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Modelling to Quantify the Likelihood that Local Elimination of Transmission has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data.
Clin Infect Dis. 2021 06 14; 72(Suppl 3):S146-S151.CI

Abstract

BACKGROUND

The gambiense human African trypanosomiasis (gHAT) elimination programme in the Democratic Republic of Congo (DRC) routinely collects case data through passive surveillance and active screening, with several regions reporting no cases for several years, despite being endemic in the early 2000s.

METHODS

We use mathematical models fitted to longitudinal data to estimate the probability that selected administrative regions have already achieved elimination of transmission (EOT) of gHAT. We examine the impact of active screening coverage on the certainty of model estimates for transmission and therefore the role of screening in the measurement of EOT.

RESULTS

In 3 example health zones of Sud-Ubangi province, we find there is a moderate (>40%) probability that EOT has been achieved by 2018, based on 2000-2016 data. Budjala and Mbaya reported zero cases during 2017-18, and this further increases our respective estimates to 99.9% and 99.6% (model S) and to 87.3% and 92.1% (model W). Bominenge had recent case reporting, however, that if zero cases were found in 2021, it would substantially raise our certainty that EOT has been met there (99.0% for model S and 88.5% for model W); this could be higher with 50% coverage screening that year (99.1% for model S and 94.0% for model W).

CONCLUSIONS

We demonstrate how routine surveillance data coupled with mechanistic modeling can estimate the likelihood that EOT has already been achieved. Such quantitative assessment will become increasingly important for measuring local achievement of EOT as 2030 approaches.

Authors+Show Affiliations

Mathematics Institute, University of Warwick, Coventry, United Kingdom. Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom.Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. University of Basel, Basel, Switzerland.Mathematics Institute, University of Warwick, Coventry, United Kingdom. Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom.Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom. Department of Statistics, University of Warwick, Coventry, United Kingdom.Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Kinshasa, the Democratic Republic of the Congo.Mathematics Institute, University of Warwick, Coventry, United Kingdom. Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom. School of Life Science, University of Warwick, Coventry, United Kingdom.Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom. Department of Statistics, University of Warwick, Coventry, United Kingdom.Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. University of Basel, Basel, Switzerland.Mathematics Institute, University of Warwick, Coventry, United Kingdom. Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33905480

Citation

Davis, Christopher N., et al. "Modelling to Quantify the Likelihood That Local Elimination of Transmission Has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 72, no. Suppl 3, 2021, pp. S146-S151.
Davis CN, Castaño MS, Aliee M, et al. Modelling to Quantify the Likelihood that Local Elimination of Transmission has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data. Clin Infect Dis. 2021;72(Suppl 3):S146-S151.
Davis, C. N., Castaño, M. S., Aliee, M., Patel, S., Miaka, E. M., Keeling, M. J., Spencer, S. E. F., Chitnis, N., & Rock, K. S. (2021). Modelling to Quantify the Likelihood that Local Elimination of Transmission has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 72(Suppl 3), S146-S151. https://doi.org/10.1093/cid/ciab190
Davis CN, et al. Modelling to Quantify the Likelihood That Local Elimination of Transmission Has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data. Clin Infect Dis. 2021 06 14;72(Suppl 3):S146-S151. PubMed PMID: 33905480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modelling to Quantify the Likelihood that Local Elimination of Transmission has Occurred Using Routine Gambiense Human African Trypanosomiasis Surveillance Data. AU - Davis,Christopher N, AU - Castaño,María Soledad, AU - Aliee,Maryam, AU - Patel,Swati, AU - Miaka,Erick Mwamba, AU - Keeling,Matt J, AU - Spencer,Simon E F, AU - Chitnis,Nakul, AU - Rock,Kat S, PY - 2021/4/28/pubmed PY - 2021/7/6/medline PY - 2021/4/27/entrez KW - gambiense human African trypanosomiasis (gHAT) KW - elimination of transmission KW - modeling KW - surveillance SP - S146 EP - S151 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 72 IS - Suppl 3 N2 - BACKGROUND: The gambiense human African trypanosomiasis (gHAT) elimination programme in the Democratic Republic of Congo (DRC) routinely collects case data through passive surveillance and active screening, with several regions reporting no cases for several years, despite being endemic in the early 2000s. METHODS: We use mathematical models fitted to longitudinal data to estimate the probability that selected administrative regions have already achieved elimination of transmission (EOT) of gHAT. We examine the impact of active screening coverage on the certainty of model estimates for transmission and therefore the role of screening in the measurement of EOT. RESULTS: In 3 example health zones of Sud-Ubangi province, we find there is a moderate (>40%) probability that EOT has been achieved by 2018, based on 2000-2016 data. Budjala and Mbaya reported zero cases during 2017-18, and this further increases our respective estimates to 99.9% and 99.6% (model S) and to 87.3% and 92.1% (model W). Bominenge had recent case reporting, however, that if zero cases were found in 2021, it would substantially raise our certainty that EOT has been met there (99.0% for model S and 88.5% for model W); this could be higher with 50% coverage screening that year (99.1% for model S and 94.0% for model W). CONCLUSIONS: We demonstrate how routine surveillance data coupled with mechanistic modeling can estimate the likelihood that EOT has already been achieved. Such quantitative assessment will become increasingly important for measuring local achievement of EOT as 2030 approaches. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/33905480/Modelling_to_Quantify_the_Likelihood_that_Local_Elimination_of_Transmission_has_Occurred_Using_Routine_Gambiense_Human_African_Trypanosomiasis_Surveillance_Data_ DB - PRIME DP - Unbound Medicine ER -