Madanitsa Mwayiwawo, Chisi John, Ngwira Bagrey
College of Medicine, Malawi.
Malawi Med J. 2009 Mar;21(1):22-7. doi: 10.4314/mmj.v21i1.10985.
Human African Trypanosomiasis (HAT) is caused by two species of the tsetse fly vectored protozoan hemoflagellates belonging to Trypanosma brucei, namely T.b gambiense which predominates in Western Africa and follows a chronic disease course and T.b rhodensiense which is more prevalent in Southern and Eastern Africa, Malawi included, and follows a more acute and aggressive disease course. Previous studies in the Democratic Republic of Congo, Angola, Uganda and Sudan have demonstrated that the prevalence rates of T.b rhodensiense infection have reached epidemic proportions.
To describe the epidemiology of Trypanosomiasis in Rumphi District over the past ten years.
A total of 163 records from January 2000 to December 2006 were retrospectively studied.
There were more males than females (121 vs. 40) with the 20 - 29 years age bracket having the highest number of cases (26.3%, n = 160). Stage 2 HAT was the commonest stage at presentation (58.2%, n = 158) with the patients in the same being 3.5 times more likely to die than those with stage 1 HAT. Case fatality rates for late and early stage disease were 21.5% (n = 92) and 7.2% (n = 66) respectively with 84.6% having been cured (n = 162). Convulsions were associated with fatal disease outcome and the majority of cases (97.2%, n = 103) lived within 5 kilometres of the Vwaza game reserve boundary.
More men have been infected than women, with a high involvement in the 20 - 29 age brackets. A dramatic increase with active case finding indicates a high under-detection of the disease with late stage HAT being predominant at presentation. Though it has been found that cases with late stage disease have an increased likelihood of dying compared to those in early stage HAT, the high proportion of successful treatment indicates that the disease still carries a high degree of favourable outcome with treatment. It has also been demonstrated in this study that more than 95% of trypanosomiasis cases live within 5 km of game reserve boundary. Disease interventions should be implemented in areas within 5 km of marshland game reserve boundary as priority areas.
人类非洲锥虫病（HAT）由采采蝇传播的两种原生动物血鞭毛虫引起，这两种血鞭毛虫属于布氏锥虫属，即西非占主导且病程呈慢性的布氏冈比亚锥虫，以及在包括马拉维在内的南部和东部非洲更为普遍且病程更急性和侵袭性的布氏罗德西亚锥虫。此前在刚果民主共和国、安哥拉、乌干达和苏丹的研究表明，布氏罗德西亚锥虫感染的患病率已达到流行程度。
描述过去十年伦皮区锥虫病的流行病学情况。
对2000年1月至2006年12月期间的163份记录进行回顾性研究。
男性患者多于女性患者（121例对40例），20 - 29岁年龄组的病例数最多（26.3%，n = 160）。就诊时二期HAT是最常见的阶段（58.2%，n = 158），该阶段患者死亡的可能性是一期HAT患者的3.5倍。晚期和早期疾病的病死率分别为21.5%（n = 92）和7.2%（n = 66），84.6%的患者已治愈（n = 162）。抽搐与疾病的致命结局相关，大多数病例（97.2%，n = 103）居住在距瓦扎禁猎区边界5公里范围内。
感染男性多于女性，20 - 29岁年龄组感染率高。主动病例发现显示病例数急剧增加，表明该疾病漏检率高，就诊时以晚期HAT为主。尽管已发现晚期疾病患者比早期HAT患者死亡可能性增加，但高比例的成功治疗表明该疾病经治疗仍有较高的良好预后。本研究还表明，超过95%的锥虫病病例居住在距禁猎区边界5公里范围内。应将沼泽地禁猎区边界5公里范围内的区域作为优先区域实施疾病干预措施。
