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Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?

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Selby, Richard ORCID: https://orcid.org/0000-0002-3034-8345, Wamboga, Charles, Erphas, Olema, Mugenyi, Albert, Jamonneau, Vincent, Waiswa, Charles, Torr, Steve ORCID: https://orcid.org/0000-0001-9550-4030 and Lehane, Mike (2019) 'Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?'. PLoS Neglected Tropical Diseases, Vol 13, Issue 8, e0007550.

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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. 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.

Item Type: Article
Subjects: WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Preventive Medicine > WA 243 Diagnositic services
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 695 Parasitic diseases (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 705 Trypanosomiasis
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0007550
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 15 Aug 2019 11:27
Last Modified: 16 Aug 2019 07:52
URI: https://archive.lstmed.ac.uk/id/eprint/11433

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