Research Article: Identification of human African Trypanosomiasis foci using school-going children in post-conflict era in Nwoya District, Northern Uganda: A cross-sectional study

Date Published: April 18, 2018

Publisher: F1000 Research Limited

Author(s): Kenneth Luryama Moi, James Henry Obol, Denis Anywar Arony.


Background: Human African Trypanosomiasis (HAT) is fatal if untreated; the drugs to treat it are toxic making its management difficult and diagnosis complex. Nwoya district has a long history of sleeping-sickness dating back to pre-colonial times. The civil war of 1986-2008 displaced many who upon return complained of cattle and dogs dying of unknown causes alongside increased tsetse flies infestation hence, the needs for the study.

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Human African Trypanosomiasis (HAT) commonly known as sleeping sickness is still active in over 30 sub-Saharan African countries
1, and found within the regions between latitude 14
0 North and 20
0 South in more than 250 active recognized different foci
2. If left untreated, it may lead to death
7. The etiologic agents are;
Trypanosoma brucei rhodesiense, the East African type that runs an acute course, and
T. b. gambiense, the West African type that runs a chronic course
8. The two species, unfortunately are morphologically undistinguishable, with characteristically different epidemiological features and drugs of treatment
10. Up to 70 million people are at risk of this debilitating and fatal disease with 30,000 individuals estimated to be infected
11. Since 2010,
T. b. gambiense was still endemic in at least 24 countries in Africa, and accounted for over 95% of HAT reported cases

A total of 3,040 pupils were enrolled for participation; 49.4% (n=1,501) were boys and 50.6% (n=1,539) were girls. The prevalence of CATT/
T. b. gambiense positive was 1.2% (n=36), (95% CI 0.8 – 1.6%); 58.3% (n=21) were boys while 41.7% (n=15) were girls. All the 36 pupils had neither parasites detected in their blood by microscopy, nor did they show swollen lymph nodes on palpation.
Table 1, below summarizes the results for schools surveyed.

A study conducted in Taraba state, Nigeria screened n=400 using CATT/
T. b. gambiense obtained a prevalence of 1.8% (7/400). Males tested more positive than their female counterparts
23 and the difference in the number of males and females who were CATT positive was statistically significant, p=0.05. Although this agrees with our study; males (21/36) being more CATT positive than females (15/36), the difference in the sexes was not statistically significance. Due to a small sample size of Taraba study, this could have influenced the prevalence causing a significant difference between the sexes in terms of infectivity. HAT is a disease that is related to behavioural risk factors through complex interactions; environmental and behavioural risk factors, vector and the human host

Data underlying the study are available on OSF:




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