Because of the civil wars that have ravaged the Republic of Congo over the past few years, monitoring of trypanosomiasis, or sleeping sickness, was considered a low priority. There has, however, been a resurgence in prevalence rates, affecting five of the country’s 11 districts.
 
“At the end of the 1997 civil war, the sleeping sickness situation was almost catastrophic. We are continuing to register cases in certain regions of the country,” said Stéphane Ngampo, head of the national programme to combat trypanosomiasis in the Ministry of Health, Social Affairs and the Family.
 
The disease had been virtually wiped out in colonial times (before the Sixties), he said. “In colonial times the strategies employed to overcome trypanosomiasis were successful. The number of people suffering from the disease could be counted on the fingers of one hand,” Ngampo added.

“But the system was not maintained. The disease still exists in Congo and is a real public health problem,” he said.

Prevalence rates

In the Congo the prevalence of sleeping sickness is 1-3 percent, depending on the region. It is estimated that 300-400 cases appear each year.

In 2006, about 300 sick people were sent abroad for treatment, against 101 in the first six months of 2007.
 
According to official statistics, the mortality rate due to sleeping sickness is barely more than 2 percent.

About 40 residents of Ngabé and Mpouya, localities in the northern part of Pool and Plateaux (in the centre) respectively, have the disease.

“All these people are being treated. We cannot abandon them because sleeping sickness kills,” Henri Joseph Parra, director-general of the national public health laboratory, said.

The vector agent is the tsetse fly, which is present along the River Congo but also in swampy zones.
 
“Every year it is difficult for us to visit all the places where the disease is rampant,” said Ngampo, because of a lack of transport but also basic material for fundamental research.
 
The disease is most prevalent in five of Congo’s 11 departments: Niari, Bouenza (in the southwest), Pool (in the south), Plateaux (in the centre) and Cuvette (in the north).
 
“One could compare the disease to malaria in terms of the mode of transmission. The tsetse fly is not restricted by borders and bites everyone – children, adults, even pregnant women,” Parra said.

Research, treatment
 
Trypanosomiasis is considered to be most endemic in five countries in Africa – the Congo, the DRC, Angola, Sudan and Uganda.
 
“The government is doing everything it can to block the path of trypanosomiasis. But, on the ground, politics is translated into inadequacy. We must do more lobbying and seeking the help of other partners,” Ngampo said.
 
Treatment is provided free by the UN World Health Organisation. “We have the necessary treatments, but because they are difficult to handle they need to be dealt with by specialists,” Ngampo said.
 
Depending on the stage of the evolution of the disease, a sick person could be hospitalised and receive an average of four drips a day over a 14-day period.

“Our problem today is to bring treatment as close as possible to those who are sick,” Ngampo said.