HISTORY OF HUMAN AFRICAN TRYPANOSOMIASIS OF NOLA IN CENTRAL AFRICAN REPUBLIC, FROM 1971 TO 2004

Human African Trypanosomiasis (HAT) or sleeping sickness, terrible affection which made major ravages in the past in different regions among which of Nola in Central African Republic (CAR), remains a public health problem in sub-saharan Africa. The 56th World Health Assembly, hold on 26/03/03, recognised that pains, suffering and mortality due to trypanosomiasis daily threat more than 60 million people over more than 37 sub-saharan African countries. We here report Nola HAT history in CAR, from 1971 to 2004. Methodologically, it consists in a retrospective survey covering the period from 1971 to 2004. Using pre established files, we have collected data in Nola from registers of patients suffering from trypanosomiasis and in the capital Bangui from active screening prospective surveys reports. Software Epi info 6 version 2000 has been used for data analysis. From 1971 to 2004, 3348 patients have been identified among them 1814 old cases and 1534 new cases. Women were more affected than men (54%) with a sex ratio of 1.2. The 20-29 years old are the most affected if the series. The epidemiological rise has reached its peak in 1999 with 468 patients. New morbidity index passed from 0.01% to 1.7% in 1991 and to 0.05% in 2004. Total contamination index passed from 0.05% in 1971 to 2.3% in 1989 and to 0.05% in 2004. Relapses and re-infections cases represented 54.2% between 1992 and 2004. Mostly screened patients were in second phase (64%). Anti-vectorial struggle with conic impregnated insecticide traps has been is the main way for tackling the epidemic in the region.