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Socio-Economic Causes and Effects of Human
African Trypanosomiasis in the Democratic
Republic of the Congo
Jen Wilson
And
Silvia Escudero
http://www.icp.ucl.ac.be/~opperd/parasites.iages/tryps6.gif
The Disease




Parasitic
Transmitted by Tsetse Fly
Infects humans and cattle
Kills over 50,000 people every
year (Kabayo 2002)
http://www.gla.ac.uk/ibls/II/parasitology/cureit.ht
m
http://www.uen.org/utahlink/activities/view_activity.cgi?activity_id=30
23
The Disease
Swelling occurs at site of bite.
 Infection travels through blood stream.
 Attacks central nervous system.
 Results in swelling of brain.
 Drowsiness during day; insomnia at night.
 Death may occur in six months if no treatment is done (Smith

2006).
Endemicity Status
Democratic
Republic of the
Congo
http://pages.unibas.ch/diss/2004/DissB_6961.pdf
History

17th – early 20th centuries: sleeping sickness and other vectorbourn diseases caused more human deaths than all other causes
combined.

1940’s-1960’s: vector control programs, modern drugs and
insecticides led to the control of disease

Past 20 years: major epidemics and a resurgence of disease
WHY?
(Gubler 1998)
Resurgence of Sleeping Sickness in
DRC
http://www.cdc.gov/ncidod/eid/vol11no09/04-1020.htm#cit
Human Influences on Tsetse Fly

Population Growth / Urbanization

Exploitation of Land

Poor Health Policies

Climate Change
Population Growth/Urbanization

Population growth

Quick movement to urban areas
http://www.kfwentwicklungsbank.de/EN_Home/Topics/Good_Governance/index.jsp

Movement is unplanned and uncontrolled

Inadequate housing, poor waste management, dirty water, densely
packed people, etc.

Ideal conditions for tsetse fly
Kinshasa
http://www.eolc-observatory.net/global_analysis/congokinshasa.htm

Study in 2005 in Kinshasa to determine where the
greatest rate of infection was.

Results showed that peri-urban areas along rivers
had high concentrations of tsetse flies (De Deken 2005).

People move to urban places and head to rivers for
water where there is a high risk of infection.
Land Use
http://www.iaea.org/OurWork/ST/NA/NAAL/agri/ent/entTSETS
Emain.php

Tsetse flies originally found in low lands

People are increasing land use and moving to
the high lands (Eradicating Tsetse)

Farmers bring cattle with them

Cattle carry the disease and take it to tsetsefree areas.
Health Policies

1960-70’s : threat for disease decreased

Health policy decisions decreased surveillance, prevention and control.

Lack of support from developed world.

DRC uses mass screening: study in 2004 showed that the effectiveness
of testing is less than 50% (Robays 2004).
Climate Change

Not too much proof correlation.

Climate change mostly linked to human consumption.

Temperature and precipitation are most important
factors determining whether the vector can survive.

A rise in temperature could conceivably increase the
range of the vector.
http://www.solcomhouse.com/globalwarming.
htm
Effects of Disease

Depletion of Livestock

Loss of Capital

Urbanization and Economic
Degradation
Livestock

Nagana: cattle variety of disease

Kills 3 million cows a year (Pearce 2002).

Decrease in meat production and other by
products such as milk

Contributes to protein shortages in people

Farmers lose labor from the animals => poverty
http://www.iaea.org/NewsCenter/Features/Tsetse/tsetse_galler
y/pages/002.shtml
Where is the problem?
http://www.genomics.liv.ac.uk/tryps/problem.html
Capital Loss

Meeting held in Ethiopia to discuss ways to fight sleeping sickness in
2004

Experts reported that African countries lose 4.5 billion dollars every
year due to the impact of disease on agriculture (Deutsche Press 2004).

Livestock owners administer 35 million dollars worth of doses of
medication every year; each at about 1 dollar (Torr et al. 2005).

Loss of jobs
Urbanization/Economic Degradation

Fear of disease spreads and families move away from fertile
lands.

Less people on fertile lands growing crops => economic
degradation (Kabayo 2002).

Urbanization loops around and becomes a cause for increase
in annual infections.
Connections
Urbanization
S
S
Threat
Number of people exposed
S
Number of people
infected
S
Connections
S
Productivity
S
S
Animal Labor
Economy
S
S
Workforce
Vector control programs
O
Number of infected
people
O
Number of infected cows
S
S
Number of tsetse flies
References
“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.blackwellsynergy.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.eolcobservatory.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.lexisnexis.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.
References
Schmid, 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.blackwellsynergy.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>.
THE
END