Trypanosomiasis cases cluster analysis for localization of interventions in endemic Malawi sites
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Date
2021-12-16
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Study type
We are proposing to conduct the following study types
Desk analysis of patient archived samples leading to geospatial maps
Cross-sectional surveys of tsetse densities and HAT in mapped cluster sites
Problem
In Malawi, trypanosomiasis is a latent threat due to interaction between humans and wild
animals. Human cases usually occur as a result of tsetse fly bites in animal reserves where the
vectors are found. For the past five years, Rumphi and Nkhotakota districts have experiencing
outbreaks which demonstrates that the risk in this environment is growing. It was noted however
in our recent work in these districts that the infected individuals present very late at the hospitals.
Late presentation means case management with very toxic drugs, and which also requires
hospitalization. It is not yet understood why a lot of people prefer to report late at the hospital.
But of most importance is to influence people to recognize signs and symptoms early enough for
them to seek medical care. We propose to use the already existing medical records of the
trypanosomiasis cases admitted at the district hospitals to trace where they came from in order
for us to understand factors that are affecting transmission in those areas. Once the areas are
identified we would want to engage with the people in those area and train them on how to use
Targets (tsetse control measure) to reduce the area density of tsetse flies. Tsetse flies are vectors
of transmission for trypanosomiasis. Our major hypothesize therefore is that mapping human
cases will show area clusters of infections which can be easily targeted for interventions.
Objectives
The main aim is to trace geospatially where trypanosomiasis cases are coming from in order to
find ways of introducing area specific control interventions in Rumphi and Nkhotakota districts
Methodology
The study is divided into two interacting work packages: Work package one (WP1) is to use
case report forms from the hospital archives, to identify villages where trypanosomiasisi casescome from in order to understand factors influencing transmission. Work package two (WP2) is
to train communities in WP1 above on how to identify Tsetse high density areas and how they
can control transmission by using tsetse targets (insecticide treated cloths).
Expected Findings and Dissemination
We hope to pinpoint exactly where the interventions should be targeted and inform them what
interventions will work in those areas. With current Centre for Disease Control efforts of using
Tsetse targets to reduce transmission we want to empower communities to be able to make and
deploy targets on their own as a control strategy. The results will be shared with the local
communities, the district executive committee and the ministry of health for policy decision
making.