SUMMARY

Human African Trypanosomiasis (HAT) is a vector borne parasitic disease transmitted to

humans by bites of infected tse-tse flies. It is one of the neglected tropical diseases that pose

millions of people in sub-Saharan Africa at risk of contracting the disease and is earmarked

for elimination by the World Health Organization (WHO). In 2006, Nigeria was listed

amongst endemic countries with transmission occurring in a known endemic focus of Delta

State however, it had been difficult to assess whether transmission is occurring elsewhere in

the country due to the lack of active surveillance in other parts of the country. Reports of

nuisance and bites from tse-tse flies by residents of the grazing reserve and the dearth of

literature on the prevalence of HAT in the grazing reserve led to the survey to determine the

knowledge and prevalence of HAT among residents of Kachia grazing reserve.

A cross sectional descriptive study was conducted using a multi-stage sampling technique

with probability proportionate to size. Respondents were administered structured

questionnaire on socio demographic characteristics, knowledge and practices relating to

HAT prevention and predisposition to risk factors for HAT infection by trained interviewers

and then screened for HAT antibodies using card agglutination test for Trypanosomiasis

(CATT). Knowledge of HAT was scored into 5 domains and categorized as poor knowledge

(score 0-2) and good (score 3-5). Predisposition to risk of infection was defined as frequent

exposure to ≥two known risk factors for HAT. A case of HAT was defined as any

respondent that tested positive on CATT. Descriptive statistics, bivariate and logistic

regression were used to analyse the data and significance was set at 0.05.

The mean age of the 300 respondents that were sampled was 39±17years. One hundred and

sixty-nine (56.3%) were males. Only 36(12.0%) had adequate knowledge on HAT and

120(40.0%) would seek medical help in a hospital if affected. Respondents exposed to risk

factors were 229(76.3%). Common practices relating to HAT prevention among

respondents included clearing of overgrown bushes around houses 297(99%), use of xiv

insecticidal treated nets and the use of protective clothing when visiting the bush 123

(41.0%). Male respondents Odds Ratio (OR) 5.0 (CI 1.8, 13.6), age of 40years and above

OR 5.0 (CI 1.1, 24.4) and family history of HAT OR 8.7 (CI 2.4, 32.1) were factors

associated with having good knowledge of HAT and practice of HAT prevention measures.

None of the 300 respondents screened for HAT antibodies tested positive.

The respondents‟ knowledge about HAT was poor despite lots of preventive measures being

put in place to prevent exposure to the insect vector. Though infested by tse-tse flies, a zero

prevalence of HAT was recorded in the grazing reserve. There is need for concerted efforts

both at the national, state and local government levels to be put in place to control these

vectors.

Key Words: Human African Trypanosomiasis, Prevalence, Knowledge, Preventive

practices

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CHAPTER ONE- INTRODUCTION

1.1. Background

Human African Trypanosomiasis (HAT) also known as Sleeping sickness is a serious

scourge to the African continent including Nigeria. It is one of the most neglected tropical

diseases[1] targeted for elimination by the World Health Organization (WHO) and millions

of people in 36 countries in sub-Saharan Africa are at risk of contracting the disease.[2] The

occurrence of HAT is restricted to the distribution of its vector; the tse-tse fly, which is

exclusively found in sub-Saharan Africa between 14°N and 20°S.[1] More than 250 discrete

active sleeping sickness foci are recognized, most of which are in poor and remote rural

areas where health systems are often weak. However, the disease has also been reported in

peri-urban areas.[1]

The disease which was in epidemics in the 1920s was controlled by active surveillance, case

management and vector control measures through aerial spraying and by the mid 1960s, the

disease had almost disappeared. After this success, surveillance was relaxed, and the disease

reappeared in several areas.[2] In 1986, it was estimated that some 70 million people lived in

areas where disease transmission could take place with an upward trend of new cases.[2]

This re-emergence of HAT has been attributed to war, migration[3, 4] of carrier populations

f