Reid H, Kibona S, Rodney A, McPherson B, Sindato C, Malele I, Kinung'hi S, Jennaway M, Changalucha J, Blake B, Vallely A
Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Herston, Brisbane, Australia.
Afr Health Sci. 2012 Jun;12(2):104-13. doi: 10.4314/ahs.v12i2.5.
The public health and socio-economic burden of Human African Trypanosomiasis (HAT) in East Africa is not well documented. Understanding the epidemiology and impact of HAT in such settings is difficult due to a lack of robust surveillance and reporting systems, restricting evidence-based policy development and contributing to the continued neglect of this disease.
To investigate the burden of HAT in Urambo District, Tanzania in order to inform future public health policy.
A rapid participatory appraisal (RPA) using a combination of qualitative and quantitative methods was conducted, that included key informant interviews, hospital record analysis, and tools adapted from participatory learning and action.
Three villages adjacent to Ugala Game Reserve appeared to be the most affected. High levels of under-reporting were noted due to a lack of diagnostic tools at peripheral health care facilities and limited access to specialist services. Community stakeholders perceived the health and socio-economic burden of HAT to be similar to that of malaria.
The burden of HAT in remote rural communities is difficult to capture through routine surveillance systems alone. The RPA represents an efficient mechanism for engaging communities in public health action for trypanosomiasis control in northwest Tanzania.
东非人类非洲锥虫病（HAT）的公共卫生和社会经济负担尚无充分记录。由于缺乏强有力的监测和报告系统，了解HAT在这些地区的流行病学和影响很困难，这限制了循证政策的制定，并导致该疾病持续被忽视。
调查坦桑尼亚乌兰博区的HAT负担，为未来的公共卫生政策提供依据。
采用定性和定量相结合的快速参与性评估（RPA），包括关键信息人访谈、医院记录分析以及改编自参与式学习与行动的工具。
乌加拉野生动物保护区附近的三个村庄似乎受影响最大。由于基层医疗保健机构缺乏诊断工具以及获得专科服务的机会有限，发现漏报率很高。社区利益相关者认为HAT的健康和社会经济负担与疟疾相似。
仅通过常规监测系统很难掌握偏远农村社区的HAT负担。快速参与性评估是让社区参与坦桑尼亚西北部锥虫病控制公共卫生行动的有效机制。
