Hydatid disease in the Turkana District of Kenya

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Abstract
This is the first paper in a series on the results of studies on hydatid disease in the Turkana District of northern Kenya. Previous work is reviewed and the setting up of a Hydatid Research Unit is described. The Unit is investigating the remarkably high prevalence of hydatid disease in this remote semi-desert region; it also hopes to improve the treatment of existing cases and to devise appropriate control measures. The Turkana are nomadic herdsmen, subsisting mainly on the blood and milk of their camels and other livestock. The various hypotheses that have been suggested to account for the high prevalence of the disease are reviewed in the light of recent observations on the parasite in wild and domestic animals and on the behaviour of the people. Particular emphasis is given to the relationship between the people and the numerous heavily infected dogs, and to the use of ‘nurse’ dogs to clean and guard children. The problem of transmission from contaminated food and water is also discussed together with the use of dog faeces as medicaments or lubricants. Very little is known about the ways in which dogs become infected but they may have acquired a parasite which is man-adapted from eating infected human corpses, or a highly infective parasite may have recently evolved from the dog/camel cycle. The Hydatid Research Unit is studying these epidemiological problems and the results of studies on prevalence, immunodiagnosis, chemotherapy and surgical treatment, together with the results of investigations on the parasites obtained from wild and domestic animals, will be presented in subsequent papers in this series.