Medical tests can quickly reduce sleeping sickness in key locations

In 2012, the World Health Organization set two public health targets for Gambia’s sleeping sickness, a parasitic disease transmitted by the tsetse fly. The first goal is to eliminate the disease as a public health problem, with fewer than 2,000 cases by 2020. The second goal is to achieve zero global transmission by 2030. Now, by mathematically simulating the impact of different intervention strategies, researchers report that in PLOS, Neglected Tropical Diseases describe how a two-pronged approach combining medical intervention and vector control can greatly accelerate the elimination of high-risk diseases in the Democratic Republic of Congo (DRC). Sleeping sickness in burdened areas.

Gambian sleeping sickness, or human African trypanosomiasis, is caused by a parasite called Trypanosoma brucei gambiense, carried by tsetse flies in Central and West Africa. Without treatment, the disease often leads to death. In recent years, intensive active and passive screening has been planned to help reduce disease incidence, and some regions have also combined these medical interventions with vector control. But some high-endemic areas in the Democratic Republic of Congo have yet to achieve disease reductions in other parts of Africa.

In the new work, author Kat Rock and colleagues at the University of Warwick, UK, developed a sophisticated mathematical model to calculate the effects of intervention strategies on tsetse fly and human population dynamics. They used these models to compare the effectiveness of six key strategies and two regional (located within the former Bandundu province) DRC within two regions. The researchers can then conclude which strategies hold the most promise for controlling and eliminating the disease.

The model concluded that strategies that rely solely on self-reported disease and screening of low-risk individuals are unlikely to lead to the elimination of sleeping sickness transmission by 2030, but to delay elimination until the next century. However, improving screening to make screening equally for all, regardless of risk factors, could eliminate elimination as a public health problem between 2023 and 2031.

  

If vector control strategies are added – such as those that use insecticide-coated “tsetse fly targets” to attract and kill flies – this elimination target is likely to be achieved within four years when combined with any screening method. If the Democratic Republic of Congo adopts any of the new strategies with vector control, transmission could be broken within six years of launching the new program in those regions, and more than 6,000 cases could be avoided between 2017 and 2030, the researchers said. case.

“We found that vector control has great potential to reduce transmission, and even if it is less effective than other regions in reducing tsetse populations, the goal of complete elimination could still be achieved by 2030,” the researchers wrote. “We recommend that control programs use a combination of medical and vector control strategies to help combat sleeping sickness.”

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