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Title: Epidemiology of human African trypanosomiasis in western Tanzania
Author: Matemba, Lucas E.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2009
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This thesis started by reviewing the existing sleeping sickness historical records in Tanzania with the aim of exploring the evidence for the existence of Trypanosoma brucei gambiense in Tanzania. Findings from the available historical data did not provide sufficient evidence for the existence of T. b. gambiense sleeping sickness in Tanzania.
The thesis further estimated under-reporting of T. b. rhodesiense in endemic areas of Tanzania using an established model. Using data from a 2000-2004 outbreak of T. b. rhodesiense in Urambo, the model predicts 46% underreporting. All unreported cases were assumed to be undetected deaths as sleeping sickness is invariable fatal if left untreated. These underreporting findings were then used to recalibrate the burden of T. b. rhodesiense (using Disability-Adjusted Life Years – DALYs), as a metric. The burden imposed to rural communities by rhodesiense sleeping sickness is high. The costs of hospitalization are very high considering the long duration of hospital stay (26 days mean hospital stay) for sleeping sickness patients. Finally the thesis investigated spatial and behavioural risk factors for T. b. rhodesiense sleeping sickness in Urambo district, through a matched case control study both at the village and within village scales. Statistically significant cluster was observed at the village level (P = 0.001). However there was no significant spatial association in an individual village’s analysis. There was an increased risk of sleeping sickness in homesteads with a previous history of the disease (P < 0.001). Presence of wild animals in the villages (P<0.001) and forest visits (P = 0.001) were also significantly associated with sleeping sickness in the district.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available