Evaluation of the sleeping sickness control program in Mukono District, Uganda
Wandera, Suzan Wendy
MetadataShow full item record
Introduction Although Sleeping sickness was eliminated from Africa in the 1960's, it has re-emerged as a disease of public health importance (WHO, 2000). In Uganda, the control target of reducing cases of sleeping sickness reported annually is less than 2 cases/100,000 population. Mukono District reported an average of 6/100,000 population in 2003, in spite of implementation of Sleeping Sickness control activities in the district for fourteen years to date. (DVCO Mukono, 2003). Objectives The main objective was to evaluate the sleeping sickness control program, in Mukono District. Specific objectives were to determine the proportions of the new cases detected annually, describe the trends in case fatality rate (CFR), to establish the cure rates over the 14 years of program implementation, and to assess the level of community knowledge on sleeping sickness. Methods This study, which was done in Mukono District, was cross-sectional with retrospective review of records, and employed both quantitative and qualitative data collection methods. Quantitative data was analysed using EPIINFO 2002, while qualitative: data was analysed using the master sheet technique. Results A total of 534 patient records were analyzed. There was a general decrease in the proportions of new cases detected, and with high proportions of late cases in the majority of years. There was an upward trend in the case fatality rate from 7.4% in 1989 to 11.4% in 1992, followed by a sharp decrease to 0% in 1996. This was followed by an increase in CFR in 1997 and a decline up to 2003. The cure rates were high (>80%) throughout the program implementation. Six out of eight focus groups knew that sleeping sickness was transmitted by the tsetse fly. Six out of eight focus groups could not clearly describe the signs and symptoms of sleeping sickness. All focus groups did not know of any risk factor for sleeping sickness. Trapping of the tsetse fly was the only control measure mentioned. Conclusions The proportions in the new cases detected in the treatment centers have decreased. The cure rates have increased, and case fatality rates decreased. Community knowledge on the transmission, signs and symptoms, and treatment of sleeping sickness is still low. Recommendations The District Health Team should ensure facilitation and regular supervision of sleeping sickness assistants, and health workers working in sleeping sickness endemic areas.