Human African Trypanosomiasis and challenges to its control in Urambo, Kasulu and Kibondo Districts, western Tanzania

A study was carried out to determine the prevalence and management of Human African Trypanosomiasis (HAT) in Urambo, Kasulu and Kibondo districts of western Tanzania. Parasitological surveys for trypanosome and other blood parasites were conducted in selected villages. Interviews with health workers were conducted to explore facility capacity to diagnose and manage HAT. Community knowledge on tsetse and availability of trypanocidal drugs was explored. Results showed that, although health facility records showed HAT is an important public health problem in the three districts, typanosomes were found in 0.6% of the examined individuals in Urambo district only. Malaria parasites with a prevalence of 12.1%, 19.7% and 9.7%, in Urambo, Kibondo and Kasulu, respectively were detected in blood samples from the same individuals examined for trypanosomes. There was poor capacity for most of the health facilities in the diagnosis, treatment and control of HAT. In both districts, communities were knowledgeable of the tsetse identity (82.4%) and had experienced tsetse bites (94%). The majority (91.4%) of the community members knew that they were at risk of acquiring HAT. However, only 29% of the respondents knew that anti-trypanocidal drugs were readily available free of charge from health care facilities. Late treatment seeking behaviour was common in Kasulu and Urambo districts. In conclusion, health facilities in western Tanzania are faced with problems of poor capacity to diagnose and manage HAT and that treatment seeking behaviour among the communities at risk is poor. Efforts should be made to strengthen the capacity of the health facility to handle HAT cases and health education to the population at risk. _______________________________________________________________________________________