A retrospective study of human African Trypanosomiasis in three Malawian Districts.

Human African Trypanosomiasis (HAT) is a neglected tropical disease (NTD). Surveillance in many of the endemic areas is often inadequate. Up to date information on the HAT situation in Malawi, where the disease is endemic in some districts, provides opportunity to raise the profile of the disease and interest in prevention and control. A retrospective study was conducted in three Malawian districts: Nkhotakota, Rumphi and Kasungu to describe the prevalence of HAT. Hospital laboratory registers from January 2000 to December 2006 were used. The calculated annual district prevalence of Trypanosomiasis ranged from 0.29 cases per 100,000 population in 2000, to 0.58 cases per 100,000 population in 2003. Nkhotakota District had the highest case detection rate of trypanosomiasis of 16.56 cases per 100,000 in 2002 and the lowest rate in 2004 of 5.23 cases per 100,000. From 2004 onwards a decline in cases detected was observed. In Rumphi district the highest number of cases (17.67 cases per 100,000 population) was identified in 2003 and the lowest rate of 1.29 cases per 100,000 in 2001. The rate (17.67 cases per 100,000) found in 2003 represented a 5-fold increase of 2002 (3.02 cases per 100,000). In Kasungu the detection rate ranged from 0 per 100,000 in 2001, 2003 and 2004 to 0.99 cases per 100,000 in 2005. The number of cases in this district has remained low including in 2006, when a detection rate of 0.16 cases per 100,000 was observed. HAT is endemic in selected districts of Malawi. There is need to explore the feasibility of active disease surveillance and the establishment of permanent preventive and control measures.