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Screening strategies for a sustainable endpoint for gambiense sleeping sickness

Castaño, M. Soledad and Aliee, Maryam and Mwamba Miaka, Erick and Keeling, Matt J. and Chitnis, Nakul and Rock, Kat S.. (2020) Screening strategies for a sustainable endpoint for gambiense sleeping sickness. Journal of infectious diseases, 221 (Suppl. 5). S539-S545.

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Abstract

Gambiense human African trypanosomiasis ([gHAT] sleeping sickness) is a vector-borne disease that is typically fatal without treatment. Intensified, mainly medical-based, interventions in endemic areas have reduced the occurrence of gHAT to historically low levels. However, persistent regions, primarily in the Democratic Republic of Congo (DRC), remain a challenge to achieving the World Health Organization's goal of global elimination of transmission (EOT).; We used stochastic models of gHAT transmission fitted to DRC case data and explored patterns of regional reporting and extinction. The time to EOT at a health zone scale (~100 000 people) and how an absence of reported cases informs about EOT was quantified.; Regional epidemiology and level of active screening (AS) both influenced the predicted time to EOT. Different AS cessation criteria had similar expected infection dynamics, and recrudescence of infection was unlikely. However, whether EOT has been achieved when AS ends is critically dependent on the stopping criteria. Two or three consecutive years of no detected cases provided greater confidence of EOT compared with a single year (~66%-75% and ~82%-84% probability of EOT, respectively, compared with 31%-51%).; Multiple years of AS without case detections is a valuable measure to assess the likelihood that the EOT target has been met locally.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Disease Dynamics > Mathematical Epidemiology (Chitnis)
UniBasel Contributors:Castaño, Soledad and Chitnis, Nakul
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
ISSN:0022-1899
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
edoc DOI:
Last Modified:10 Jul 2020 12:40
Deposited On:10 Jul 2020 12:40

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