Interventions for African trypanosomiasis

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
IEC on African trypanosomiasis to all age cohorts	The main approaches to controlling African trypanosomiasis are to reduce the reservoirs of infection and the presence of the tsetse fly. Primary prevention emasures * Fly control measures clear bushes. Use insect repellent, vector control using a multisectoral appraoch use of Protective clothings: Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. (Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing). Inspection of places before entry eg cars --since the flies are attracted to bright lights eg car lights The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread. Fly control is another option but is difficult to implement. screening -The card agglutination test for trypanosomiasis T. b. gambiense (CATT) is a serologic screening test used for population screening Screening of people at risk helps identify patients at an early stage.
Primary Care
			Physical and clinical examinaton Direct observation of tredatrmnet offered at the hospital level (for outpatient referred back to primary facilities for obsaervation) Monitor any complicdations including adverse drugs reaction and refer Referal to a hospital for a patient suspected to have african trypanasomiasis
Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Public education on personal protection against the bites of the tsetse fly Community leaders and advocates engagement to eliminate breeding sites for tsetse fly and identification of barriers to accessing care	Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Use of personal repellents and protective clothing
Primary Care
			Physical and clinical examinaton Direct observation of tredatrmnet offered at the hospital level (for outpatient referred back to primary facilities for obsaervation) Monitor any complicdations including adverse drugs reaction and refer Referal to a hospital for a patient suspected to have african trypanasomiasis
Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
IEC on African trypanosomiasis to all age cohorts	The main approaches to controlling African trypanosomiasis are to reduce the reservoirs of infection and the presence of the tsetse fly. Primary prevention emasures * Fly control measures clear bushes. Use insect repellent, vector control using a multisectoral appraoch use of Protective clothings: Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. (Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing). Inspection of places before entry eg cars --since the flies are attracted to bright lights eg car lights The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread. Fly control is another option but is difficult to implement. screening -The card agglutination test for trypanosomiasis T. b. gambiense (CATT) is a serologic screening test used for population screening Screening of people at risk helps identify patients at an early stage.
Primary Care
			Physical and clinical examinaton Direct observation of tredatrmnet offered at the hospital level (for outpatient referred back to primary facilities for obsaervation) Monitor any complicdations including adverse drugs reaction and refer Referal to a hospital for a patient suspected to have african trypanasomiasis
Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
IEC on African trypanosomiasis to all age cohorts	The main approaches to controlling African trypanosomiasis are to reduce the reservoirs of infection and the presence of the tsetse fly. Primary prevention emasures * Fly control measures clear bushes. Use insect repellent, vector control using a multisectoral appraoch use of Protective clothings: Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. (Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing). Inspection of places before entry eg cars --since the flies are attracted to bright lights eg car lights The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread. Fly control is another option but is difficult to implement. screening -The card agglutination test for trypanosomiasis T. b. gambiense (CATT) is a serologic screening test used for population screening Screening of people at risk helps identify patients at an early stage.
Primary Care

Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
IEC on African trypanosomiasis to all age cohorts	The main approaches to controlling African trypanosomiasis are to reduce the reservoirs of infection and the presence of the tsetse fly. Primary prevention emasures * Fly control measures clear bushes. Use insect repellent, vector control using a multisectoral appraoch use of Protective clothings: Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. (Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing). Inspection of places before entry eg cars --since the flies are attracted to bright lights eg car lights The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread. Fly control is another option but is difficult to implement. screening -The card agglutination test for trypanosomiasis T. b. gambiense (CATT) is a serologic screening test used for population screening Screening of people at risk helps identify patients at an early stage.
Primary Care

Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
			First-line treatment Second line treatment Management of relapses Management of complications Management of adverse drug effects

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
IEC on African trypanosomiasis to all age cohorts	Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Use of personal repellents and protective clothing
Primary Care

Referral Facility: General
			Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
			First-line treatment Second line treatmnet Management of relapses Management of complications Management of adverse drug effects