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African trypanosomiasis in the south-eastern Uganda, Buikwe South Health sub-district, 19892008

Abstract number: R2299

Background: In central and south-eastern Uganda, where the Buikwe South Health subdistrict (HSD) is located, the acute form of sleeping sickness, caused by Trypanosoma brucei rhodesiense, is predominant. Here we report the incidence of T. b. rhodesiense sleeping sickness in the last functioning treatment centre in Buikwe south HSD in south-eastern Uganda, for a 19-year period (1989–2008), the treatment outcome, structure of population affected, and functioning of sleeping sickness control programme in this area.

Methods: Sleeping sickness data from 1989 to 2008 were collected retrospectively in 2009 at Buikwe Sleeping Sickness Treatment Centre from available sleeping sickness registers. Case definition was based on the clinical and laboratory diagnosis, all recorded cases were included. Data have been analysed by EpiInfo programme.

Results: In the period from 1989 to 2008, 372 cases of sleeping sickness were diagnosed and treated. Number of patients in age 0–5 years was 12 (3.22%), from 6 to 15 years 51 (13.7%), and above 15 years 309 (56.18%). 158 (42.5%) patients have been diagnosed in the early stage of disease. After excluding the presence of microfilaria in BS was treatment with suramin initiated and all of them recovered, except 4 men, who escaped from the hospital. 214 patients (57.5%) had been diagnosed in the late stage of disease. After therapy with melarsoprol 170 (79.4%) were treated, 30 (14%) died and 14 (6.5%) were referred to other health unit. Case fatality rate was 8%, in the late stage of the disease was case fatality rate 14%. Median interval between the diagnosis and death was 14.4 days.

The highest incidence was in early nineties, in 1991 (83 cases). Until 2004 the incidence was decreasing, but due to closure of treatment centers, lack of supervision and motivation of health-care workers, the disease started to re-emerge. In 2009 5 new cases have been diagnosed.

Conclusion: Sleeping sickness still remains serious public health problem. Since the preventive and educational activities for the control of this neglected disease are not functioning appropriately, it can re-emerge very easily.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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