Socio-Economic Causes and Socio-Economic Causes and Effects of Human African Effects of Human African Trypanosomiasis in the Trypanosomiasis in the

Democratic Republic of the Democratic Republic of the CongoCongo

Jen WilsonJen Wilson

AndAnd

Silvia Silvia EscuderoEscudero http://www.icp.ucl.ac.be/~opperd/parasites.iages/

tryps6.gif

The DiseaseThe Disease

ParasiticParasitic Transmitted by Tsetse FlyTransmitted by Tsetse Fly Infects humans and Infects humans and

cattlecattle Kills over 50,000 people Kills over 50,000 people

every year every year (Kabayo 2002)(Kabayo 2002)

http://www.gla.ac.uk/ibls/II/parasitology/cureit.htm

http://www.uen.org/utahlink/activities/view_activity.cgi?activity_id=3023

The DiseaseThe Disease Swelling occurs at site of bite.Swelling occurs at site of bite. Infection travels through blood stream.Infection travels through blood stream. Attacks central nervous system.Attacks central nervous system. Results in swelling of brain.Results in swelling of brain. Drowsiness during day; insomnia at Drowsiness during day; insomnia at

night.night. Death may occur in six months if no Death may occur in six months if no

treatment is done treatment is done (Smith 2006). (Smith 2006).

Endemicity StatusEndemicity Status

Democratic Republic of the Congo

http://pages.unibas.ch/diss/2004/DissB_6961.pdf

HistoryHistory 1717thth – early 20 – early 20thth centuries centuries: : sleeping sleeping

sickness and other vector-bourn diseases sickness and other vector-bourn diseases caused more human deaths than all other caused more human deaths than all other causes combined.causes combined.

1940’s-1960’s:1940’s-1960’s: vector control programs, vector control programs, modern drugs and insecticides led to the modern drugs and insecticides led to the control of diseasecontrol of disease

Past 20 years:Past 20 years: major epidemics and a major epidemics and a resurgence of disease WHY? resurgence of disease WHY? (Gubler 1998)(Gubler 1998)

Resurgence of Sleeping Resurgence of Sleeping Sickness in DRCSickness in DRC

http://www.cdc.gov/ncidod/eid/vol11no09/04-1020.htm#cit

Human Influences on Human Influences on Tsetse FlyTsetse Fly

Population Growth / UrbanizationPopulation Growth / Urbanization

Exploitation of LandExploitation of Land

Poor Health PoliciesPoor Health Policies

Climate ChangeClimate Change

Population Population Growth/UrbanizationGrowth/Urbanization

Population growthPopulation growth

Quick movement to urban areasQuick movement to urban areas

Movement is unplanned and uncontrolledMovement is unplanned and uncontrolled

Inadequate housing, poor waste Inadequate housing, poor waste management, dirty water, densely packed management, dirty water, densely packed people, etc.people, etc.

Ideal conditions for tsetse flyIdeal conditions for tsetse fly

http://www.kfw-entwicklungsbank.de/EN_Home/Topics/Good_Governance/index.jsp

KinshasaKinshasa Study in 2005 in Kinshasa to Study in 2005 in Kinshasa to

determine where the greatest determine where the greatest rate of infection was. rate of infection was.

Results showed that peri-Results showed that peri-urban areas along rivers had urban areas along rivers had high concentrations of tsetse high concentrations of tsetse flies flies (De Deken 2005)(De Deken 2005)..

People move to urban places People move to urban places and head to rivers for water and head to rivers for water where there is a high risk of where there is a high risk of infection.infection.

http://www.eolc-observatory.net/global_analysis/congokinshasa.htm

Land UseLand Use Tsetse flies originally found in Tsetse flies originally found in

low landslow lands

People are increasing land People are increasing land use and moving to the high use and moving to the high lands lands (Eradicating Tsetse)(Eradicating Tsetse)

Farmers bring cattle with Farmers bring cattle with themthem

Cattle carry the disease and Cattle carry the disease and take it to tsetse-free areas.take it to tsetse-free areas.

http://www.iaea.org/OurWork/ST/NA/NAAL/agri/ent/entTSETSEmain.php

Health PoliciesHealth Policies

1960-70’s : threat for disease decreased1960-70’s : threat for disease decreased

Health policy decisions decreased Health policy decisions decreased surveillance, prevention and control. surveillance, prevention and control.

Lack of support from developed world.Lack of support from developed world.

DRC uses mass screening: study in 2004 DRC uses mass screening: study in 2004 showed that the effectiveness of testing is showed that the effectiveness of testing is less than 50% less than 50% (Robays 2004). (Robays 2004).

Climate ChangeClimate Change Not too much proof correlation.Not too much proof correlation.

Climate change mostly linked to Climate change mostly linked to human consumption.human consumption.

Temperature and precipitation are Temperature and precipitation are most important factors most important factors determining whether the vector determining whether the vector can survive. can survive.

A rise in temperature could A rise in temperature could conceivably increase the range of conceivably increase the range of the vector. the vector.

http://www.solcomhouse.com/globalwarming.htm

Effects of DiseaseEffects of Disease

Depletion of LivestockDepletion of Livestock

Loss of CapitalLoss of Capital

Urbanization and Economic Urbanization and Economic

DegradationDegradation

LivestockLivestock Nagana: cattle variety of diseaseNagana: cattle variety of disease

Kills 3 million cows a year Kills 3 million cows a year (Pearce (Pearce 2002). 2002).

Decrease in meat production and Decrease in meat production and other by products such as milkother by products such as milk

Contributes to protein shortages Contributes to protein shortages in peoplein people

Farmers lose labor from the Farmers lose labor from the animals => povertyanimals => poverty

http://www.iaea.org/NewsCenter/Features/Tsetse/tsetse_gallery/pages/002.shtml

Where is the problem?Where is the problem?

http://www.genomics.liv.ac.uk/tryps/problem.html

Capital LossCapital Loss Meeting held in Ethiopia to discuss ways to Meeting held in Ethiopia to discuss ways to

fight sleeping sickness in 2004fight sleeping sickness in 2004

Experts reported that African countries lose Experts reported that African countries lose 4.5 billion dollars every year due to the 4.5 billion dollars every year due to the impact of disease on agriculture impact of disease on agriculture (Deutsche Press (Deutsche Press

2004)2004). .

Livestock owners administer 35 million Livestock owners administer 35 million dollars worth of doses of medication every dollars worth of doses of medication every year; each at about 1 dollar year; each at about 1 dollar (Torr et al. 2005).(Torr et al. 2005).

Loss of jobs Loss of jobs

Urbanization/Economic Urbanization/Economic DegradationDegradation

Fear of disease spreads and families Fear of disease spreads and families move away from fertile lands. move away from fertile lands.

Less people on fertile lands growing Less people on fertile lands growing crops => economic degradation crops => economic degradation (Kabayo 2002)(Kabayo 2002)..

Urbanization loops around and becomes Urbanization loops around and becomes a cause for increase in annual infections.a cause for increase in annual infections.

ConnectionsConnections

UrbanizatioUrbanizationn

Number of Number of people exposedpeople exposed

Number of Number of people people

infectedinfected

ThreatThreat

SS

SSSS

SS

ConnectionsConnections

Economy

Vector control programs

Number of tsetse flies

Number of infected people

Workforce

S

O

S

O

S

Number of infected cows

Animal Labor

Productivity

S

O

SSS

S

ReferencesReferences“Cure It.” Institute of Biomedical Life Sciences. University of Glasgow. 7 April 2007 <

http://www.gla.ac.uk/ibls/II/parasitology/cureit.htm>.De Deken, Redgi. “Trypanosomiasis in Kinshasa: Distribution of the Vector, Glossina fuscipes

quanzensis, and Risk of Transmission in Peri-Urban Area.” Medical and Veterinary Entomology. 19.4 353-359 (2005). Blackwell Synergy. 6 April 2007. <http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2915.2005.00580>.

“Democratic Republic of the Congo (Congo-Kinshasa).” The International Observatory on End of Life Care. 9 April 2007. <http://www.eolc-observatory.net/global_analysis/congokinshasa.htm>.

“Eradicating Tsetse from the Southern Rift Valley of Ethiopia.” WREN Media. 6 April 2007. <http://tc.iaea.org/tcweb/publications/factsheets/ethiopia.pdf>.

“Good Governance.” KfW Entwicklungsbank. 9 April 2007 <http://www.kfw-entwicklungsbank.de/EN_Home/Topics/Good_Governance/index.jsp>.

Gubler, D.J. “Resurgent Vector-Borne Diseases as a Global Health Problem.” Emerging Infectious Diseases. Sept. 1998. 6 April 2007. <http://www.cdc.gov/ncidod/eid/vol4no3/gubler.htm>.

Kabayo, J.P. (2002). Aiming to eliminate tsetse from Africa. TRENDS in Parasitology, 11, 473-475. Lutumba, Pascal. “Trypanosomiasis Control, Democratic Republic of Congo, 1993-2003.” Emerging

Infectious Diseases. 11.9 (2005). Centers for Disease Control and Prevention. 9 April 2007. <http://www.cdc.gov/ncidod/eid/vol11no09/04-1020.htm#cit>.

“Meeting Held in Ethiopia to Dscuss Ways to Fight Sleeping Sickness.” (2004). Deutsche Presse-Agentur. 7 March 2007. <http://web.lexis-nexis.com/universe/>.

Opperdoes, Fred. “African Trypanosomiasis or Sleeping Sickness.” 19 Oct. 1997. 7 April 2007 <http://www.icp.ucl.ac.be/~opperd/parasites/tryps9.htm>.

Pearce, F. (2002). An atomic-powered plan to end sleeping sickness. The Boston Globe,3. Retrieved March 7,2007, from Lexis-Nexis Academic database.

ReferencesReferencesSchmid, Caecilia. “10-Day Melarsoprol Treatment of Trypanosoma Brucei Gambiense Sleeping

Sickness: From Efficacy to Effectiveness.” 21 Sept. 2004. 9 April 2007. <http://pages.unibas.ch/diss/2004/DissB_6961.pdf>.

Smith, Scott. “Sleeping Sickness.” Medical Encyclopedia. 27 Nov. 2007. Medline Plus. 7 April 2007. <http://www.nlm.nih.gov/medlineplus/ency/article/001362.htm>.

Robays, Jo. “The Effectiveness of Active Population Screening and Treatment for Sleeping Sickness Control in the Democratic Republic of Congo.” Tropical Medicine & International Health. 9.5 542-550. (2004). Blackwell Synergy. 6 April 2007. <http://www.blackwell-synergy.com/links/doi/10.1111%2Fj.1365-3156.2004.01240.x>.

Torr, S.J., Hargrove, J.W., & Vale, G.A. (2005) Towards a rational policy for dealing with tsetse. TRENDS in Parasitology, 11, 537-541.

“Tsetse Flies.” Entomology Unit. 2004. International Atomic Energy Agency. 9 April 2007. <http://www.iaea.org/OurWork/ST/NA/NAAL/agri/ent/entTSETSEmain.php>.

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