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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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Official URL: https://doi.org/10.1371/journal.pntd.0007838

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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
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science > Life Sciences (2010- )
Faculty of Science > Mathematics
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:
DateEvent
28 October 2019Published
10 October 2019Accepted
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:
Project/Grant IDRIOXX Funder NameFunder ID
388Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
390Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
389Task Force for Global Healthhttps://taskforce.org/
OPP1053230NTD Modelling Consortiumhttps://www.ntdmodelling.org/
MathSys Centre for Doctoral Training[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
MathSys Centre for Doctoral Training[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
Human African Trypanosomiasis Modelling, 391Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
Economic Predictions for Policy (HAT MEPP), OPP1177824Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
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