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Predicting the impact of intervention strategies for sleeping sickness in two high-endemicity health zones of the Democratic Republic of Congo
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Rock, Kat S., Torr, Steven J., Lumbala, Crispin and Keeling, Matthew James (2017) Predicting the impact of intervention strategies for sleeping sickness in two high-endemicity health zones of the Democratic Republic of Congo. PLoS Neglected Tropical Diseases, 11 (1). e0005162. doi:10.1371/journal.pntd.0005162 ISSN 1935-2727.
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Official URL: https://doi.org/10.1371/journal.pntd.0005162
Abstract
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.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) Faculty of Science, Engineering and Medicine > Science > Mathematics Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | African trypanosomiasis -- Treatment, Tsetse-flies, Vector control | ||||||
Journal or Publication Title: | PLoS Neglected Tropical Diseases | ||||||
Publisher: | Public Library of Science | ||||||
ISSN: | 1935-2727 | ||||||
Official Date: | 5 January 2017 | ||||||
Dates: |
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Volume: | 11 | ||||||
Number: | 1 | ||||||
Article Number: | e0005162 | ||||||
DOI: | 10.1371/journal.pntd.0005162 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 8 November 2016 | ||||||
Date of first compliant Open Access: | 23 May 2017 | ||||||
Funder: | Bill & Melinda Gates Foundation, Biotechnology and Biological Sciences Research Council (Great Britain) (BBSRC), Great Britain. Department for International Development, Economic and Social Research Council (Great Britain) (ESRC), Natural Environment Research Council (Great Britain) (NERC), Defence Science and Technology Laboratory (Great Britain) | ||||||
Grant number: | OPP1053230 (Bill & Melinda Gates Foundation), programme Grant no. BB/L0190 35/1 (Defence Science and Technology Laboratory (Great Britain)) |
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