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

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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
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science > Life Sciences (2010- ) Faculty of Science > Mathematics Faculty of Medicine > Warwick Medical School
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:	Date Event 5 January 2017 Published 4 November 2016 Accepted
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
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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