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The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020.
PLoS Negl Trop Dis. 2022 01; 16(1):e0010047.PN

Abstract

BACKGROUND

In the 20th century, epidemics of human African trypanosomiasis (HAT) ravaged communities in a number of African countries. The latest surge in disease transmission was recorded in the late 1990s, with more than 35,000 cases reported annually in 1997 and 1998. In 2013, after more than a decade of sustained control efforts and steady progress, the World Health Assembly resolved to target the elimination of HAT as a public health problem by 2020. We report here on recent progress towards this goal.

METHODOLOGY/PRINCIPAL FINDINGS

With 992 and 663 cases reported in 2019 and 2020 respectively, the first global target was amply achieved (i.e. fewer than 2,000 HAT cases/year). Areas at moderate or higher risk of HAT, where more than 1 case/10,000 people/year are reported, shrunk to 120,000 km2 for the five-year period 2016-2020. This reduction of 83% from the 2000-2004 baseline (i.e. 709,000 km2) is slightly below the target (i.e. 90% reduction). As a result, the second global target for HAT elimination as a public health problem cannot be considered fully achieved yet. The number of health facilities able to diagnose and treat HAT expanded (+9.6% compared to a 2019 survey), thus reinforcing the capacity for passive detection and improving epidemiological knowledge of the disease. Active surveillance for gambiense HAT was sustained. In particular, 2.8 million people were actively screened in 2019 and 1.6 million in 2020, the decrease in 2020 being mainly caused by COVID-19-related restrictions. Togo and Côte d'Ivoire were the first countries to be validated for achieving elimination of HAT as a public health problem at the national level; applications from three additional countries are under review by the World Health Organization (WHO).

CONCLUSIONS/SIGNIFICANCE

The steady progress towards the elimination of HAT is a testament to the power of multi-stakeholder commitment and coordination. At the end of 2020, the World Health Assembly endorsed a new road map for 2021-2030 that set new bold targets for neglected tropical diseases. While rhodesiense HAT remains among the diseases targeted for elimination as a public health problem, gambiense HAT is targeted for elimination of transmission. The goal for gambiense HAT is expected to be particularly arduous, as it might be hindered by cryptic reservoirs and a number of other challenges (e.g. further integration of HAT surveillance and control into national health systems, availability of skilled health care workers, development of more effective and adapted tools, and funding for and coordination of elimination efforts).

Links

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Authors+Show Affiliations

Franco JR
World Health Organization, Control of Neglected Tropical Diseases, Prevention Treatment and Care, Geneva, Switzerland.
Cecchi G
Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Rome, Italy.
Paone M
Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Rome, Italy.
Diarra A
World Health Organization, Regional Office for Africa, Communicable Disease Unit, Brazzaville, Congo.
Grout L
World Health Organization, Control of Neglected Tropical Diseases, Prevention Treatment and Care, Geneva, Switzerland.
Kadima Ebeja A
World Health Organization, Regional Office for Africa, Communicable Disease Unit, Brazzaville, Congo.
Simarro PP
Consultant, World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland.
Zhao W
Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Rome, Italy.
Argaw D
World Health Organization, Control of Neglected Tropical Diseases, Prevention Treatment and Care, Geneva, Switzerland.

MeSH

Africa South of the SaharaAnimalsEndemic DiseasesHumansInsect ControlInsect VectorsTrypanosoma brucei bruceiTrypanosoma brucei gambienseTrypanosoma brucei rhodesienseTrypanosomiasis, AfricanTsetse FliesWorld Health Organization

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35041668

Citation

Franco, Jose R., et al. "The Elimination of Human African Trypanosomiasis: Achievements in Relation to WHO Road Map Targets for 2020." PLoS Neglected Tropical Diseases, vol. 16, no. 1, 2022, pp. e0010047.
Franco JR, Cecchi G, Paone M, et al. The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020. PLoS Negl Trop Dis. 2022;16(1):e0010047.
Franco, J. R., Cecchi, G., Paone, M., Diarra, A., Grout, L., Kadima Ebeja, A., Simarro, P. P., Zhao, W., & Argaw, D. (2022). The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020. PLoS Neglected Tropical Diseases, 16(1), e0010047. https://doi.org/10.1371/journal.pntd.0010047
Franco JR, et al. The Elimination of Human African Trypanosomiasis: Achievements in Relation to WHO Road Map Targets for 2020. PLoS Negl Trop Dis. 2022;16(1):e0010047. PubMed PMID: 35041668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020. AU - Franco,Jose R, AU - Cecchi,Giuliano, AU - Paone,Massimo, AU - Diarra,Abdoulaye, AU - Grout,Lise, AU - Kadima Ebeja,Augustin, AU - Simarro,Pere P, AU - Zhao,Weining, AU - Argaw,Daniel, Y1 - 2022/01/18/ PY - 2021/09/21/received PY - 2021/12/02/accepted PY - 2022/1/18/entrez PY - 2022/1/19/pubmed PY - 2022/2/12/medline SP - e0010047 EP - e0010047 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 16 IS - 1 N2 - BACKGROUND: In the 20th century, epidemics of human African trypanosomiasis (HAT) ravaged communities in a number of African countries. The latest surge in disease transmission was recorded in the late 1990s, with more than 35,000 cases reported annually in 1997 and 1998. In 2013, after more than a decade of sustained control efforts and steady progress, the World Health Assembly resolved to target the elimination of HAT as a public health problem by 2020. We report here on recent progress towards this goal. METHODOLOGY/PRINCIPAL FINDINGS: With 992 and 663 cases reported in 2019 and 2020 respectively, the first global target was amply achieved (i.e. fewer than 2,000 HAT cases/year). Areas at moderate or higher risk of HAT, where more than 1 case/10,000 people/year are reported, shrunk to 120,000 km2 for the five-year period 2016-2020. This reduction of 83% from the 2000-2004 baseline (i.e. 709,000 km2) is slightly below the target (i.e. 90% reduction). As a result, the second global target for HAT elimination as a public health problem cannot be considered fully achieved yet. The number of health facilities able to diagnose and treat HAT expanded (+9.6% compared to a 2019 survey), thus reinforcing the capacity for passive detection and improving epidemiological knowledge of the disease. Active surveillance for gambiense HAT was sustained. In particular, 2.8 million people were actively screened in 2019 and 1.6 million in 2020, the decrease in 2020 being mainly caused by COVID-19-related restrictions. Togo and Côte d'Ivoire were the first countries to be validated for achieving elimination of HAT as a public health problem at the national level; applications from three additional countries are under review by the World Health Organization (WHO). CONCLUSIONS/SIGNIFICANCE: The steady progress towards the elimination of HAT is a testament to the power of multi-stakeholder commitment and coordination. At the end of 2020, the World Health Assembly endorsed a new road map for 2021-2030 that set new bold targets for neglected tropical diseases. While rhodesiense HAT remains among the diseases targeted for elimination as a public health problem, gambiense HAT is targeted for elimination of transmission. The goal for gambiense HAT is expected to be particularly arduous, as it might be hindered by cryptic reservoirs and a number of other challenges (e.g. further integration of HAT surveillance and control into national health systems, availability of skilled health care workers, development of more effective and adapted tools, and funding for and coordination of elimination efforts). SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/35041668/The_elimination_of_human_African_trypanosomiasis:_Achievements_in_relation_to_WHO_road_map_targets_for_2020_ DB - PRIME DP - Unbound Medicine ER -