Prevalence of Human African Trypanosomiasis in the Democratic Republic of the Congo

Mumba, Dieudonné; Bohorquez, Elaine; Messina, Jane P.; Kande, Victor; Taylor, Steven M.; Tshefu, Antoinette; Muwonga, Jérémie; Kashamuka, Melchior; Emch, Michael; Tidwell, Richard R.; Büscher, Philippe; Meshnick, Steven R.

doi:10.1371/journal.pntd.0001246

Cited by 44 publications

(36 citation statements)

References 12 publications

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“…Nevertheless, HAT mainly affects remote rural communities where the health infrastructure is basic; furthermore, there are other endemic areas where accessibility is complicated because of security problems or topography constraints. Therefore, a certain number of cases are not recognized and diagnosed 1,128,134–136. Despite the fact that epidemiological knowledge about the disease has improved considerably in the past decade, there is still a gap between the number of cases declared and the number of actual cases.…”

Section: Incidence Of the Disease And Time Trendsmentioning

confidence: 99%

Epidemiology of human African trypanosomiasis

Franco¹,

Simarro²,

Diarra³

et al. 2014

CLEP

262

230

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Human African trypanosomiasis (HAT), or sleeping sickness, is caused by Trypanosoma brucei gambiense, which is a chronic form of the disease present in western and central Africa, and by Trypanosoma brucei rhodesiense, which is an acute disease located in eastern and southern Africa. The rhodesiense form is a zoonosis, with the occasional infection of humans, but in the gambiense form, the human being is regarded as the main reservoir that plays a key role in the transmission cycle of the disease. The gambiense form currently assumes that 98% of the cases are declared; the Democratic Republic of the Congo is the most affected country, with more than 75% of the gambiense cases declared. The epidemiology of the disease is mediated by the interaction of the parasite (trypanosome) with the vectors (tsetse flies), as well as with the human and animal hosts within a particular environment. Related to these interactions, the disease is confined in spatially limited areas called “foci”, which are located in Sub-Saharan Africa, mainly in remote rural areas. The risk of contracting HAT is, therefore, determined by the possibility of contact of a human being with an infected tsetse fly. Epidemics of HAT were described at the beginning of the 20th century; intensive activities have been set up to confront the disease, and it was under control in the 1960s, with fewer than 5,000 cases reported in the whole continent. The disease resurged at the end of the 1990s, but renewed efforts from endemic countries, cooperation agencies, and nongovernmental organizations led by the World Health Organization succeeded to raise awareness and resources, while reinforcing national programs, reversing the trend of the cases reported, and bringing the disease under control again. In this context, sustainable elimination of the gambiense HAT, defined as the interruption of the transmission of the disease, was considered as a feasible target for 2030. Since rhodesiense HAT is a zoonosis, where the animal reservoir plays a key role, the interruption of the disease’s transmission is not deemed feasible.

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Section: Incidence Of the Disease And Time Trendsmentioning

confidence: 99%

Epidemiology of human African trypanosomiasis

Franco¹,

Simarro²,

Diarra³

et al. 2014

CLEP

262

230

View full text Add to dashboard Cite

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“…There are, however, caveats in using reported case incidence. Firstly there is thought to be high levels of underreporting, with the WHO previously estimating this at around 65–75% [27, 28]. Secondly, and crucially, the active case detection and reporting is dependent upon both the accuracy of the diagnostic algorithm and the percentage of the population screened.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT.

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“…rhodesiense DNA was successfully detected in blood of 128 sleeping sickness patients from Uganda and Tanzania [22]. A low-cost alternative for FTA cards are plain cellulose filters such as Whatman 4, which work well for DNA storage [23]. In conclusion, for RNA preservation in clinical specimens, commercial buffers or quality-controlled homemade guanidium-based buffers are recommended.…”

Section: Sample Collection and Nucleic Acid Extractionmentioning

confidence: 99%

“…The need for a continuous supply of electricity, expensive equipment and consumables, and purified DNA as starting material limits their use to research laboratories. PCR has been successfully applied in disease surveillance [23,68], travel medicine [5,69] and identification of atypical human infections with animal-infecting trypanosomes [70][71][72]. In disease surveillance, specimens are transported to a central laboratory for nucleic acid extraction and analysis.…”

Section: Expert Commentarymentioning

confidence: 99%

Recent progress in molecular diagnosis of sleeping sickness

Deborggraeve¹,

Büscher²

2012

Expert Review of Molecular Diagnostics

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This article will review the most recent progress in the molecular diagnosis of sleeping sickness and its potential role in patient management and disease control. While PCR remains restricted to research and reference laboratories, promising alternative molecular platforms have emerged over the last few years. Several loop-mediated isothermal amplification assays have been developed for detection and identification of the parasite with reported high analytical sensitivity and specificity. Simplified loop-mediated isothermal amplification formats have been designed and are undergoing evaluation studies in the field. Accurate diagnosis based on specific detection of the parasite's ribosomal RNA has been made possible by the isothermal nucleic acid sequence-based amplification and by direct hybridization with fluorescent detection probes. In addition to the technological progress, the authors also discuss the diagnostic performance of molecular tests in the most recent clinical evaluation studies and briefly present some viewpoints for the near future.

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Prevalence of Human African Trypanosomiasis in the Democratic Republic of the Congo

Cited by 44 publications

References 12 publications

Epidemiology of human African trypanosomiasis

Epidemiology of human African trypanosomiasis

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

Recent progress in molecular diagnosis of sleeping sickness

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