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Towards the sustainable elimination of gambiense human African trypanosomiasis in Côte d’Ivoire using an integrated approach
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(2023) Towards the sustainable elimination of gambiense human African trypanosomiasis in Côte d’Ivoire using an integrated approach. PLoS Neglected Tropical Diseases, 17 (7). e0011514. doi:10.1371/journal.pntd.0011514 ISSN 1935-2727.
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Official URL: http://doi.org/10.1371/journal.pntd.0011514
Abstract
Background
Human African trypanosomiasis is a parasitic disease caused by trypanosomes among which Trypanosoma brucei gambiense is responsible for a chronic form (gHAT) in West and Central Africa. Its elimination as a public health problem (EPHP) was targeted for 2020. Côte d’Ivoire was one of the first countries to be validated by WHO in 2020 and this was particularly challenging as the country still reported around a hundred cases a year in the early 2000s. This article describes the strategies implemented including a mathematical model to evaluate the reporting results and infer progress towards sustainable elimination.
Methods
The control methods used combined both exhaustive and targeted medical screening strategies including the follow-up of seropositive subjects– considered as potential asymptomatic carriers to diagnose and treat cases– as well as vector control to reduce the risk of transmission in the most at-risk areas. A mechanistic model was used to estimate the number of underlying infections and the probability of elimination of transmission (EoT) was met between 2000–2021 in two endemic and two hypo-endemic health districts.
Results
Between 2015 and 2019, nine gHAT cases were detected in the two endemic health districts of Bouaflé and Sinfra in which the number of cases/10,000 inhabitants was far below 1, a necessary condition for validating EPHP. Modelling estimated a slow but steady decline in transmission across the health districts, bolstered in the two endemic health districts by the introduction of vector control. The decrease in underlying transmission in all health districts corresponds to a high probability that EoT has already occurred in Côte d’Ivoire.
Conclusion
This success was achieved through a multi-stakeholder and multidisciplinary one health approach where research has played a major role in adapting tools and strategies to this large epidemiological transition to a very low prevalence. This integrated approach will need to continue to reach the verification of EoT in Côte d’Ivoire targeted by 2025.
| Item Type: | Journal Article | ||||||
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| 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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| Journal or Publication Title: | PLoS Neglected Tropical Diseases | ||||||
| Publisher: | Public Library of Science | ||||||
| ISSN: | 1935-2727 | ||||||
| Official Date: | 31 July 2023 | ||||||
| Dates: |
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| Volume: | 17 | ||||||
| Number: | 7 | ||||||
| Article Number: | e0011514 | ||||||
| DOI: | 10.1371/journal.pntd.0011514 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 6 September 2023 | ||||||
| Date of first compliant Open Access: | 6 September 2023 |
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