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A modelling assessment of short- and medium-term risks of programme interruptions for gambiense human African trypanosomiasis in the DRC
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Huang, Ching-I, Crump, Ronald E., Crowley, Emily, Hope, Andrew, Bessell, Paul R., Shampa, Chansy, Mwamba Miaka, Erick and Rock, Kat S. (2023) A modelling assessment of short- and medium-term risks of programme interruptions for gambiense human African trypanosomiasis in the DRC. PLoS Neglected Tropical Diseases, 17 (4). e0011299. doi:10.1371/journal.pntd.0011299 ISSN 1935-2727.
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Official URL: http://doi.org/10.1371/journal.pntd.0011299
Abstract
Gambiense human African trypanosomiasis (gHAT) is a deadly vector-borne, neglected tropical disease found in West and Central Africa targeted for elimination of transmission (EoT) by 2030. The recent pandemic has illustrated how it can be important to quantify the impact that unplanned disruption to programme activities may have in achieving EoT. We used a previously developed model of gHAT fitted to data from the Democratic Republic of the Congo, the country with the highest global case burden, to explore how interruptions to intervention activities, due to e.g. COVID-19, Ebola or political instability, could impact progress towards EoT and gHAT burden. We simulated transmission and reporting dynamics in 38 regions within Kwilu, Mai Ndombe and Kwango provinces under six interruption scenarios lasting for nine or twenty-one months. Included in the interruption scenarios are the cessation of active screening in all scenarios and a reduction in passive detection rates and a delay or suspension of vector control deployments in some scenarios. Our results indicate that, even under the most extreme 21-month interruption scenario, EoT is not predicted to be delayed by more than one additional year compared to the length of the interruption. If existing vector control deployments continue, we predict no delay in achieving EoT even when both active and passive screening activities are interrupted. If passive screening remains as functional as in 2019, we expect a marginal negative impact on transmission, however this depends on the strength of passive screening in each health zone. We predict a pronounced increase in additional gHAT disease burden (morbidity and mortality) in many health zones if both active and passive screening were interrupted compared to the interruption of active screening alone. The ability to continue existing vector control during medical activity interruption is also predicted to avert a moderate proportion of disease burden.
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 |
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Library of Congress Subject Headings (LCSH): | African trypanosomiasis -- Mathematical models, Communicable diseases -- Mathematical models, Tropical medicine -- Africa | ||||||||||||
Journal or Publication Title: | PLoS Neglected Tropical Diseases | ||||||||||||
Publisher: | Public Library of Science | ||||||||||||
ISSN: | 1935-2727 | ||||||||||||
Official Date: | 28 April 2023 | ||||||||||||
Dates: |
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Volume: | 17 | ||||||||||||
Number: | 4 | ||||||||||||
Article Number: | e0011299 | ||||||||||||
DOI: | 10.1371/journal.pntd.0011299 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 21 June 2023 | ||||||||||||
Date of first compliant Open Access: | 21 June 2023 | ||||||||||||
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