Human African Trypanosomiasis in the Kafue National Park, Zambia
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Date
2016-05-19
Authors
Chisoni, Mumba
Squarre, David
Kabongo, Ilunga
Munyeme, Musso
Mwasinga, Wizaso
Hachaambwa, Lottie
Sugimoto, Chihiro
Namangala, Boniface
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS Neglected Tropical Diseases
Abstract
Human African Trypanosomiasis (HAT) is a neglected tropical disease [1] caused by Trypanosoma
brucei rhodesiense (eastern and southern Africa) or Trypanosoma brucei gambiense
(western and central Africa) and is transmitted through the bite of an infected tsetse fly (Glossina
species) [2,3]. The tsetse flies acquire their infections from humans or animals harbouring
the human pathogenic parasites [2]. The disease is endemic in tropical and subtropical Africa
[4], where it affects low-income populations [3]. Whereas T. b. rhodesiense causes acute HAT
[5,6], T. b. gambiense causes a more chronic form of the disease [5]. Although HAT has been
re-emerging in most of the old foci within sub-Saharan Africa since the 1970s, with T. b. gambiense
accounting for more than 98% of the reported cases [7], the latest World Health Organization
(WHO) reports suggest that the number of new cases have been reduced [1]. In the year
2009, after continued control efforts, the number of cases of HAT reported dropped below
10,000 (9,878) for the first time in 50 years. This decline in number of cases has continued with
6,314 new cases reported in 2012 [1]. However, the estimated number of actual cases is about
20,000 and the estimated population at risk is 65 million people. Despite such progress, only a
fraction of the population at risk for contracting HAT in sub-Saharan Africa is under surveillance
and relatively few cases are diagnosed annually [8,9]. In particular, there is considerable
underdiagnosis of rhodesiense HAT in sub-Saharan Africa, including Zambia, mainly due to
lack of HAT surveillance and control programmes [10,11].
Historically, epidemics of rhodesiense HAT were reported from the northern and southern
regions of the Luangwa Valley and the Kafue River Valley in the 1960s and early 1970s [12].
According to WHO [1], Zambia currently reports <100 new HAT cases annually, mainly from
the old foci in the tsetse-infested Luangwa River Valley, including the Chama, Mpika, Chipata,
Mambwe, and, recently, Rufunsa districts, where the disease is re-emerging [13–15].
The Kafue National Park (KNP) and its surrounding Game Management Areas (GMA)
form the Kafue ecosystem, which is a vast and continuous wildlife conservation area located in
the central part of Zambia [16] and rich in biodiversity of high biomass [17]. It is a pristine ecosystem
that supports a wide variety of undisturbed flora and fauna of important conservation
status [17]. The area also supports the communities that live there by harnessing the benefits
from ecotourism and ecosystem services [18]. Importantly, it has abundant wildlife and tsetse
flies [16].
PLOS Neglected Tropical Diseases | DOI:10.1371/journal.pntd.0004567 May 19, 2016 1 / 6
a11111
OPEN ACCESS
Citation: Squarre D, Kabongo I, Munyeme M,
Mumba C, Mwasinga W, Hachaambwa L, et al.
(2016) Human African Trypanosomiasis in the Kafue
National Park, Zambia. PLoS Negl Trop Dis 10(5):
e0004567. doi:10.1371/journal.pntd.0004567
Editor: Carlos Franco-Paredes, Hospital Infantil de
Mexico Federico Gomez, UNITED STATES
Published: May 19, 2016
Copyright: © 2016 Squarre et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are
credited.
Funding: The authors received no specific funding
for this work.
Competing Interests: The authors have declared
that no competing interests exist.
The Kafue ecosystem has in the past reported cases and epidemics of HAT [16,19]. The
Primitive Methodist Church of England established Nkala Mission in 1893, which was later
abandoned in 1930 because of tsetse flies and sleeping sickness [16]. Today Nkala lies in the
heart of the Kafue ecosystem. Another focus, Itumbi Safari Camp, which was opened in 1958
in the KNP, was closed down in 1959 due to severe cases of sleeping sickness [19]. This demonstrates
the historical presence of HAT in the Kafue ecosystem. However, for over 50 years now
no reports or notable incidences of HAT have been recorded in the area. Based on this fact, it
has been assumed that the area was devoid of HAT despite the obvious presence of tsetse flies.
The present report describes a case of HAT in an adult male from KNP, 16 km away from
Itumbi Safari Camp, its diagnosis, and management.
Description
Journal Article
Keywords
Human African Trypanosomiasis , Tsetse Fly