Journal of Epidemiology and Global Health

In Press, Corrected Proof, Available Online: 27 March 2020

Improved Access to Diagnostics for Rhodesian Sleeping Sickness around a Conservation Area in Malawi Results in Earlier Detection of Cases and Reduced Mortality

Authors
Marshal Lemerani1, Fredrick Jumah1, Paul Bessell2, Sylvain Biéler3, *, Joseph Mathu Ndung’u3
1Ministry of Health, Lilongwe, Malawi
2Epi Interventions Ltd., Edinburgh, UK
3Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
*Corresponding author. Email: sylvain.bieler@finddx.org
Corresponding Author
Sylvain Biéler
Received 28 October 2019, Accepted 25 January 2020, Available Online 27 March 2020.
DOI
https://doi.org/10.2991/jegh.k.200321.001How to use a DOI?
Keywords
Sleeping sickness, human African trypanosomiasis, rhodesian, rhodesiense, diagnosis, diagnostic, Malawi
Abstract

Trypanosoma brucei rhodesiense Human African Trypanosomiasis (rHAT) is a zoonotic disease transmitted by tsetse flies from wild and domestic animals. It presents as an acute disease and advances rapidly into a neurological form that can only be treated with melarsoprol, which is associated with a high fatality rate. Bringing diagnostic services for rHAT closer to at-risk populations would increase chances of detecting cases in early stages of disease when treatment is safer and more effective. In Malawi, most of the rHAT cases occur around Vwaza Marsh Wildlife Reserve. Until 2013, diagnosis of rHAT in the region was only available at the Rumphi District Hospital that is more than 60 km away from the reserve. In 2013, Malawi’s Ministry of Health initiated a project to enhance the detection of rHAT in five health facilities around Vwaza Marsh by upgrading laboratories and training technicians. We report here a retrospective study that was carried out to evaluate the impact of improving access to diagnostic services on the disease stage at diagnosis and on mortality. Between August 2014 and July 2017, 2014 patients suspected of having the disease were tested by microscopy, including 1267 who were tested in the new facilities. This resulted in the identification of 78 new rHAT cases, of which six died. Compared with previous years, data obtained during this period indicate that access to diagnostic services closer to where people at the greatest risk of infection live promotes identification of cases in earlier stages of infection, and improves treatment outcomes.

Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Journal of Epidemiology and Global Health
Publication Date
2020/03
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.200321.001How to use a DOI?
Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Marshal Lemerani
AU  - Fredrick Jumah
AU  - Paul Bessell
AU  - Sylvain Biéler
AU  - Joseph Mathu Ndung’u
PY  - 2020
DA  - 2020/03
TI  - Improved Access to Diagnostics for Rhodesian Sleeping Sickness around a Conservation Area in Malawi Results in Earlier Detection of Cases and Reduced Mortality
JO  - Journal of Epidemiology and Global Health
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200321.001
DO  - https://doi.org/10.2991/jegh.k.200321.001
ID  - Lemerani2020
ER  -