Transactions of the Royal Society of Tropical Medicine and Hygiene (2004) 98, 569—576 Spatial and temporal risk factors for the early detection of Trypanosoma brucei rhodesiense sleeping sickness patients in Tororo and Busia districts, Uganda M. Odiit a,b, * , P.G. Coleman c , J.J. McDermott d , E.M. Fèvre b , S.C. Welburn b , M.E.J. Woolhouse b a Sleeping Sickness Programme, LIRI Hospital, P.O. Box 96, Tororo, Uganda b Centre for Tropical Veterinary Medicine, University of Edinburgh, Easter Bush, Roslin, Midlothian, Edinburgh EH25 9RG, UK c London School of Hygiene and Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK d International Livestock Research Institute, P.O. Box 30709, Nairobi, Kenya Received 10 July 2003; received in revised form 11 December 2003; accepted 16 December 2003 KEYWORDS Rhodesiense sleeping sickness; African trypanosomiasis; Trypanosoma brucei rhodesiense; Early detection; Uganda Summary We have carried out a study of risk factors for early detection of Try- panosoma brucei rhodesiense sleeping sickness. Records of sleeping sickness patients from 1987 to 2001 from Tororo and Busia districts in Uganda were reviewed for their village of origin and clinical stage (early or late). All villages that reported sleeping sickness and fixed post-diagnostic sleeping sickness health units in Tororo and Busia districts were geo-referenced. The spatial distribution of early and late stage pa- tient detection by health units was analysed using Geographical Information Systems (GIS). Of 1316 sleeping sickness patients admitted at the Livestock Health Research Institute and Busolwe hospitals and Lumino health centre from Tororo and Busia dis- tricts, 471 (35.8%) were early stage, 825 (62.7%) were late stage, while 20 (1.5%) were not staged. Five hundred and eighty-five (44.5%) came from within a 10 km ra- dius of the reporting health units. After multivariate analysis, the proportion of early stage patients detected was found to be significantly associated with patients orig- inating from within a 10 km radius of the health unit (P < 0.01), with adults ( >19 years) (P < 0.01), and with annual parish incidence (P < 0.01). Application of GIS and the early to late stages ratio are an informative and powerful means of determining efficiency of surveillance of sleeping sickness. © 2004 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved. * Corresponding author. Tel.: +256-77-690007; fax: +256-45-45052. E-mail address: m.odiit@cgiar.org (M. Odiit). 1. Introduction Human African trypanosomiasis, also known as sleeping sickness, is a disease resulting from in- fection with either Trypanosoma brucei gambi- ense or rhodesiense (WHO, 1998). Sleeping sick- 0035-9203/$ – see front matter © 2004 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.trstmh.2003.12.012 at University of Edinburgh on March 6, 2014 http://trstmh.oxfordjournals.org/ Downloaded from