Abstract
In the Democratic Republic of Congo (DRC), human African trypanosomiasis (HAT) reached unprecedented levels in the 1990s. To assess recent trends and evaluate control efforts, we analyzed epidemiologic and financial data collected by all agencies involved in HAT control in DRC from 1993 to 2003. Funds allocated to control populations, as well as to the population screened, doubled from 1993 to 1997 and from 1998 to 2003. The number of cases detected decreased from 26,000 new cases per year in 1998 to 11,000 in 2003. Our analysis shows that HAT control in DRC is almost completely dependent on international aid and that sudden withdrawal of such aid in 1990 had a long-lasting effect. Since 1998, control efforts intensified because of renewed donor interest, including a public-private partnership, and this effort led to a major reduction in HAT incidence. To avoid reemergence of this disease, such efforts should be sustained.
Highlights
In the Democratic Republic of Congo (DRC), human African trypanosomiasis (HAT) reached unprecedented levels in the 1990s
We examined the recent trends of HAT in DRC and evaluated the effects and sustainability of the control program
After 1998, a marked decline occurred in the number of HAT cases detected, which was not due to an overall decrease in screening activities; the number of operational mobile teams and number of screened persons continued to increase over that period (Figure 3)
Summary
In the Democratic Republic of Congo (DRC), human African trypanosomiasis (HAT) reached unprecedented levels in the 1990s. To assess recent trends and evaluate control efforts, we analyzed epidemiologic and financial data collected by all agencies involved in HAT control in DRC from 1993 to 2003. Human African trypanosomiasis (HAT), or sleeping sickness, is a vectorborne disease caused by the parasite Trypanosoma brucei. The only proven effective way to control T.b. gambiense HAT is mass population screening and treatment of those infected. SanofiAventis donated the 3 most used anti-HAT drugs (DFMO [difluoromethylornithine], melarsoprol, and pentamidine) for 5 years and offered funding for disease control and innovative research. Bayer AG (Leverkusen, Germany) has donated a 5-year supply of suramin, another anti-HAT drug. We examined the recent trends of HAT in DRC and evaluated the effects and sustainability of the control program
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