The treatment pathways followed by cases of human African trypanosomiasis in western Kenya and eastern Uganda

Ann Trop Med Parasitol. 2009 Apr;103(3):211-20. doi: 10.1179/136485909X398230.

Abstract

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Qualitative Research
  • Risk Factors
  • Rural Health
  • Time Factors
  • Treatment Outcome
  • Trypanocidal Agents / therapeutic use*
  • Trypanosomiasis, African / diagnosis
  • Trypanosomiasis, African / drug therapy*
  • Trypanosomiasis, African / epidemiology
  • Uganda / epidemiology
  • Young Adult

Substances

  • Trypanocidal Agents