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Screening strategies for a sustainable endpoint for Gambiense sleeping sickness
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Castaño, Soledad, Aliee, Maryam, Miaka, Erick Mwamba, Keeling, Matthew James, Chitnis, Nakul and Rock, Kat S. (2020) Screening strategies for a sustainable endpoint for Gambiense sleeping sickness. Journal of Infectious Diseases, 221 (5). S539-S545. doi:10.1093/infdis/jiz588 ISSN 0022-1899.
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Official URL: https://doi.org/10.1093/infdis/jiz588
Abstract
Background.
Gambiense human African trypanosomiasis (gHAT, sleeping sickness) is a vector-borne disease typically fatal without treatment. Intensified, mainly medical-based, interventions in endemic areas have reduced the occurrence of gHAT to historically low levels. However, persistent regions, mainly in the Democratic Republic of Congo (DRC), remain a challenge to achieving the World Health Organization global elimination of transmission (EOT) target.
Methods.
Stochastic models of gHAT transmission fitted to DRC case data explored patterns of regional reporting and extinction. The time to EOT at a health zone scale (∼100,000 people) and how an absence of reported cases informs about EOT was quantified.
Results.
Regional epidemiology and level of active screening (AS) both influenced the predicted time to EOT. Different AS cessation criteria had similar expected infection dynamics and recrudescence of infection was unlikely. However, whether EOT has been achieved when AS ends, is critically dependent on the stopping criteria. Two or three consecutive years of no detected cases provided greater confidence of EOT compared to a single year (66-75% and 82-84% probability of EOT respectively compared to 31-51%).
Conclusion.
Multiple years of AS without case detections is a valuable measure to assess the likelihood that the EOT target has been met locally.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RC Internal medicine | |||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Mathematics | |||||||||
| Library of Congress Subject Headings (LCSH): | African trypanosomiasis -- Congo (Democratic Republic), African trypanosomiasis -- Diagnosis, African trypanosomiasis -- Transmission -- Mathematical models | |||||||||
| Journal or Publication Title: | Journal of Infectious Diseases | |||||||||
| Publisher: | Oxford University Press | |||||||||
| ISSN: | 0022-1899 | |||||||||
| Official Date: | June 2020 | |||||||||
| Dates: |
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| Volume: | 221 | |||||||||
| Number: | 5 | |||||||||
| Page Range: | S539-S545 | |||||||||
| DOI: | 10.1093/infdis/jiz588 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Reuse Statement (publisher, data, author rights): | This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Infectious Diseases following peer review. The version of record [insert complete citation information here] is available online at: xxxxxxx [insert URL and DOI of the article on the OUP website]. | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Date of first compliant deposit: | 10 January 2020 | |||||||||
| Date of first compliant Open Access: | 10 January 2020 | |||||||||
| Funder: | BMGF | |||||||||
| RIOXX Funder/Project Grant: |
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