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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