Monitoring the Progress towards the Elimination of Gambiense Human African Trypanosomiasis

Abstract

BackgroundOver the last few years, momentum has gathered around the feasibility and opportunity of eliminating gambiense human African trypanosomiasis (g-HAT). Under the leadership of the World Health Organization (WHO), a large coalition of stakeholders is now committed to achieving this goal. A roadmap has been laid out, and indicators and milestones have been defined to monitor the progress of the elimination of g-HAT as a public health problem by 2020. Subsequently, a more ambitious objective was set for 2030: to stop disease transmission. This paper provides a situational update to 2012 for a number of indicators of elimination: number of cases annually reported, geographic distribution of the disease and areas and populations at different levels of risk.ResultsComparing the 5-year periods 2003-2007 and 2008-2012, the area at high or very high risk of g-HAT shrank by 60%, while the area at moderate risk decreased by 22%. These are the areas where g-HAT is still to be considered a public health problem (i.e. > 1 HAT reported case per 10,000 people per annum). This contraction of at-risk areas corresponds to a reduction of 57% for the population at high or very high risk (from 4.1 to 1.8 million), and 20% for moderate risk (from 14.0 to 11.3 million).DiscussionImproved data completeness and accuracy of the Atlas of HAT enhanced our capacity to monitor the progress towards the elimination of g-HAT. The trends in the selected indicators suggest that, in recent years, progress has been steady and in line with the elimination goal laid out in the WHO roadmap on neglected tropical diseases.

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo

“…In recent years, great improvements to curative drugs and screening programmes have contributed to a substantial decline in disease incidence [1]. In addition, advances in tsetse control have meant that control programmes can use strategies with interventions against both the parasite and vector [2, 3].…”

Trypanosoma brucei Invasion and T-Cell Infiltration of the Brain Parenchyma in Experimental Sleeping Sickness: Timing and Correlation with Functional Changes

“…, spread by tsetse fly vectors (genus Glossina ). The disease is endemic in foci in sub-Saharan Africa [1, 2]. After a peak of infection in the 1990s, the incidence of HAT has considerably declined in recent years [1].…”

“…The disease is endemic in foci in sub-Saharan Africa [1, 2]. After a peak of infection in the 1990s, the incidence of HAT has considerably declined in recent years [1]. It is estimated, however, that a significant number of new cases remain unreported or undiagnosed [3–5].…”

Future treatment options for human African trypanosomiasis

“…The first report monitoring the progress of the gambiense elimination campaign indicated that the program was on track, with a progressive decrease in the number of cases reported over the two time periods studied and a 57% reduction in the population classified at high or very high risk of gambiense HAT [9]. Although progress has been made in achieving the goal of eliminating gambiense HAT as a public health problem by 2020, many challenges still lie ahead.…”