Search

Since 1979, the Lakes region (Kivu in Zaïre, Western Uganda, Rwanda, Burundi) has been stricken by a bacillary dysentery epidemic at S. dysenteriae type 1. Supposed to be extinct since the 1950s., this bacillus has revealed a very noticeable virulence as well by the number of registered cases (524/100.000 in 1983 at Ruhengeri-Rwanda) as its fast break through. Demographic density (from 400 to 600/km2) has played an important role and has facilitated the transition toward epidemicity. Systematic bacteriological exams on the spot has allowed prompt identification of the involved germ, antibiotics to be used, and resistance variations during the period under consideration. The role of a regional laboratory to monitor diarrheal diseases has been demonstrated as of prime importance to set up a fighting strategy at regional level.

From january 1985 to march 1985, an epidemic of bacillary dysentery stroke one of the region in north Rwanda. The area struck, only 160 km2, is densely populated (720 inhabitants/km2). Multiresistant Shigella dysenteriae n. 1 is the only responsible factor. The study of this epidemic shows that, from an endemic disease, burst out can occur in a narrow area and in a short interval of time (7 weeks). The main risk factors have been identified on individual as well as collective level. The authors demonstrate the interest of a Public Health Laboratory as technical support of an Epidemiology Monitoring Department.