Factors Influencing Individual and Community Participation in the Control of Tetse Flies and Human African Trypanosomiasis in Urambo District; Tanzania

This study was carried out to assess the knowledge and level of individual and community participation in the control of Human African trypanosomiasis in Urambo District; western Tanzania. Semi structured questionnaires were used to collect information from individuals at house hold level. Retrospective data of HAT was sought from the medicalofficers in-charge of health facilities. The results indicate that; 191 (90.5 ; n = 211) individuals knew tsetse flies and 187(88.6; n=211) knew HAT. All nine key informants reported that; the communities were aware of HAT while seven key informants reported that; the communities were aware of health risks associated with tsetse bites in human. There was poor knowledge about the role played by animals in the transmission of HAT (26.7; n=187). Majority of those who knew HAT (n = 187) were willing to contribute labour (70.1) and money (64.2) to tsetse and HAT control whereas amongst those who knew tsetse flies; 66.5 and 60.7 were willing to contribute labour and money; respectively. Amongst those who knew any HAT control technique (n = 108); 78.7 and 82.4were willing to contribute money and labour respectively. A total of 454 cases of HAT were reported in the area from 1999 to 2006. It is concluded that; the factors influencing individual and community participation include the knowledge of tsetse; HAT and control measures

Characterisation of the Trypanosoma brucei rhodesiense isolates from Tanzania using serum resistance associated gene as molecular marker

Serum resistance associated (SRA) gene has been found to confer resistance to the innate trypanolytic factor (TLF) found in normal human serum; thus allowing Trypanosoma brucei brucei to survive exposure to normal human serum. This study was carried out to examine the presence of SRA gene and identify the origin of T. b. rhodesiense isolates from three districts in Tanzania, namely Kibondo, Kasulu and Urambo. Twenty-six T. b. rhodesiense isolates and two references T. b. rhodesiense isolates from Kenya were examined for SRA gene using simple Polymerase Chain Reaction technique. The gene was found to be present in all 26 T. b. rhodesiense isolates including the two references isolates from Kenya. The SRA gene was confirmed to be specific to T. b. rhodesiense since it could not be amplified from all other Trypanozoon including T. b. gambiense; and gave an amplified fragment of the expected size (3.9kb), confirming that all these isolates were T. b. rhodesiense of the northern variant. Although the geographic distributions of T. b. gambiense and T. b. rhodesiense are clearly localized to west/central Africa and eastern Africa, respectively, natural movement of people and recent influx of large number of refugees into Tanzania from the Democratic Republic of Congo, could have brought T. b. gambiense in western Tanzania. The overlap in distribution of both of these pathogenic sub-species could result in erroneous diagnoses since both trypanosome sub-species are morphologically identical, and currently serologic methods have low specificity. Both the susceptible and resistant T.b. rhodesiense isolates possessed the SRA gene suggesting that there is no correlation between drug resistance and presence of SRA gene. The use of SRA gene helps to confirm the identity and diversity of some of the isolates resistant to various drugs.

Human African Trypanosomiasis and challenges to its control in Urambo; Kasulu and Kibondo Districts; western Tanzania

A study was carried out to determine the prevalence and management of Human African Trypanosomiasis (HAT) in Urambo; Kasulu and Kibondo districts of western Tanzania. Parasitological surveys for trypanosome and other blood parasites were conducted in selected villages. Interviews with health workers were conducted to explore facility capacity to diagnose and manage HAT. Community knowledge on tsetse and availability of trypanocidal drugs was explored. Results showed that; although health facility records showed HAT is an important public health problem in the three districts; typanosomes were found in 0.6of the examined individuals in Urambo district only. Malaria parasites with a prevalence of 12.1; 19.7and 9.7; in Urambo; Kibondo and Kasulu; respectively were detected in blood samples from the same individuals examined for trypanosomes. There was poor capacity for most of the health facilities in the diagnosis; treatment and control of HAT. In both districts; communities were knowledgeable of the tsetse identity (82.4) and had experienced tsetse bites (94). The majority (91.4) of the community members knew that they were at risk of acquiring HAT. However; only 29of the respondents knew that anti-trypanocidal drugs were readily available free of charge from health care facilities. Late treatment seeking behaviour was common in Kasulu and Urambo districts. In conclusion; health facilities in western Tanzania are faced with problems of poor capacity to diagnose and manage HAT and that treatment seeking behaviour among the communities at risk is poor. Efforts should be made to strengthen the capacity of the health facility to handle HAT cases and health education to the population at risk