Gambiense Sleeping Sickness In The Abraka Region Of Delta State, Nigeria: Passive Case Detection (Pcd) At The Baptist Medical Centre (BMC) Eku 1999 – 2004.

Abstract

Gambiense sleeping sickness is a parasitic disease that is difficult to diagnose due to insidious clinical signs and transient parasitaemias and it poses a major pubic health problem in the Abraka area of Delta State, Nigeria. Passive case detection (PCD) is defined as sleeping sickness cases diagnosed in patients who present voluntarily to the health institution for attention. PCD has remained the mainstay of intervention and control of the disease in this area. This study was conducted to obtain relevant information based on PCD in assessing current situation of the disease and to highlight some challenges evident from the baseline data. The Baptist Medical Centre, (BMC) Eku is located in the Abraka Sleeping Sickness Focus (ASSF). The case records of 73 patients (38 males and 35 females) admitted to the Medical Wards of BMC, Eku between June 1999 and May 2004, with a diagnosis of gambiense sleeping sickness were reviewed for reporting.
Five milliliters of venous blood was obtained from each patient into Ethlyene Diamine Tetraacetic acid (EDTA) bottle for microscopy. Lymph node fluid and tissue biopsies were taken from those with lymphadenopathy and CSF collected for screening from all the patients. Buffy coat layer (BCL) and deposits of lymph node fluid (LNF) and CSF were examined for trypanosomes. All patients received three courses of intravascular Melarsoprol at a dose of 2 to 3.6mgkg-1 day-1 for three days for a course, with one week interval between the courses.
Trypanosome parasites were detected in blood samples of 2(2.7%) and in the lymph node fluid of 8(11%) patients. All patients were positive by CSF microscopy. The highest prevalence of infection was among patients aged between 26-35 years with 35.6% infection rate, 23.3 percent was recorded among those aged 36-45 years. Of all the 73 cases treated at the BMC, only 10(13.7%) were previously treated in hospital while 44(60.3%) were in traditional centers. Thus traditional care for sleeping sickness is widely practiced in the study area.


Keywords: Sleeping sickness, Treatment seeking behaviour, Traditional healers, Abraka, Nigeria

Sahel Medical Journal Vol. 10 (3) 2007: pp. 89-92