Diversity of human African trypanosomiasis epidemiological settings requires fine-tuning control strategies to facilitate disease elimination - PubMed (original) (raw)

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Diversity of human African trypanosomiasis epidemiological settings requires fine-tuning control strategies to facilitate disease elimination

P P Simarro et al. Res Rep Trop Med. 2013.

Abstract

In 2001, the World Health Organization (WHO) established a public-private partnership to fight human African trypanosomiasis (HAT). As a result of this continuous collaboration, and in addition to the coordination with nongovernmental organizations and bilateral cooperation agencies, the number of new cases of HAT annually reported by the WHO has strikingly decreased. In 2012, HAT was included in WHO's roadmap on neglected tropical diseases with a 2020 target date for elimination. Although the prevalence of HAT is decreasing and its elimination is targeted, control approaches must be adapted to the different epidemiological patterns in order to adopt the most adequate strategies to maintain their cost-effectiveness. These strategies must be flexible and dynamic in order to be adapted to the disease progression, as well as to the changes affecting the existing health facilities in transmission areas, including their accessibility, their capabilities, and their involvement in the elimination process. Considering the different patterns of transmission (Trypanosoma brucei (T.b.) rhodesiense HAT) and transmission intensity (T.b. gambiense HAT), different settings have been defined. In the case of T.b. rhodesiense, this form exists primarily where wild animals are the main parasite reservoir, and where the main parasite reservoir is cattle. In T.b. gambiense, this form exists in areas with high intensity transmission, areas with moderate intensity transmission, and areas with low intensity transmission. Criteria and indicators must be established to monitor and evaluate the actions implemented toward the elimination of HAT.

Keywords: HAT; T.b. gambiense; T.b. rhodesiense; disease elimination; human African trypanosomiasis; sleeping sickness.

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Conflict of interest statement

Disclosures The authors report no conflicts of interest in this work. The boundaries and names shown and the designations used on the maps presented in this paper do not imply the expression of any opinion whatsoever on the part of the WHO concerning the legal status of any country, territory, city, or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the WHO.

Figures

Figure 1

Figure 1

Various estimates of the number and distribution of people at risk for T.b. gambiense and T.b. rhodesiense infection. Abbreviation: T.b., Trypanosoma brucei.

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References

    1. Simarro PP, Cecchi G, Paone M, et al. The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases. Int J Health Geogr. 2010;9:57. - PMC - PubMed
    1. Simarro PP, Diarra A, Ruiz Postigo JA, Franco JR, Jannin JG. The human African trypanosomiasis control and surveillance programme of the World Health Organization 2000–2009: the way forward. PLoS Negl Trop Dis. 2011;5(2):e1007. - PMC - PubMed
    1. World Health Organization . Report of a WHO Informal Consultation on Sustainable Control of Human African Trypanosomiasis. May 1–3, 2007. Geneva, Switzerland: World Health Organization; 2007. [Accessed November 30, 2012]. Available from: http://whqlibdoc.who.int/hq/2007/WHO_CDS_NTD_IDM_2007.6_eng.pdf.
    1. World Health Organization . Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases. A Roadmap for Implementation. Geneva, Switzerland: World Health Organization; 2012. [Accessed November 30, 2012]. Available from: http://www.who.int/neglected_diseases/NTD_RoadMap_2012_Fullver-sion.pdf.
    1. NTD Partners Uniting to Combat Neglected Tropical Diseases. London Declaration on Neglected Tropical Diseases. [Accessed November 8, 2012]. Available from: http://www.unitingtocombatntds.org/downloads/press/london_declaration_on....

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