Assessment of the burden of human African trypanosomiasis by rapid participatory appraisal in three high-risk villages in Urambo District, northwest Tanzania

Background: The public health and socio-economic burden of Human African Trypanosomiasis (HAT) in East Africa is not well documented. Understanding the epidemiology and impact of HAT in such settings is difficult due to a lack of robust surveillance and reporting systems, restricting evidence-based policy development and contributing to the continued neglect of this disease. Objective: To investigate the burden of HAT in Urambo District, Tanzania in order to inform future public health policy. Methods: A rapid participatory appraisal (RPA) using a combination of qualitative and quantitative methods was conducted, that included key informant interviews, hospital record analysis, and tools adapted from participatory learning and action. Results: Three villages adjacent to Ugala Game Reserve appeared to be the most affected. High levels of under-reporting were noted due to a lack of diagnostic tools at peripheral health care facilities and limited access to specialist services. Community stakeholders perceived the health and socio-economic burden of HAT to be similar to that of malaria. Conclusion: The burden of HAT in remote rural communities is difficult to capture through routine surveillance systems alone. The RPA represents an efficient mechanism for engaging communities in public health action for trypanosomiasis control in northwest Tanzania