Paediatric Sleeping Sickness in Kenya : A Case Report

Sleeping sickness is often considered a disease of adults rather than children due to their reduced exposure to the vector. Presumptive diagnosis of sleeping sickness was however difficult since the clinical signs observed were non-specific. This makes clinical diagnosis difficult. Often the disease in children masquerades as a pulmonary infection that is undetectable on x-ray or auscultation. A male child aged two years and eight months was diagnosed with the disease in western Kenya. The patient presented with severe respiratory distress; hepatosplenomegay and neurological symptoms. The disease transmission was associated with the socio-cultural habit of placing children under bushes whilst farming. The implications of delayed diagnosis on response to treatment are discussed

Control of tsetse and trypanosomiasis transmission in Uganda by applications of lambda-cyhalothrin

The pyrethroid insecticide lambda-cyhalothrin was evaluated in field trials against Glossina f.fuscipes and sleeping sickness transmission in Iyolwa sub-county; Tororo District; Uganda. The insecticide was applied selectively to the resting-sites of tsetse; by bush-spraying; using 10pc wettable powder (10WP) formulation at an application rate of 11.6 g a.i./ha over an area of 28 km2; or by a 2pc Electrodyn formulation (2ED) applied at 0.9 g a.i./ha over 30 km2. In a third trial area of 32 km2; 215 pyramidal traps treated with lambda-cyhalothrin 100 mg/m2 were set. The best impact was obtained with 10WP lambda-cyhalothrin which eliminated tsetse within 1-2 months; whereas G.f.fuscipes persisted at very low density in part of the area treated with 2ED lambda-cyhalothrin. In both treated areas the numbers of human sleeping sickness cases fell to no more than one per month; compared with four to twelve per month previously. The overall rate of cattle trypanosomiasis (T.brucei and T.vivax) was also reduced slightly. Insecticide-treated traps remained fully effective for at least 6 months under field conditions and catches were reduced 20-90-fold. These results in the control of tsetse and trypanosomiasis transmission lead us to recommend lambda-cyhalothrin for tsetse control operations