Investigations into an outbreak of human trypanosomiasis in the lower Luangwa Valley, Eastern Province, Zambia

Rickman, L.R.

East African Medical Journal 51(6): 467-487

1974


ISSN/ISBN: 0012-835X
PMID: 4424295
Document Number: 16
An outbreak of Rhodesian sleeping sickness in the lower Luangwa Valley, Zambia, was first detected in 1971, although it probably had earlier origins. Field investigations located the main focus of transmission as being in and around a small cluster of villages between the Luangwa and Lukusashi Rivers in the Petauke District, Eastern Province, Zambia. Records show that this area was notorious for sleeping sickness transmission in the early part of this century. During 1971 a total of 36 cases occurred here, 16 of whom died. Most of the cases diagnosed in the Nyimba hospital had central-nervoussystem involvement, but field surveys later detected 15 cases, 12 of whom were totally or almost totally asymptomatic. Two of these 'healthy carriers', who were blood positive at the time of the initial survey, showed apparent spontaneous remission of their infections, being aparasitaemic when re-examined a week later-as shown by stained blood-film examination and mouse inoculation. Venous blood from one other asymptomatic and parasitaemic case failed to infect the inoculated mouse. Of 33 goats belonging to the Chief of Luembe, 13 had trypanosome infections, one of which (a T.(T)brucei complex strain) proved to be noninfective for mice. No other domestic animals were seen but game animals abound in the area and are hunted vigorously by the local men-folk. Agricultural activity outside the immediate confines of the villages is minimal and the surrounding bush grows right up to the huts. Man-tsetse contact is everywhere high and flies were caught biting even inside the villages. Human trypanosomiasis has dire connotations in the minds of the people who show a very marked reluctance to attend any medical centre for treatment of this disease. Bush clearing around the villages, to reduce the level of man-fly contact and case detection and treatment, are measures recommended to lessen the risk of further sleepink sickness epidemics of this kind. A warning is given of the risk of resettling villagers into other areas before they have been properly examined for trypanosomiasis, and treated if necessary.

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Investigations into an outbreak of human trypanosomiasis in the lower Luangwa Valley, Eastern Province, Zambia