Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo

Abstract Background The virulent vector-borne disease, Gambian human African trypanosomiasis (HAT), is one of several diseases targeted for elimination by the World Health Organization. This article utilises human case data from a high-endemicity region of the Democratic Republic of Congo in conjunc...

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Main Authors: Kat S. Rock, Steve J. Torr, Crispin Lumbala, Matt J. Keeling
Format: Article
Language:English
Published: BMC 2015-10-01
Series:Parasites & Vectors
Subjects:
Online Access:https://doi.org/10.1186/s13071-015-1131-8
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author Kat S. Rock
Steve J. Torr
Crispin Lumbala
Matt J. Keeling
author_facet Kat S. Rock
Steve J. Torr
Crispin Lumbala
Matt J. Keeling
author_sort Kat S. Rock
collection DOAJ
description Abstract Background The virulent vector-borne disease, Gambian human African trypanosomiasis (HAT), is one of several diseases targeted for elimination by the World Health Organization. This article utilises human case data from a high-endemicity region of the Democratic Republic of Congo in conjunction with a suite of novel mechanistic mathematical models to address the effectiveness of on-going active screening and treatment programmes and compute the likely time to elimination as a public health problem (i.e. <1 case per 10,000 per year). Methods The model variants address uncertainties surrounding transmission of HAT infection including heterogeneous risk of exposure to tsetse bites, non-participation of certain groups during active screening campaigns and potential animal reservoirs of infection. Results Model fitting indicates that variation in human risk of tsetse bites and participation in active screening play a key role in transmission of this disease, whilst the existence of animal reservoirs remains unclear. Active screening campaigns in this region are calculated to have been effective, reducing the incidence of new human infections by 52–53 % over a 15-year period (1998–2012). However, projections of disease dynamics in this region indicate that the elimination goal may not be met until later this century (2059–2092) under the current intervention strategy. Conclusions Improvements to active detection, such as screening those who have not previously participated and raising overall screening levels, as well as beginning widespread vector control in the area have the potential to ensure successful and timely elimination.
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spelling doaj.art-15d76ac027b24a25bf186cf4171d81492023-06-04T11:09:19ZengBMCParasites & Vectors1756-33052015-10-018111310.1186/s13071-015-1131-8Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of CongoKat S. Rock0Steve J. Torr1Crispin Lumbala2Matt J. Keeling3Life Sciences, Warwick UniversityWIDER, Warwick UniversityProgramme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA)Life Sciences, Warwick UniversityAbstract Background The virulent vector-borne disease, Gambian human African trypanosomiasis (HAT), is one of several diseases targeted for elimination by the World Health Organization. This article utilises human case data from a high-endemicity region of the Democratic Republic of Congo in conjunction with a suite of novel mechanistic mathematical models to address the effectiveness of on-going active screening and treatment programmes and compute the likely time to elimination as a public health problem (i.e. <1 case per 10,000 per year). Methods The model variants address uncertainties surrounding transmission of HAT infection including heterogeneous risk of exposure to tsetse bites, non-participation of certain groups during active screening campaigns and potential animal reservoirs of infection. Results Model fitting indicates that variation in human risk of tsetse bites and participation in active screening play a key role in transmission of this disease, whilst the existence of animal reservoirs remains unclear. Active screening campaigns in this region are calculated to have been effective, reducing the incidence of new human infections by 52–53 % over a 15-year period (1998–2012). However, projections of disease dynamics in this region indicate that the elimination goal may not be met until later this century (2059–2092) under the current intervention strategy. Conclusions Improvements to active detection, such as screening those who have not previously participated and raising overall screening levels, as well as beginning widespread vector control in the area have the potential to ensure successful and timely elimination.https://doi.org/10.1186/s13071-015-1131-8Sleeping sicknessGambian human African trypanosomiasisMathematical modelBasic reproductive ratioEliminationDemocratic Republic of Congo
spellingShingle Kat S. Rock
Steve J. Torr
Crispin Lumbala
Matt J. Keeling
Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
Parasites & Vectors
Sleeping sickness
Gambian human African trypanosomiasis
Mathematical model
Basic reproductive ratio
Elimination
Democratic Republic of Congo
title Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
title_full Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
title_fullStr Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
title_full_unstemmed Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
title_short Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo
title_sort quantitative evaluation of the strategy to eliminate human african trypanosomiasis in the democratic republic of congo
topic Sleeping sickness
Gambian human African trypanosomiasis
Mathematical model
Basic reproductive ratio
Elimination
Democratic Republic of Congo
url https://doi.org/10.1186/s13071-015-1131-8
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