Abstract
The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT) within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.
Highlights
Human African trypanosomiasis (HAT), or sleeping sickness, is caused by two sub species of a hemoflagellate parasite that are transmitted by tsetse flies
Trypanosoma brucei rhodesiense causes an acute disease in eastern sub-Saharan Africa and has a reservoir in wild and domestic animals while Trypanosoma brucei gambiense causes a chronic form of the disease in western and central sub-Saharan Africa
Human African Trypanosomiasis (HAT) or sleeping sickness is a parasitic disease of humans, transmitted by the tsetse fly
Summary
Human African trypanosomiasis (HAT), or sleeping sickness, is caused by two sub species of a hemoflagellate parasite that are transmitted by tsetse flies. Rhodesiense) was introduced into Tororo District in 1987, the disease has persistently spread northwards into previously unaffected areas of Uganda [3,4]. The Northwards spread of disease has narrowed the area between the active foci of Rhodesian and Gambian HAT, with an estimated 150 km separating the two forms of the disease [3]. The further spread into Kaberamaido, Dokolo, Lira and Amolotar districts raised the possibility of the potential overlap of the two types of the disease and stimulated the creation of a Public Private Partnership, Stamp Out Sleeping Sickness, to control the disease spread by treating the animal reservoir of infection [7]. It is essential that the dynamics of disease spread are understood if HAT is to be controlled in Uganda. The occurrence of disease in Spatial Methods to Predict Sleeping Sickness
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