Sleeping sickness outbreak reported in Katende, Kasai Occidental

An outbreak of sleeping sickness has been reported in Katende health zone, 90 km northeast of Kananga, capital of Kasai Occidental Province in south-central Democratic Republic of the Congo (DRC), according to Dr Victor Kande Betukumesu, director of the Congo's national programme to fight the disease. "Our representatives on the ground have recorded more than a dozen cases of the illness," he told IRIN on Monday. He added that the disease had already caused a number of deaths that had not been registered owing to a lack of infrastructure, public understanding of the illness and health personnel in the region. "Because of a lack of infrastructure, numerous people suffering from the disease must travel sometimes great distances to Kananga or Mbuji-Mayi [capital of neighbouring Kasai Oriental Province], while the majority of the ill are not identified because they remain in their villages outside the Katende health zone," he added. "The majority of people suffering from trypanosomiasis [sleeping sickness] believe they are suffering from malaria, because the two illnesses present the same symptoms," he said. According to Kande, the resurgence of sleeping sickness is due largely to the destruction of infrastructure during recent years of war in the DRC. "There are hardly any medical personnel in this area anymore, and motor vehicles as well as just about every other essential equipment were pillaged during the two successive wars in the DRC," Kande said. The national programme for the fight against trypanosomiasis (Programme national de lutte contre la trypanosomiase) suspended its activities in 1993. It is trying to resume its efforts, pending support from national and international partners. Sleeping sickness is transmitted via the bite of bloodsucking male and female tsetse flies that transfer the parasites from human to human. Cattle and other wild mammals act as reservoir hosts of the parasites. Tsetse flies can acquire parasites by feeding on these animals, or on an infected person. Prevention and control of sleeping sickness relies mainly on systematic surveillance of at-risk populations, coupled with treatment of infected people. In addition, reduction in numbers of tsetse flies plays a significant role. In the past, this has involved extensive clearance of bush to destroy tsetse fly breeding and resting sites, and widespread application of insecticides. More recently, efficient traps and screens have been developed that, usually with community participation, can keep tsetse populations at low levels in a cost-effective manner. Other than Katende, sleeping sickness has been reported in other regions of Kasai Occidental. According to the World Health Organization, although sleeping sickness claims comparatively few lives annually, the risk of major epidemics means that surveillance and ongoing control measures must be maintained. [For more on trypanosomiasis, go to www.who.int]