Monitoring the elimination of human African trypanosomiasis: Update to 2014.

José R Franco,Gerardo Priotto,Massimo Paone,Lise Grout,Abdoulaye Diarra,Daniel Argaw,Raffaele C Mattioli,Giuliano Cecchi,Marleen Boelaert

doi:10.1371/journal.pntd.0005585

Abstract

BackgroundThe World Health Organization (WHO) has targeted the elimination of Human African trypanosomiasis (HAT) ‘as a public health problem’ by 2020. The selected indicators of elimination should be monitored every two years, and we provide here a comprehensive update to 2014. The monitoring system is underpinned by the Atlas of HAT.ResultsWith 3,797 reported cases in 2014, the corresponding milestone (5,000 cases) was surpassed, and the 2020 global target of ‘fewer than 2,000 reported cases per year’ seems within reach. The areas where HAT is still a public health problem (i.e. > 1 HAT reported case per 10,000 people per year) have halved in less than a decade, and in 2014 they corresponded to 350 thousand km2. The number and potential coverage of fixed health facilities offering diagnosis and treatment for HAT has expanded, and approximately 1,000 are now operating in 23 endemic countries. The observed trends are supported by sustained surveillance and improved reporting.DiscussionHAT elimination appears to be on track. For gambiense HAT, still accounting for the vast majority of reported cases, progress continues unabated in a context of sustained intensity of screening activities. For rhodesiense HAT, a slow-down was observed in the last few years. Looking beyond the 2020 target, innovative tools and approaches will be increasingly needed. Coordination, through the WHO network for HAT elimination, will remain crucial to overcome the foreseeable and unforeseeable challenges that an elimination process will inevitably pose.

Highlights

In the last decade of the 20th century, the number of cases of human African trypanosomiasis (HAT), known as sleeping sickness, reached alarming levels [1,2,3,4]
The areas where Human African trypanosomiasis (HAT) is still a public health problem (i.e. > 1 HAT reported case per 10,000 people per year) have halved in less than a decade, and in 2014 they corresponded to 350 thousand km2
In this paper we provide a comprehensive update of the indicators of HAT elimination to 2014, including number of reported cases and the areas and populations at risk

Summary

Introduction

In the last decade of the 20th century, the number of cases of human African trypanosomiasis (HAT), known as sleeping sickness, reached alarming levels [1,2,3,4] In reaction to this epidemiological situation of a lethal disease, a number of stakeholders came together to support the affected countries. In the early years of the 21st century, the World Health Organization (WHO) launched a public-private partnership that, together with important efforts from bilateral cooperation and non-governmental organizations (NGOs), enabled to reverse the epidemiological trend [5]. In this process, the key role was played by the National Sleeping Sickness Control Programmes (NSSCPs) of endemic countries and their committed health workers. The monitoring system is underpinned by the Atlas of HAT

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Conclusion