Pastoral communities need education to tackle sleeping sickness
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SLEEPING sickness is wreaking havoc among pastoral communities in Northern Tanzania, calling for immediate solution to control the infections.

According to the World Health Organisation (WHO), human African trypanosomiasis, also known as sleeping sickness, is a vector-borne parasitic disease. It is caused by infection with protozoan parasites and is transmitted to humans by tsetse fly bites which have acquired their infection from human beings or from animals harboring human pathogenic parasites.

Lack of data on tsetse flies and their infection rates renders trypanosomiasis control strategies ineffective. Joint efforts between community, government and researchers and an Ecohealth partnership will enhance strategies to reduce burden and risks of trypanosomiasis.

A Scientist in Sokoine University of Agriculture, Prof Paul Gwakisa, who is the Principal Investigator of a WHO/TDR-funded project on human African Trypanosomiasis among pastoralist communities in Northern part of the country, recently observed that immediate measures are needed to control the disease. “If the disease is not immediately placed under control it is likely that infection will increase, resulting in uncontrolled deaths of people and animals in the pastoral communities in the country,” he explained.

He said the World Health Organisation has classified sleeping sickness as among neglected diseases, although it possesses magnitude effects to the lives of people. Prof Gwakisa said the disease needs to be accorded due recognition to ensure it gains influence at policy level.

He called for the need to educate pastoralists to equip them with enough knowledge about the disease to combat its spread, noting that majority of the livestock keepers reside near national parks where tsetse flies are abundant.

“It’s most likely that these people at times may be bitten by tsetse flies and contract a fever and think that it’s a normal feverish condition or malaria hence opt for self-medication using anti-malarials,” he said.

A study was conducted in 5 villages including Emboreet, Loiborsiret, Kimotorok, Loiborsoit and Ortukai from 94 Bomas close to Tarangire National park. At least 1,002 cattle blood samples were collected in the period between June, August 2015 and February 2016.

About 1,584 tsetse flies were caught in November 2014 and June 2015, leading to an analysis of the samples which was performed using the polymerase chain reaction (PCR), a technique used in molecular biology to detect the parasites, which cause trypanosomiasis.

The study identified trypanosomes a 17.2 percent and 6.9 percent prevalence of trypanosome infections in cattle and tsetse flies, Comparison of trypanosome infections from November 2014 to August 2015 in both hosts, cattle and tsetse flies, showed higher infection prevalence in June.

No human infective trypanosomes were detected in cattle and tsetse flies, however human risk was document ed based on demonstration of human DNA in blood meals of the gathered tsetse flies. The researchers had interviewed 400 respondents from four villages to examine the community knowledge and attitudes to tsetse and trypanosomiasis at the humanwildlife interface.

About over six percent of the respondents declared to use a variety of medicinal plants for the treatment of different diseases including sleeping sickness. Overall, it was revealed that Maasai pastoralists have higher awareness of animal trypanosomiasis (AAT) than of human trypanosomiasis (HAT).

About 87 percent of respondents were familiar with AAT, and clinical signs in cattle, whereas the most frequently-mentioned impacts of tsetse on livestock was identified as reduced milk production by 14.2 percent and 10.9 percent death.

A minority of respondents (40.7 percent) was familiar with HAT and much fewer (34 percent) knew its clinical signs. About 45 percent of the respondents ranked AAT as an economically important problem to their households and the majority (53 percent) reported that they did not know HAT as a disease caused by the tsetse fly in humans.

The study recommends that partnership with pastoralists on medicinal plants will help identify useful herbs with trypanocidal activity. On the other hand, control of strategies at community level, including organized grazing and livestock movement patterns, will reduce risk and spread of trypanosome infections.

The Director of Preventive Services at the Ministry of Health, Community Development, Gender, Elderly and Children, Dr Neema Rusibamayila, at a recent policy dialogue which was conducted through the coordination of the National Institute for Medical Research (NIMR) noted that climate change, community engagement, land use and risk prediction of Maasai community requires attention of policy makers in the country.

“Research will help to meet future challenges of climate change adaptation which we see it’s being imminent across all sectors. Such results assist policy makers to make informed decisions and programmed solutions for the wellbeing of the nation,” said Dr Rusibamayila.

The Director General of the National Institute for Medical Research (NIMR), Prof Yunus Mgaya, said surveillance of the disease in Tanzania began way back at the Tabora centre of the National Institute for Medical Research.

“The lives of millions of people in sub-Saharan African including Tanzania are negatively affected and rendered more vulnerable through interaction with animals. Climate change and variability is creating immense pressure on eco-systems and health influences that causes global change affecting people,” said Prof Mgaya.

He pointed out that SubSaharan Africa is disadvantaged because it has the highest burden of infections and diseases and yet the least capacity of the diagnosis, detection and management of the diseases.

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