Sleeping Sickness No longer a Public Health Problem in Uganda – Health Ministry

The Ministry of Health has declared that the chronic sleeping sickness is no longer a public health problem in Uganda.

The disease that was common in districts of Adjumani, Arua, Moyo, Obongi, Koboko, Maracha, Terego, Madi Okolo, Yumbe and Amuru in Northern Uganda had its first epidemic recorded in 1927. The epidemic was resolved in 1934 with over 3723 patients were treated, according to the Health Minister Dr. Jane Ruth Aceng.

Other epidemics were reported in 1947 and 1959 before the sickness was considered largely controlled. However, in the 1980s, the cases raised due to inadequate control and surveillance as a result of political instability in the Country, specifically in West Nile region. Major epidemics were reported from 1990 to 1995 with a peak of 1500 cases in 1994.  

Speaking at an event at Hotel Africana on Friday, the Health Minister said that from 2013 to 2022 only 32 cases of chronic sleeping sickness known to the experts as gambiense were reported and non in the last two years.

Hundreds of thousands are reported to have died due to sleeping sickness in Uganda. Dr. Aceng says that the Ministry of Health working with partners like the World Health Organisation – WHO initiated Control interventions which included active screening campaigns using mobile teams, passive screening at health facilities, case management and community sensitization on the transmission, detection of cases and prevention of transmission of the disease.

In a period of about 15 years, over one million people were screened and 18132 cases treated in Moyo, Adjumani, Omuko and Yumbe districts. Dr. Acheng says that from 2000 to 2012, the Ministry of Health and other partners continued interventions and 20,244 cases were treated.

From 2013 with the introduction of Rapid Diagnostic Kits, Dr. Aceng says that Uganda scaled up passive screening, maintained reactive active screening in areas reporting cases and also introduced vector control in which they sought to limit or eradicate tsetse fly responsible for transmission of pathogens.      

Sleeping Sickness is transmitted by the tsetse fly (Glossina species), which is found only in sub-Saharan Africa. The fight against it goes beyond detecting cases and managing to prevention of transmission. Dr. Aceng says they shall continue interventions to limit or eradicate tsetse fly which transmit disease pathogens.

In 2020, government following the 2018 WHO protocols compiled documentation to show that the sickness was nolonger a public health problem in Uganda. Dr. Bayo Fatunmbi, the Head disease prevention and control team at WHO office in Uganda says that they looked at the data, reports of the inventions made, the success registered and the dossier showing patterns of interventions all submitted by the Ministry of Health. The dossier also shows how long a country has gone without registering a case.

Dr. Bayo says it should be three years but also depending on the data, two years of no case reported can be taken in the evaluation to declare a disease is no longer a public health problem. He says, WHO also conducts independent investigations before a declaration is made. For Uganda, WHO declared that the sickness wasn’t a public health problem anymore in May 2022. Other African countries declared are Rwanda and Benin.

Dr. Erphas Olema, the Human African trypanosomiasis (HAT) Regional coordinator says that while this is a great milestone, they will continue with interventions such as active surveillance, community sensitization and reactive active screening which involves screening a whole area where a case has been confirmed.

He says that such interventions shall help in early detection and management of cases in the region. He however says that the journey isn’t void of challenges which include limited financial support and difficulty in transportation since some affected areas are remotely located.

At the event, Faida Lucy, a survivor of the sickness recalled how in the late 1980s, almost all her family members were admitted due to the sickness and when she chose to run tests herself, she was found positive. She battled the sickness for more than two months before she completely recovered. Several people known to her died to the sickness and she too dropped out of school due to stigma having survived death to sleeping Sickness. 

Sleeping sickness is categorized majorly into two, the Chronic and Acute one. Victims of sleeping sickness present with symptoms such as pain the joints or muscles, insomnia or lacking sleep and muscle loss and weakness or weight loss. Other symptoms include fever, headache, impaired coordination, itching, mental confusion, personality or behavior changes, skin rash, or swollen lymph nodes.

The World Health Organisation has set 2030 as the target to eliminate the transmission of sickness and other Neglected Tropical Diseases. 

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