title: Proposed scheme for the control of hydatid disease in Karamoja region of Uganda, East Africa
title: A proposed scheme for the control of hydatid disease in Karamoja region of Uganda, East Africa
titleType: AlternativeTitle
Creators: name: Otim, Charles Alexi
Publisher: name: The University of Edinburgh
Year: 1982
Subjects: subject: Annexe MSc Digitisation Project 2022 Block 49
subject: Hydatid Disease
subject: Karamoja Region
subject: Control Measures
subject: Zoonotic Importance
subject: Pilot Scheme

description: The presence of hydatid disease (Echinococcus granulosus) in northern and eastern parts of Uganda was mentioned by Templeton (1 970) without any detailed study being done. Mann (1 97U) stated that human hydatidosis represents a great public health problem in Turkana district, Kenya, which borders Karamoja region of Uganda. This had been shown in an earlier survey carried out in Kenya by Nelson and Rausch (1 963). Fuller and Fuller (1981) carried out a survey in various regions of Ethiopia and found out that a hyperendemic focus of the disease exists in the southwestern region, an area inhabited by the Dassanetch and Nyangatom people, which is contiguous with the area occupied by the Turkana of Kenya and the Karamojong of Uganda. The Turkana, Karamojong, Dassanetch and Nyangatom are members of the Nilohamitic ethnic group of people who are pastoralists and have similar socio cultural backgrounds. In Uganda, Owor and Bitakaramine (1975) examined all the biopsy and autopsy records from 1967 to 1972 in the Department of Pathology, Makerere University, which provides a histopathology service for the whole country, and found out that all the twenty-three recorded cases of hydatid disease came from Karamoja region and the two neighbouring districts of Acholi and Lango. At the Uganda Meat Packers Abattoir, Kampala, they also found out that the highest prevalence of the disease is in cattle from Karamoja region. The same authors, however, noted that although hydatidosis occurs in slaughtered cattle in other parts of Uganda where man associates with dogs, human disease is not recorded in these areas. A similar difference had been observed in Kenya between the inhabitants of Turkana district and those in other areas (Wray, 1958, Nelson and Rausch, 1963, and Schwabe, 1969). There is therefore no doubt that the high prevalence of hydatid disease in Karamoja region of Uganda is of zoonotic importance. Since the disease is both of medical and, to a lesser extent, economic importance in this area it is desirable to take control measures to reduce the prevalence of the disease in the region. Although drugs like mebendazole have been found to be effective in treating some patients in other parts of the world (Schantz, Van den Bossche and Eckert, 1 982), they are not being used in Uganda so that the only effective treatment of the disease is through surgery. Since the prognosis in cases presented late is quite poor (Mann, 1974), the best means for controlling the disease would, therefore, be a preventive approach. The purpose of this dissertation is to prepare a proposed practical scheme which could be used for the control of hydatidosis in Karamoja, despite the peculiar sociological and economic problems encountered in the region. Since a scheme for the control of this disease in the area has not been designed before, the dissertation first gives a brief review of pertinent literature. The background information on Karamoja, which is of importance to understanding the epidemiology of the disease and essential for the preparation of the scheme is also outlined. The need for a Hydatid Control Authority is then presented, its functions defined and its organisation outlined. The dissertation then gives a design for a pilot scheme as an initial programme to determine the prevalence of the disease in Karamoja. This should primarily seek to determine how intensive the control measures to be implemented would need to be. However, some Initial control measures are incorporated during the period of the pilot scheme. In drawing up these schemes, some assumptions have been made, derived from studies carried out in other areas, like Turkana district of Kenya, which have so many factors common to Karamoja region. The main control programme which could be applied in Karamoja is then described, problems likely to be encountered in the scheme are discussed and alternative measures suggested where possible. It is important to emphasize that the scheme aims, only, at reducing the prevalence of the disease in the area, since eradication is not thought to be feasible at the moment.