November 10, 2011

Day 54: Tsetse fly - Can a fly be God?

Tsetse fly. American Museum of Natural History. Foto: Tam Nguyen.
Tsetse fly is determining the destiny of as many as 70,000 people affected annually by the African sleeping sickness.

African trypanosomiasis, commonly called sleeping sickness, is transmitted to humans through the bite of an infected tsetse fly, a grey-brown insect the size of a honey bee. The course of the disease in animals is similar to the course of sleeping sickness in humans. Following entry into a human host, the parasitic protozoa - called trypanosomes - multiply in the blood stream and lymph glands.
There are two distinct forms of sleeping sickness: in central and West Africa (in the central and western regions of Africa in forests and areas of heavy vegetation by rivers and waterholes) the tsetse fly carries the gambiense strain, and in southern and east Africa (in woodland and savannah areas) it transmits the rhodesiense trypanosome.
Rhodesiense causes an acute infection of the brain that emerges after a few weeks and is easier to detect. Gambiense can infect a person for months, or years, without symptoms while parasites multiply in the bloodstream and lymphatic system.
Despite various drastic efforts over the past 100 years to eradicate the tsetse fly, most of the time it has recovered. In some regions of the war-torn Democratic Republic of the Congo, in central Africa, sleeping sickness is killing more people than any other communicable disease, including HIV/Aids, says the World Health Organization.
In 2002, the deputy director of the Vienna based joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture claimed that this disease "is a root of poverty in sub-Saharan Africa, a devastating problem that has been allowed to fester because there was a perception it could not be solved, and because it is a problem of the rural poor." Curiously, the tsetse infests 37 sub-Saharan African countries -- 32 of them among the 42 most Heavily Indebted Poor Countries (HIPCs) in the world. So the root of the problem seems to be poverty itself. We are in fact participating in a cycle of poverty-economic-apathy instead of dedicating financial investment and human resources to eliminate poverty once and for all.

A disease which had been virtually eliminated from Africa during the 1960s, has come back as a major threat to public health. Major pharmaceutical companies and US foundations are committing funds to assist World Health Organization in combating sleeping sickness. 

The current sleeping sickness epidemic in Africa began in the mid-1970s, WHO says. Systematic screening treatment between 1940 and 1960 resulted in the number of cases of sleeping sickness declining to almost zero.

Patients are seen in a hospital in the Democratic Republic of Congo in 2006 (AFP/, Jose Cendon)
Sleeping sickness could threaten tens of millions more people as the tsetse fly which transmits the disease spreads to southern Africa as a result of global warming (AFP)
Two days ago, a new study published on the Journal of the Royal Society Interface alerts for climate change to widen sleeping sickness risk to southern Africa. The scientists base the estimate on how the tsetse and the Trypanosoma parasite it carries are likely to respond to rising temperatures in coming decades. By 2090, an additional 40 to 77 million people could be at risk of exposure to the disease, the study concludes. Currently 75 million people live within its range.

Tsetse free zones: successful cases

In 1997 the Tanzanian island of Zanzibar was declared free of the tsetse after conventional methods reduced its numbers and the release of hundreds of thousands of infertile male flies into the wild -- sterilized using a nuclear technology -- clinched its success. 
In Burkina Faso in 2001, the Organization of African Unity inaugurated the Pan African Tsetse and Trypanosomosis Eradication Campaign (PATTEC), based on the successful Zanzibar program. The  Regional Coordinator of PATTEC condirmed that it was no accident that the concentration of much of the world's most acute poverty is in regions of sub-Saharan Africa infested with it. "But Zanzibar was the breakthrough. Now we know how to control it." Since the program to control and eradicate the tsetse began, milk production has tripled, local beef production has doubled and the number of farmers who fertilize crops with manure has multiplied five fold. Fears that tsetse elimination would have a harmful environmental impact on the island's biodiversity have been unfounded. 

Campaign to Eliminate Tsetse Fly

In 2002 a campaign to control the deadly tsetse fly in Africa was launched by the Organization of African Unity (OAU). The key was said to be political perseverance by Africa and securing financial support. At that time PATTEC was owing a major debt thanks to the International Atomic Energy Agency (IAEA), which has fostered its development and encouraged the use of the sterile insect technique (SIT), in combination with applying insecticide to the backs of cattle and setting insecticide impregnated traps to reduce the tsetse population, in the process of creating tsetse free zones.

Global BIG solution at last

As part of the Millennium Development Goals, the world is committed to halving the number of undernourished people by 2015 "but without addressing the root causes of low agricultural productivity all other efforts will fail."said the Regional Coordinator of PATTEC almost ten years ago...

Poverty creates the conditions for the establishment of infected flies. As a consequence, much of Africa's best land (particularly in river valleys and moist areas, where the potential for mixed farming is good) lies uncultivated, while tsetse free areas face collapse from overuse by humans -- the cycle of poverty seems endless. Until when are we going to accept such destiny? Is it out of our reach? Can we fly higher in our thought and focus on a global economic solution in the name of Life for every being on this planet?

There's a riddle in Africa that asks how you eat an elephant -- and the answer is in small pieces.The first BIG step for humanity at this moment is the Basic Income Grant in order to establish an equal level of dignity, opening the way for the Equal Money System which will definitely support Life for All unconditionally.


When they cross the blood-brain barrier and invade the central nervous system, there are neurological changes that are often irreversible, particularly for children who are often the most vulnerable to the disease.
Treatment at this stage must follow the same path and is radical: Melarsoprol, an arsenic and glycol compound, may cause up to ten percent fatalities; Eflornithine, a modern alternative, requires a strict and complex regimen of treatment that often makes it unusable.


  • In West African trypanosomiasis (Trypanosoma brucei gambiense), symptoms can take months or years to appear. They include fever, rash, swelling around the eyes and hands, severe headaches, extreme fatigue, swollen lymph nodes, and aching muscles and joints. If the disease is not treated at this stage, it attacks the central nervous system, producing progressive confusion, slurred speech, personality changes, seizures and difficulty in walking and talking. Symptoms progress and lead to death if left untreated. 

  • In East African trypanosomiasis (Trypanosoma brucei rhodesiense), symptoms occur 1 to 4 weeks after exposure and are the same as those listed above for the West African variety of trypanosomiasis.


Prevention and Recommendations

There is no vaccine for the prevention of African trypanosomiasis. 

Protective clothing:
  • Wear thick clothing that reduces the amount of exposed skin, such as heavy long-sleeved shirts, long pants, socks and shoes.
  • Avoid wearing bright or dark-coloured clothing as these colours attract tsetse flies.
Screens and bed nets:
  • Sleep inside screened areas, under a net or in an air-conditioned room.
  • Use bed nets that are rectangular in size, impregnated with permethrin every 6 months and tucked tightly under the mattress before dusk
Other measures:
  • Avoid riding in the back of open vehicles as tsetse flies are attracted to dust churned up by moving vehicles or animal herds.
  • Check the inside of all vehicles for tsetse flies before getting in.
  • Stay away from bushy areas especially during the heat of the day. Tsetse flies rest in bushes during high heat periods and can bite if disturbed.
  • Insect repellent has not been proven to prevent tsetse fly bites.



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