1. Socio-Economic Causes and Effects of Human African Trypanosomiasis in the Democratic Republic of the Congo Jen Wilson And Silvia Escudero http://www.icp.ucl.ac.be/~opperd/parasites.iages/tryps6.gif

2. The Disease Parasitic Parasitic Transmitted by Tsetse Fly Transmitted by Tsetse Fly Infects humans and cattle Infects humans and cattle Kills over 50,000 people every year (Kabayo 2002) Kills over 50,000 people every year (Kabayo 2002) http://www.gla.ac.uk/ibls/II/parasitol ogy/cureit.htm http://www.uen.org/utahlink/activities/view_activity. cgi?activity_id=3023

3. The Disease Swelling occurs at site of bite. Swelling occurs at site of bite. Infection travels through blood stream. Infection travels through blood stream. Attacks central nervous system. Attacks central nervous system. Results in swelling of brain. Results in swelling of brain. Drowsiness during day; insomnia at night. Drowsiness during day; insomnia at night. Death may occur in six months if no treatment is done (Smith 2006). Death may occur in six months if no treatment is done (Smith 2006).

4. Endemicity Status Democratic Republic of the Congo http://pages.unibas.ch/diss/2004/DissB_6961.pdf

5. History 17 th – early 20 th centuries: sleeping sickness and other vector-bourn diseases caused more human deaths than all other causes combined. 17 th – early 20 th centuries: sleeping sickness and other vector-bourn diseases caused more human deaths than all other causes combined. 1940’s-1960’s: vector control programs, modern drugs and insecticides led to the control of disease 1940’s-1960’s: vector control programs, modern drugs and insecticides led to the control of disease Past 20 years: major epidemics and a resurgence of disease WHY? (Gubler 1998) Past 20 years: major epidemics and a resurgence of disease WHY? (Gubler 1998)

6. Resurgence of Sleeping Sickness in DRC http://www.cdc.gov/ncidod/eid/vol11no09/04-1020.htm#cit

7. Human Influences on Tsetse Fly Population Growth / Urbanization Population Growth / Urbanization Exploitation of Land Exploitation of Land Poor Health Policies Poor Health Policies Climate Change Climate Change

8. Population Growth/Urbanization Population growth Population growth Quick movement to urban areas Quick movement to urban areas Movement is unplanned and uncontrolled Movement is unplanned and uncontrolled Inadequate housing, poor waste management, dirty water, densely packed people, etc. Inadequate housing, poor waste management, dirty water, densely packed people, etc. Ideal conditions for tsetse fly Ideal conditions for tsetse fly http://www.kfw- entwicklungsbank.de/EN_Home/Topics/Good_Govern ance/index.jsp

9. Kinshasa Study in 2005 in Kinshasa to determine where the greatest rate of infection was. Study in 2005 in Kinshasa to determine where the greatest rate of infection was. Results showed that peri-urban areas along rivers had high concentrations of tsetse flies (De Deken 2005). Results showed that peri-urban areas along rivers had high concentrations of tsetse flies (De Deken 2005). People move to urban places and head to rivers for water where there is a high risk of infection. People move to urban places and head to rivers for water where there is a high risk of infection. http://www.eolc- observatory.net/global_analysis/congokinshasa.htm

10. Land Use Tsetse flies originally found in low lands Tsetse flies originally found in low lands People are increasing land use and moving to the high lands (Eradicating Tsetse) People are increasing land use and moving to the high lands (Eradicating Tsetse) Farmers bring cattle with them Farmers bring cattle with them Cattle carry the disease and take it to tsetse-free areas. Cattle carry the disease and take it to tsetse-free areas. http://www.iaea.org/OurWork/ST/NA/NAAL/a gri/ent/entTSETSEmain.php

11. Health Policies 1960-70’s : threat for disease decreased 1960-70’s : threat for disease decreased Health policy decisions decreased surveillance, prevention and control. Health policy decisions decreased surveillance, prevention and control. Lack of support from developed world. Lack of support from developed world. DRC uses mass screening: study in 2004 showed that the effectiveness of testing is less than 50% (Robays 2004). DRC uses mass screening: study in 2004 showed that the effectiveness of testing is less than 50% (Robays 2004).

12. Climate Change Not too much proof correlation. Not too much proof correlation. Climate change mostly linked to human consumption. Climate change mostly linked to human consumption. Temperature and precipitation are most important factors determining whether the vector can survive. Temperature and precipitation are most important factors determining whether the vector can survive. A rise in temperature could conceivably increase the range of the vector. A rise in temperature could conceivably increase the range of the vector. http://www.solcomhouse.com/glo balwarming.htm

13. Effects of Disease Depletion of Livestock Depletion of Livestock Loss of Capital Loss of Capital Urbanization and Economic Urbanization and Economic Degradation Degradation

14. Livestock Nagana: cattle variety of disease Nagana: cattle variety of disease Kills 3 million cows a year (Pearce 2002). Kills 3 million cows a year (Pearce 2002). Decrease in meat production and other by products such as milk Decrease in meat production and other by products such as milk Contributes to protein shortages in people Contributes to protein shortages in people Farmers lose labor from the animals => poverty Farmers lose labor from the animals => poverty http://www.iaea.org/NewsCenter/Features/Ts etse/tsetse_gallery/pages/002.shtml

15. Where is the problem? http://www.genomics.liv.ac.uk/tryps/problem.html

16. Capital Loss Meeting held in Ethiopia to discuss ways to fight sleeping sickness in 2004 Meeting held in Ethiopia to discuss ways to fight sleeping sickness in 2004 Experts reported that African countries lose 4.5 billion dollars every year due to the impact of disease on agriculture (Deutsche Press 2004). Experts reported that African countries lose 4.5 billion dollars every year due to the impact of disease on agriculture (Deutsche Press 2004). Livestock owners administer 35 million dollars worth of doses of medication every year; each at about 1 dollar (Torr et al. 2005). Livestock owners administer 35 million dollars worth of doses of medication every year; each at about 1 dollar (Torr et al. 2005). Loss of jobs Loss of jobs

17. Urbanization/Economic Degradation Fear of disease spreads and families move away from fertile lands. Fear of disease spreads and families move away from fertile lands. Less people on fertile lands growing crops => economic degradation (Kabayo 2002). Less people on fertile lands growing crops => economic degradation (Kabayo 2002). Urbanization loops around and becomes a cause for increase in annual infections. Urbanization loops around and becomes a cause for increase in annual infections.

18. Connections Urbanization Number of people exposed Number of people infected Threat S S S S

19. Connections Economy Vector control programs Number of tsetse flies Number of infected people Workforce S O S O S Number of infected cows Animal Labor Productivity S O S S S

20. References “Cure It.” Institute of Biomedical Life Sciences. University of Glasgow. 7 April 2007.http://www.gla.ac.uk/ibls/II/parasitology/cureit.htm De Deken, Redgi. “Trypanosomiasis in Kinshasa: Distribution of the Vector, Glossina fuscipes quanzensis, and Risk of Transmission in Peri-Urban Area.” Medical and Veterinary Entomology. 19.4 353-359 (2005). Blackwell Synergy. 6 April 2007..http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365- 2915.2005.00580 “Democratic Republic of the Congo (Congo-Kinshasa).” The International Observatory on End of Life Care. 9 April 2007..http://www.eolc-observatory.net/global_analysis/congokinshasa.htm “Eradicating Tsetse from the Southern Rift Valley of Ethiopia.” WREN Media. 6 April 2007..http://tc.iaea.org/tcweb/publications/factsheets/ethiopia.pdf “Good Governance.” KfW Entwicklungsbank. 9 April 2007.http://www.kfw- entwicklungsbank.de/EN_Home/Topics/Good_Governance/index.jsp Gubler, D.J. “Resurgent Vector-Borne Diseases as a Global Health Problem.” Emerging Infectious Diseases. Sept. 1998. 6 April 2007..http://www.cdc.gov/ncidod/eid/vol4no3/gubler.htm Kabayo, J.P. (2002). Aiming to eliminate tsetse from Africa. TRENDS in Parasitology, 11, 473-475. Lutumba, Pascal. “Trypanosomiasis Control, Democratic Republic of Congo, 1993-2003.” Emerging Infectious Diseases. 11.9 (2005). Centers for Disease Control and Prevention. 9 April 2007..http://www.cdc.gov/ncidod/eid/vol11no09/04-1020.htm#cit “Meeting Held in Ethiopia to Dscuss Ways to Fight Sleeping Sickness.” (2004). Deutsche Presse-Agentur. 7 March 2007..http://web.lexis-nexis.com/universe/ Opperdoes, Fred. “African Trypanosomiasis or Sleeping Sickness.” 19 Oct. 1997. 7 April 2007.http://www.icp.ucl.ac.be/~opperd/parasites/tryps9.htm Pearce, F. (2002). An atomic-powered plan to end sleeping sickness. The Boston Globe,3. Retrieved March 7,2007, from Lexis-Nexis Academic database.

21. References Schmid, Caecilia. “10-Day Melarsoprol Treatment of Trypanosoma Brucei Gambiense Sleeping Sickness: From Efficacy to Effectiveness.” 21 Sept. 2004. 9 April 2007..http://pages.unibas.ch/diss/2004/DissB_6961.pdf Smith, Scott. “Sleeping Sickness.” Medical Encyclopedia. 27 Nov. 2007. Medline Plus. 7 April 2007..http://www.nlm.nih.gov/medlineplus/ency/article/001362.htm Robays, Jo. “The Effectiveness of Active Population Screening and Treatment for Sleeping Sickness Control in the Democratic Republic of Congo.” Tropical Medicine & International Health. 9.5 542-550. (2004). Blackwell Synergy. 6 April 2007..http://www.blackwell-synergy.com/links/doi/10.1111%2Fj.1365- 3156.2004.01240.x Torr, S.J., Hargrove, J.W., & Vale, G.A. (2005) Towards a rational policy for dealing with tsetse. TRENDS in Parasitology, 11, 537-541. “Tsetse Flies.” Entomology Unit. 2004. International Atomic Energy Agency. 9 April 2007..http://www.iaea.org/OurWork/ST/NA/NAAL/agri/ent/entTSETSEmain.php

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