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WHO interim guidelines for the treatment of gambiense human African trypanosomiasis

Minguell, J.R. Franco (ed) (2019) WHO interim guidelines for the treatment of gambiense human African trypanosomiasis, France, World Health Organization.

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Human African trypanosomiasis (HAT), or sleeping sickness, is a parasitic infection that is almost invariably fatal unless treated. It is a neglected tropical disease that occurs in sub-Saharan Africa.

The incidence of the disease is declining in response to intensive surveillance and control in endemic areas. As a result, HAT is among the neglected tropical diseases targeted by the World Health Organization (WHO) for elimination. WHO maintains exhaustive records of all declared cases; in 2018, a historically low number of cases (less than 1000) was reported.

The remarkable progress in the control of gambiense HAT has relied on case-finding and curative treatment, a strategy that interrupts transmission by depleting the reservoir of parasites in humans. This has been combined occasionally with vector control activities. The subject of these guidelines, therefore, is of utmost importance for the continuation of progress to eliminate HAT.

The recent approval of a new medicine (fexinidazole) for the treatment of gambiense HAT has opened new possibilities for the management of cases and thus warrants the new WHO recommendations contained herein. While studies of fexinidazole and other therapies are ongoing, these guidelines are considered interim guidelines until new information becomes available.

This document focuses on the management of patients affected by gambiense HAT and constitutes an update to the WHO therapeutic guidance issued in 2013.

Item Type: Book
Corporate Authors: World Health Organization
Additional Information: The World Health Organization (WHO) is sincerely grateful to the many professionals from a range of backgrounds and specialties who contributed their time and expertise to the development of this guidance. Guideline Development Group Members: Andreas Lindner (Institute of Tropical Medicine and International Health, Berlin), Erick Mwamba (Ministry of Health, Democratic Republic of the Congo), François Chappuis (Hôpitaux Universitaires de Genève), Jorge Seixas (Instituto de Higiene e Medicina Tropical, Lisbon), Leon Kazumba (University of Kinshasa), Michael Barrett (University of Glasgow), Olema Erphas (Ministry of Health, Uganda), Veerle Lejon (Institut de Recherche pour le Développement, Montpellier)Guidelines methodologist: Elie Akl (American University of Beirut, Lebanon)Experts providing specialized input on clinical assessment aspects: Johannes Blum (Swiss Tropical and Public Health Institute, Basel), Peter Kennedy (University of Glasgow, UK)WHO Secretariat: Abdoulaye Diarra (AF/RGO/CDS/CDU, Brazzaville, Augustin Kadima Ebeja (AF/ACO/SRC/COD/CD3, Kinshasa), Gerardo Priotto, Jose Ramon Franco Minguell, Pere Perez Simarro, Raquel Mercado (HQ/CDS/NTD/IDM), Geneva.External peer reviewThe following experts reviewed the pre-final guidelines document and provided valuable input: Serena Kasparian (Médecins Sans Frontières, Montreal), Philippe Büscher (Institute of Tropical Medicine, Antwerp), Enock Matovu (Makerere University, Kampala, Uganda), Vincent Jamonneau (Institut de Recherche pour le Développement, Montpellier).Systematic evidence reviewThe following researchers conducted the systematic reviews and developed the evidence profiles and GRADE tables: Gemma Villanueva (senior systematic reviewer and lead reviewer, Cochrane Response), Hanna Bergman (systematic reviewer, Cochrane Response), Katrin Probyn (systematic reviewer, Cochrane Response), Nicholas Henschke (senior systematic reviewer, Cochrane Response), Chantelle Garritty (senior scientist, Cochrane Response), Vittoria Lutje (information specialist, Cochrane Infectious Diseases Group, UK), Paul Garner (principal investigator, Cochrane Infectious Diseases Group, UK).Conceptual validation with usersThe changes to recommendations were discussed and validated conceptually with the directors or focal points of national sleeping sickness control programmes of the following disease-endemic countries: Benin, Burkina Faso, Cameroon, Congo, Côte d’Ivoire, Gabon, Ghana, Guinea, Equatorial Guinea, Mali, Nigeria, South Sudan, Central African Republic, Democratic Republic of the Congo, Chad and Togo. Overall coordinationGerardo Priotto and Jose Ramon Franco Minguell (HAT Programme, WHO) coordinated the development of the guidelines. Steering CommitteeThe Guidelines Steering Committee comprised the following WHO staff: Abdoulaye Diarra (Communicable Diseases Unit (AF/RGO/CDS/CDU), Brazzaville), Gerardo Priotto, Jose Ramon Franco Minguell, Daniel Dagne, Sophie Lambert and Lise Grout (Innovative and Intensified Disease Management (HQ/CDS/NTD/IDM), Geneva), Nicola Magrini, (Innovation, Accessand Use (HQ/HIS/EMP/IAU), Geneva) and Pere Perez Simarro (Consultant).
Subjects: WA Public Health > Health Administration and Organization > WA 530 International health administration
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 705 Trypanosomiasis
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Depositing User: Christianne Esparza
Date Deposited: 18 Oct 2019 13:55
Last Modified: 18 Oct 2019 13:55


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