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

Authors Simarro P, Franco J, Diarra A, Ruiz Postigo JA, Jannin J

Received 10 November 2012

Accepted for publication 14 December 2012

Published 5 February 2013 Volume 2013:4 Pages 1—6


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

PP Simarro,1 JR Franco,1 A Diarra,2 JA Ruiz Postigo,3 J Jannin1

1World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland; 2World Health Organization, Regional Office for Africa, Brazzaville, Congo; 3World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt

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

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