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Village-scale persistence and elimination of gambiense human African trypanosomiasis
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Davis, Christopher N., Rock, Kat S., Mwamba Miaka, Erick and Keeling, Matthew James (2019) Village-scale persistence and elimination of gambiense human African trypanosomiasis. PLOS Neglected Tropical Diseases, 13 (10). e0007838. doi:10.1371/journal.pntd.0007838
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WRAP-village-scale-persistence-elimination-African-trypanosomiasis-Davis-2019.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (2873Kb) | Preview |
Official URL: https://doi.org/10.1371/journal.pntd.0007838
Abstract
Gambiense human African trypanosomiasis (gHAT) is one of several neglected tropical diseases that is targeted for elimination by the World Health Organization. Recent years have seen a substantial decline in the number of globally reported cases, largely driven by an intensive process of screening and treatment. However, this infection is highly focal, continuing to persist at low prevalence even in small populations. Regional elimination, and ultimately global eradication, rests on understanding the dynamics and persistence of this infection at the local population scale. Here we develop a stochastic model of gHAT dynamics, which is underpinned by screening and reporting data from one of the highest gHAT incidence regions, Kwilu Province, in the Democratic Republic of Congo. We use this model to explore the persistence of gHAT in villages of different population sizes and subject to different patterns of screening. Our models demonstrate that infection is expected to persist for long periods even in relatively small isolated populations. We further use the model to assess the risk of recrudescence following local elimination and consider how failing to detect cases during active screening events informs the probability of elimination. These quantitative results provide insights for public health policy in the region, particularly highlighting the difficulties in achieving and measuring the 2030 elimination goal.
| Item Type: | Journal Article | |||||||||||||||||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science > Life Sciences (2010- ) Faculty of Science > Mathematics |
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| SWORD Depositor: | Library Publications Router | |||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Communicable diseases -- Mathematical models, African trypanosomiasis -- Mathematical models, Tropical medicine -- Africa | |||||||||||||||||||||||||||
| Journal or Publication Title: | PLOS Neglected Tropical Diseases | |||||||||||||||||||||||||||
| Publisher: | Public Library of Science (PLoS) | |||||||||||||||||||||||||||
| ISSN: | 1935-2735 | |||||||||||||||||||||||||||
| Official Date: | 28 October 2019 | |||||||||||||||||||||||||||
| Dates: |
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| Volume: | 13 | |||||||||||||||||||||||||||
| Number: | 10 | |||||||||||||||||||||||||||
| Article Number: | e0007838 | |||||||||||||||||||||||||||
| DOI: | 10.1371/journal.pntd.0007838 | |||||||||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||||||||
| Publication Status: | Published | |||||||||||||||||||||||||||
| Publisher Statement: | ** Article version: AM ** From Crossref via Jisc Publications Router ** History: epub 28-10-2019; issued 28-10-2019. ** Licence for AM version of this article starting on 28-10-2019: http://creativecommons.org/licenses/by/4.0/ | |||||||||||||||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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