Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?
In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detec...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2019-08, Vol.13 (8), p.e0007550-e0007550 |
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| description | In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. The findings of this study can be used to guide future HAT and tsetse management in other gHAT foci, where reduced caseloads necessitate a shift from active to passive screening. |
| doi_str_mv | 10.1371/journal.pntd.0007550 |
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Are we on course for the 2020 target?</title><source>MEDLINE</source><source>Public Library of Science</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central</source><source>EZB Electronic Journals Library</source><source>PubMed Central Open Access</source><creator>Selby, Richard ; Wamboga, Charles ; Erphas, Olema ; Mugenyi, Albert ; Jamonneau, Vincent ; Waiswa, Charles ; Torr, Steve J ; Lehane, Michael</creator><contributor>Matovu, Enock</contributor><creatorcontrib>Selby, Richard ; Wamboga, Charles ; Erphas, Olema ; Mugenyi, Albert ; Jamonneau, Vincent ; Waiswa, Charles ; Torr, Steve J ; Lehane, Michael ; Matovu, Enock</creatorcontrib><description>In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. The findings of this study can be used to guide future HAT and tsetse management in other gHAT foci, where reduced caseloads necessitate a shift from active to passive screening.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0007550</identifier><identifier>PMID: 31412035</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>African trypanosomiasis ; Agglutination tests ; Area ; Beef cattle ; Biology ; Biology and Life Sciences ; Control ; Diagnosis ; Disease ; Disease transmission ; Earth Sciences ; Female ; Forecasts and trends ; Gambia - epidemiology ; Geographic Mapping ; Health facilities ; Health screening ; Health surveillance ; Humans ; Infection control ; Male ; Mass Screening ; Medicine ; Medicine and Health Sciences ; Microscopy ; Parasites ; People and Places ; Prevalence ; Programmes ; Protozoa ; Public Health ; Screening ; Social Sciences ; Supervision ; Transmission ; Tropical diseases ; Trypanosoma brucei gambiense - isolation & purification ; Trypanosomiasis ; Trypanosomiasis, African - diagnosis ; Trypanosomiasis, African - epidemiology ; Trypanosomiasis, African - transmission ; Uganda - epidemiology ; Vector-borne diseases</subject><ispartof>PLoS neglected tropical diseases, 2019-08, Vol.13 (8), p.e0007550-e0007550</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Selby et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. 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Are we on course for the 2020 target?</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>13</volume><issue>8</issue><spage>e0007550</spage><epage>e0007550</epage><pages>e0007550-e0007550</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. 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| subjects | African trypanosomiasis Agglutination tests Area Beef cattle Biology Biology and Life Sciences Control Diagnosis Disease Disease transmission Earth Sciences Female Forecasts and trends Gambia - epidemiology Geographic Mapping Health facilities Health screening Health surveillance Humans Infection control Male Mass Screening Medicine Medicine and Health Sciences Microscopy Parasites People and Places Prevalence Programmes Protozoa Public Health Screening Social Sciences Supervision Transmission Tropical diseases Trypanosoma brucei gambiense - isolation & purification Trypanosomiasis Trypanosomiasis, African - diagnosis Trypanosomiasis, African - epidemiology Trypanosomiasis, African - transmission Uganda - epidemiology Vector-borne diseases |
| title | Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target? |
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