African trypanosomiasis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid ; Aditya Ganti M.B.B.S. [2]

Overview

Primary Prevention

Prevention and control focus on the eradication of the parasitic host, the tsetse fly. Regular active surveillance, involving case detection and treatment, in addition to tsetse fly control, is the backbone of the strategy for control of sleeping sickness. Two alternative strategies have been used in the attempts to reduce the African trypanosomiases.

  • One tactic is primarily medical or veterinary and targets the disease directly using monitoring, prophylaxis, treatment, and surveillance to reduce the number of organisms which carry the disease.
  • The second strategy is generally entomological and intends to disrupt the cycle of transmission by reducing the number of flies. For in depth information on prevention of the disease via tsetse fly control see Tsetse fly control
  • Instances of sleeping sickness are being reduced by the use of the sterile insect technique.
  • Systematic screening of communities in identified foci is the best approach as case-by-case screening is not practically possible in highly endemic regions.
  • Systematic screening may be in the form of mobile clinics or fixed screening centres where teams travel daily to the foci.
  • The nature of gambiense disease is such that patients don't seek treatment early enough because the symptoms at that stage are not evident or serious enough to warrant seeking medical attention, considering the remoteness of some affected areas. Also, diagnosis of the disease is difficult and most health workers may not be able to detect it.
  • Systematic screening allows early-stage disease to be detected and treated before the disease progresses, and removes the potential human reservoir.[1]

Vaccine

  • There is neither a vaccine nor recommended drug available to prevent East African trypanosomiasis and West African trypanosomiasis.

Prevention of Tsetse fly and other Insect bites

  • Wear protective clothing, including long-sleeved shirts and pants. The tsetse fly can bite through thin fabrics, so clothing should be made of thick material.
  • Wear khaki or olive colored clothing. The tsetse fly is attracted to bright colors and very dark colors.
  • Use insect repellant. Though insect repellants have not proven effective in preventing tsetse fly bites, they are effective in preventing other insects from biting and causing illness.
  • Use bed netting when sleeping.
  • Inspect vehicles for tsetse flies before entering.
  • Do not ride in the back of jeeps, pickup trucks or other open vehicles. The tsetse fly is attracted to the dust that moving vehicles and wild animals create.
  • Avoid bushes. The tsetse fly is less active during the hottest period of the day. It rests in bushes but will bite if disturbed. [2]

References

  1. "Strategic Direction for African Trypanosomiasis Research". Special Programme for Research and Training in Tropical Diseases. Retrieved 2006-03-01.
  2. http://www.cdc.gov/ncidod/dpd/parasites/trypanosomiasis/factsht_ea_trypanosomiasis.htm#what http://www.cdc.gov/ncidod/dpd/parasites/trypanosomiasis/factsht_wa_trypanosomiasis.htm#Top