HAT in Africa

The number of Human African Trypanosomiasis cases reported to the WHO has decreased by 77%. This is according to reports tabled by Dr. Pere Perez Simarro, the boss of the HAT Department of Neglected Tropical Disease at the World Health Organization (WHO) in Geneva since 2005. The Democratic Republic of Congo contributed largely to the percentage by recording a 65% decrease between 2000 and 2012.

Closer home, the people in Western Kenya can celebrate. Soon enough they will be away from the risk of infection. This is because by 2012 only 18 cases of HAT had been reported from the Uganda-Kenya border region. The economic resources invested in sleeping sickness patients or infected animals will be used on other development activities. This will raise the living standards of many. 

HAT is in two; Gambiense Trypanomiasis caused by Trypanosoma brucei gambiense and Rhodesiense Trypanomiasis caused by Trypanosoma brucei rhodesiense. Their significant reservoirs are humans and Domestic and wildlife respectively. The earliest cases were reported to WHO in 1998.Gambiense took 98% of the 36000 infections. In 2001, WHO joined partnerships with manufacturers of drugs to fight the disease .They also aimed at maintaining availability of the drugs. By the end of 2006, less than 10 000 cases were being reported in Africa. A meeting was held in Geneva in May 2007 which exposed greatly the feasibility of finding a cure to HAT. The talking was transmuted into walking after the WHO published its roadmap in 2011 towards elimination of the neglected tropical disease (NTD) by 2020.This was publicized during the London Declaration on Neglected Diseases in January 2012.

Now only 37.5 million people are exposed to Gambiense trypanosomiasis in Angola, Chad, DRC, Uganda, Sudan, Guinea, and Cote d’Ivoire. Rhodesiense trypanosomiasis is major in North Tanzania’s Serengeti and Ngorongoro reserves .It is also in South East of Uganda. It is finishing the wild and domestic animals. Sadly, Rhodesiense HAT complete elimination is not feasible yet.

The progress would have been faster were it not for the few challenges. 

Professor Theophile Josenando, director of the Trypanosomiasis Fight and Control Institute (ICCT), Angola, added that , “People will not win elections via trypanosomiasis so they want to involve themselves with other popular diseases.” These include Cancer and HIV.

Moreover, people in the some parts of Africa associate some diseases with witch craft so the ailing are abandoned or killed. Scientific negligence and disorganization among research institutions has made it harder to know the diseases and reach the infected.

However Dr. Grace Murilla, Deputy Director of Research, Kenya Trypanosomiasis Research Institute, said that the HAT situation was in control in Kenya. This has been achieved through advocacy.

“The impact has been effective and fruitful.”

She  explained that,

“The Antitrypanosomal medicines are affordable through donations from manufacturers. Geographical distribution of the disease is well known and limited. There are economic benefits from elimination versus control of the deadly disease.” 

She also spoke of the need to use of mobile technology to check prevalence of disease in Kenya. This will make it easier to get facts to present to the policy makers who “need convincing to invest funds.” 

The current tools and strategies have proven effective in progressively reducing prevalence of HAT. Better yet, new tools for diagnosis and treatment are in development. The Atlas of HAT initiative by WHO is a good example. It is a database implemented in conjunction with FAO to ensure progress of the elimination process. It also serves as the framework for checking quality of elimination process, monitoring impact, classification of villages according to cases reported and frequency and planning and controlling activities. The database is updated annually in terms of the geographical extent of the disease and population at risk.

The greatest ambition to eliminate Sleeping sickness can be attributed to the Nifurtimox -Eflorithine Combination Therapy (NECT) through WHO in 2009.