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. 2017 May 22;11(5):e0005585.
doi: 10.1371/journal.pntd.0005585. eCollection 2017 May.

Monitoring the elimination of human African trypanosomiasis: Update to 2014

José R Franco  1 , Giuliano Cecchi  2 , Gerardo Priotto  1 , Massimo Paone  3 , Abdoulaye Diarra  4 , Lise Grout  1 , Raffaele C Mattioli  3 , Daniel Argaw  1
Affiliations

Monitoring the elimination of human African trypanosomiasis: Update to 2014

José R Franco et al. PLoS Negl Trop Dis. .

Abstract

Background: The World Health Organization (WHO) has targeted the elimination of Human African trypanosomiasis (HAT) 'as a public health problem' by 2020. The selected indicators of elimination should be monitored every two years, and we provide here a comprehensive update to 2014. The monitoring system is underpinned by the Atlas of HAT.

Results: With 3,797 reported cases in 2014, the corresponding milestone (5,000 cases) was surpassed, and the 2020 global target of 'fewer than 2,000 reported cases per year' seems within reach. The areas where HAT is still a public health problem (i.e. > 1 HAT reported case per 10,000 people per year) have halved in less than a decade, and in 2014 they corresponded to 350 thousand km2. The number and potential coverage of fixed health facilities offering diagnosis and treatment for HAT has expanded, and approximately 1,000 are now operating in 23 endemic countries. The observed trends are supported by sustained surveillance and improved reporting.

Discussion: HAT elimination appears to be on track. For gambiense HAT, still accounting for the vast majority of reported cases, progress continues unabated in a context of sustained intensity of screening activities. For rhodesiense HAT, a slow-down was observed in the last few years. Looking beyond the 2020 target, innovative tools and approaches will be increasingly needed. Coordination, through the WHO network for HAT elimination, will remain crucial to overcome the foreseeable and unforeseeable challenges that an elimination process will inevitably pose.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
(a) Total number of reported cases of HAT (gambiense and rhodesiense) per year. The green line shows the milestones set in the WHO Roadmap for HAT elimination [7]. (b) Number of reported cases of gambiense HAT per year and per country. (c) Number of reported cases of rhodesiense HAT per year and per country.
Fig 2
Fig 2. Number of people screened by active case-finding surveys, in countries endemic for T. b. gambiense (2000–2014).
Fig 3
Fig 3. The distribution of human African trypanosomiasis.
Period 2010–2014. Red circles (gambiense HAT cases) are plotted so as to overlay green circles (active screening campaigns in which no HAT case was detected). As a result, only the green circles that are at the fringes of gambiense HAT distribution are visible.
Fig 4
Fig 4. The areas at risk of HAT infection.
Period 2010–2014.
Fig 5
Fig 5. Trends in areas at risk of gambiense HAT (a) and rhodesiense HAT (b) from 2000–2004 to 2010–2014.
Fig 6
Fig 6. Trends in population at risk of gambiense HAT (a) and rhodesiense HAT (b) from 2000–2004 to 2010–2014.
Fig 7
Fig 7. Geographic distribution of fixed health facilities offering diagnosis and treatment of gambiense and rhodesiense HAT.
Data were collected by WHO from National Sleeping Sickness Control Programmes between September 2015 and April 2016.
See this image and copyright information in PMC

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