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Sleeping sickness in Uganda: a thin line between two fatal diseases
Kim Picozzi1, Eric M Fèvre, Martin Odiit
1Centre for Infectious Diseases, Royal (Dick) School of Veterinary Studies, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH25 9RG.
BMJ (Clinical Research Ed.)
|November 26, 2005
Summary
Molecular diagnostics show the two human African trypanosomiasis parasite species remain distinct. However, the spread of the acute form in Uganda has expanded significantly, risking future convergence without intervention.
Area of Science:
- Medical Entomology
- Molecular Diagnostics
- Parasitology
Background:
- Human African trypanosomiasis (HAT) is caused by two distinct parasite species.
- Understanding their geographic distribution is crucial for disease control.
Purpose of the Study:
- To determine if the two HAT parasite species, Trypanosoma brucei rhodesiense and T. b. gambiense, have become sympatric in Uganda.
- To assess the geographic spread of HAT in Uganda using molecular tools.
Main Methods:
- Molecular diagnostic tools were used to identify parasite species from patient blood samples.
- Samples were collected from central and northwest Uganda, and south Sudan between 2001 and 2005.
- Parasite identification involved detecting specific genes (SRA for T. b. rhodesiense, TgsGP for T. b. gambiense).
Main Results:
- All parasites from central Uganda were identified as T. b. rhodesiense.
- All parasites from northwest Uganda and south Sudan were identified as T. b. gambiense.
- The two disease foci remain geographically discrete.
Conclusions:
- The distinct geographic distribution of the two HAT parasite species persists.
- The area affected by acute HAT (T. b. rhodesiense) in Uganda has expanded 2.5-fold since 1985.
- Preventive measures targeting the livestock reservoir are essential to prevent future convergence of disease foci and impact on diagnosis and treatment.