Assessing the capacity to diagnose human African trypanosomiasis among health care personnel from Chama and Mambwe districts of eastern Zambia

Abstract

Background: Human African Trypanosomiasis (HAT) is a neglected tropical disease affecting poor rural communities living in tsetse-infested regions of sub-Saharan Africa. In Zambia, sporadic cases of HAT have been reported mainly in the old foci along the tsetse-infested Luangwa river valley in north-eastern part of the country. In such places where malaria is the major endemic febrile disease, with possibilities of co-infections of HAT and malaria and where the levels of alertness to the presence of HAT among health care personnel (HCP) is low, there is a high chance of misdiagnosing HAT for malaria because of their similarities in clinical presentation. This study, conducted in Zambia's tsetse-infested rural health centres (RHCs) of Chama and Mambwe districts, was designed to investigate the staffing levels, the HCP levels of alertness to the occurrence of HAT and their capacity to detect the disease. Methods: Structured questionnaires were used to collect information pertaining to HAT alertness and the capacity to detect the disease from 101 HCP in a cross sectional study of 23 RHCs drawn from Zambia's Chama and Mambwe districts between April and July 2013. The data collected were analyzed using Stata/SE version 11.0. Results: Participants from both Chama and Mambwe district RHCs reported similar very low levels of qualified HCP and laboratory technicians, and that they had similar basic tools for HAT diagnosis. Although not statistically significant, respondents from Chama (~89 %) tended to be more aware about the occurrence of HAT compared to their Mambwe counterparts (~78 %). Whereas ~40 % of the HCP from Chama district (n = 52) claimed to have encountered at least one case of HAT, only ~4 % of their Mambwe counterparts (n = 49) had similar experiences (P = 0.000). Conclusion: Health care personnel in RHCs from Chama tended to be more alert to the occurrence of HAT than the HCP from Mambwe district. The extremely low levels of categorized HCP, general absence of functional laboratories, coupled with absence of national HAT surveillance and control programs, are among some of the serious challenges that Zambia's Chama and Mambwe districts face to control/eliminate HAT.