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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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
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
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:	Date Event 28 April 2023 Published 12 April 2023 Accepted
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
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID OPP1177824 ; INV005121 Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/100000865 OPP1184344 Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/100000865 OPP1155293 Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/100000865
Open Access Version:	Publisher

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