Epidemiological Observation on the Current Epidemic of Human Trypanosomiasis in Uganda

우간다의 Human Trypanosomiasis 대유행(大流行)에 관한 역학적(疫學的) 관찰(觀察)

The first recorded trypanosomiasis epidemic in Uganda took place at the beginning of this century in the islands and in a strip along the northern shores of Lake Victoria, which resulted in deaths of 1/3 million people. The disease was partly controlled by early 1930's and continued to occur sporadically in certain localized foci. The disease has however flared up in an explosive outbreak in Busoga district along Lake Victoria since 1977. The incidence of disease in northern district adjacent to Southern Sudan is also increasing lately. This paper describes the three month observation on the surveillance and control activities in the epidemic areas and of various health units including the Vector Control Division, the Tsetse fly Control Division, Tororo Trypanosomiasis Research Institute, medical units in Busoga, and Acholi districts. Data analysis and review were made of disease information so far collected by various health units in the Ministry of Health and district health offices. The findings may be summarized in the following: 1) A total of 12, 100 patients and 38 deaths: have occured in Busoga district since 1977 onward, and over 100 cases of diseases arc occuring in the Northern region bordering Southern Sudan. 2) the distribution of trypanosomiasis is characterized with two district patterns. The disease caused by Trypanosoma rhodesiense occurs in Busoga and is transmitted by Glossina palpalis, G. fuscipes infested in the islands and in the northern shore of forests of Lake Victoria. Another type caused by Trypanosoma gambiense occurs in Madi and Acholi in the north and is transmitted by Glossina morsitans in Savannah. 3) The house survey in Rusoga indicated that most of patients keep domestic animals in their house premises, and are engaging in either farming or fishing. Practically all the patients remembered that they had been bitten by tsetse in the field. 4) The routine diagnostic methods in the hospital laboratory is carried out through the microscopic examination of trypanosome with Giemsa stain of blood and cerebro-spinal fluid, The measurement of ESR and IgM has been used by Tororo Tryponosomiasis Research Institute for field screening.