate treatment seeking behaviour in the area. This approach will highlight acceptable levels of effective disease suppression with the involvement and cooperation of the affected communities.

Keywords: Gambiense sleeping sickiness, CATT screening, Melasoprol, Abraka, Nigeria.

Annals of Biomedical Science Vol. 2 (1) 2003: pp. 20-29