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Reducing Human-Tsetse Contact Significantly Enhances the Efficacy of Sleeping Sickness Active Screening Campaigns: A Promising Result in the Context of Elimination

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Courtin, Fabrice, Camara, Mamadou, Rayaisse, Jean-Baptiste, Kagbadouno, Moise, Dama, Emilie, Camara, Oumou, Traoré, Ibrahima S., Rouamba, Jérémi, Peylhard, Moana, Somda, Martin B., Leno, Mamadou, Lehane, Mike, Torr, Steve ORCID: https://orcid.org/0000-0001-9550-4030, Solano, Philippe, Jamonneau, Vincent and Bucheton, Bruno (2015) 'Reducing Human-Tsetse Contact Significantly Enhances the Efficacy of Sleeping Sickness Active Screening Campaigns: A Promising Result in the Context of Elimination'. PLoS Neglected Tropical Diseases, Vol 9, Issue 8, e0003727.

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Abstract

Background

Control of gambiense sleeping sickness, a neglected tropical disease targeted for elimination by 2020, relies mainly on mass screening of populations at risk and treatment of cases. This strategy is however challenged by the existence of undetected reservoirs of parasites that contribute to the maintenance of transmission. In this study, performed in the Boffa disease focus of Guinea, we evaluated the value of adding vector control to medical surveys and measured its impact on disease burden.

Methods

The focus was divided into two parts (screen and treat in the western part; screen and treat plus vector control in the eastern part) separated by the Rio Pongo river. Population census and baseline entomological data were collected from the entire focus at the beginning of the study and insecticide impregnated targets were deployed on the eastern bank only. Medical surveys were performed in both areas in 2012 and 2013.

Findings

In the vector control area, there was an 80% decrease in tsetse density, resulting in a significant decrease of human tsetse contacts, and a decrease of disease prevalence (from 0.3% to 0.1%; p=0.01), and an almost nil incidence of new infections (<0.1%). In contrast, incidence was 10 times higher in the area without vector control (>1%, p<0.0001) with a disease prevalence increasing slightly (from 0.5 to 0.7%, p=0.34).

Interpretation

Combining medical and vector control was decisive in reducing T. b. gambiense transmission and in speeding up progress towards elimination. Similar strategies could be applied in other foci.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 505 Diptera
QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
QX Parasitology > Insects. Other Parasites > QX 650 Insect vectors
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 705 Trypanosomiasis
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0003727
Depositing User: Lynn Roberts-Maloney
Date Deposited: 30 Sep 2015 11:24
Last Modified: 06 Feb 2018 13:10
URI: https://archive.lstmed.ac.uk/id/eprint/5338

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