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Reanalyzing the 1900-1920 sleeping sickness epidemic in Uganda
E M Fèvre1, P G Coleman, S C Welburn
1University of Edinburgh, Roslin, Midlothian, United Kingdom. Eric.Fevre@ed.ac.uk
Emerging Infectious Diseases
|June 18, 2004
Summary
Early 20th-century sleeping sickness in Uganda, previously attributed to Trypanosoma brucei gambiense, likely involved Trypanosoma brucei rhodesiense. Clinical data suggests T.b. rhodesiense contributed to the major epidemic, challenging historical understanding.
Area of Science:
- Medical Entomology
- Parasitology
- African History
Background:
- Sleeping sickness has been a significant public health issue in Uganda for over a century.
- A major epidemic from 1900-1920 caused over 250,000 deaths, primarily in the Busoga region.
- This epidemic was historically attributed to Trypanosoma brucei gambiense, a parasite now found in West and Central Africa.
Purpose of the Study:
- To re-evaluate the causative agent of the early 20th-century sleeping sickness epidemic in Uganda.
- To investigate the historical presence and role of Trypanosoma brucei rhodesiense in Uganda.
- To reassess the historical context of sleeping sickness in the Busoga region.
Main Methods:
- Analysis of historical clinical data from sleeping sickness cases in Uganda between 1900 and 1920.
- Comparison of the clinical presentation of historical cases with known clinical courses of Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense infections.
- Review of historical epidemiological records and scientific literature.
Main Results:
- The clinical course of sleeping sickness during the 1900-1920 epidemic in Uganda differed significantly from typical Trypanosoma brucei gambiense cases.
- The observed clinical patterns were markedly similar to those caused by Trypanosoma brucei rhodesiense.
- These findings suggest Trypanosoma brucei rhodesiense was present in Uganda during this period and likely contributed to the epidemic.
Conclusions:
- Trypanosoma brucei rhodesiense may have been present in Uganda earlier than previously believed, potentially predating the 1940s.
- The historical attribution of the 1900-1920 sleeping sickness epidemic solely to Trypanosoma brucei gambiense requires re-evaluation.
- This study highlights the importance of analyzing historical clinical data to understand the evolution of parasitic diseases and their epidemiology.