Mahamat, Mahamat Hissene, Peka, Mallaye, Rayaisse, Jean-Baptiste, Rock, Kat S., Toko, Mahamat Abdelrahim, Darnas, Justin, Brahim, Guihini Mollo, Alkatib, Ali Bachar, Yoni, Wilfrid, Tirados, Inaki, Courtin, Fabrice, Brand, Samuel, Nersy, Cyrus, Alfaroukh, Idriss Oumar, Torr, Stephen J., Lehane, Mike J. and Solano, Philippe (2017) Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad). PLoS Neglected Tropical Diseases, 11 (7). e0005792. doi:10.1371/journal.pntd.0005792 ISSN 1935-2727.

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Abstract

A global programme aims to eliminate Gambian sleeping sickness (Human African Trypanosomiasis, HAT) as a public health problem by 2020. Gambian HAT is a neglected tropical disease caused by trypanosomes spread by tsetse flies and its control has relied largely on detection and treatment of human cases. In the Mandoul focus of southern Chad, regular screening of the human population (~39000 people) between 2002 and 2013 resulted in the detection and treatment of ~100 cases/year. We examined whether even better control might be achieved through the addition of vector control to medical screening. In February 4 2014, 2600 insecticide-treated targets (‘Tiny Targets’) were deployed in areas where tsetse were present; tsetse are attracted to the targets and on contacting it they pick up a lethal dose of insecticide. Monitoring of the tsetse population, using a network of 44 traps operated regularly between November 2013 and October 2016, showed that the mean daily catch of tsetse declined by 99.99%, from 0.7 tsetse/trap before targets were deployed to 0.005 tsetse/trap. The number of HAT cases detected by a programme of active screening also declined during this period. Mathematical modelling of the number of HAT cases reported during the period 2000-2015 suggests that 70% of the decline in cases during 2014-2015 was due to vector control. The model also suggests that the combination of these interventions may have interrupted transmission and may to lead to the elimination of sleeping sickness in the Mandoul focus by 2020. The results from Mandoul provide further empirical and theoretical evidence that the global elimination of Gambian HAT can be achieved through the integrated use of (i) case detection and treatment and (ii) vector control

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH):	African trypanosomiasis -- Chad, African trypanosomiasis -- Prevention, Vector control, Tsetse-flies
Journal or Publication Title:	PLoS Neglected Tropical Diseases
Publisher:	Public Library of Science
ISSN:	1935-2727
Official Date:	27 July 2017
Dates:	Date Event 27 July 2017 Available 25 July 2017 Accepted
Volume:	11
Number:	7
Article Number:	e0005792
DOI:	10.1371/journal.pntd.0005792
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	3 August 2017
Date of first compliant Open Access:	3 August 2017

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