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Table of Contents   
LETTER TO THE EDITOR  
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 438-439
Human African trypanosomiasis: Aiming to eliminate the disease by 2020


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication14-Nov-2016
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Human African trypanosomiasis: Aiming to eliminate the disease by 2020. Ann Trop Med Public Health 2016;9:438-9

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Human African trypanosomiasis: Aiming to eliminate the disease by 2020. Ann Trop Med Public Health [serial online] 2016 [cited 2017 Mar 28];9:438-9. Available from: http://www.atmph.org/text.asp?2016/9/6/438/193975
Dear Sir,

Human African trypanosomiasis is a vector-borne neglected tropical disease, reported across more than 36 sub-Saharan Africa nations, and is predominantly transmitted to humans by the bites of the tsetse fly.[1],[2] In fact, the estimates for the year 2014 suggest that close to 3800 cases of disease were reported among the affected nations and the lives of millions of people are threatened simultaneously.[1] The Democratic Republic of the Congo alone accounts for almost 85% of the overall cases.[1]

The patients of the disease have two phases, namely a prolonged asymptomatic and a neurological phase, which is associated with various complications.[2] It is extremely frequent among the rural populations who are involved in occupations such as agriculture and fishing which directly increases the potential risk for exposure to the tsetse fly.[1],[2] In addition, epidemiological determinants such as population displacement and poverty plays a defining role in promoting the disease transmission.[1],[2],[3]

However, it is quite an encouraging fact that owing to the sustained efforts of the World Health Organization, national programs, and through the support of nongovernmental agencies, the number of disease cases has reduced to <10,000 in the last five decades and no major outbreaks of the disease have been reported since the 1990.[1],[2] Further, it has been aimed to eliminate the disease as a public health concern from the entire African region by the year 2020.[1],[4]

A wide range of challenges like the infection being more common among the remote rural settings, where the infected people have a limited access to the health services; defects in the completeness of the surveillance and precise estimates of the disease; necessity to conduct an exhaustive and active screening of the population at risk as the disease has a long asymptomatic phase; over-reliance on mass screening of populations at risk and treatment of cases to achieve elimination, while a large number of undetected reservoirs of parasites are prevalent in the region and maintain the transmission; extensive investment of human and material resources; the complex nature of the diagnostics as it requires the assistance of a skilled professional; fatal nature of the disease in the absence of appropriate treatment; extent of the safety of the drugs in the second stage of the disease; follow-up extending up to 24 months; and high-risk treatment procedures, have been identified.[2],[3],[4]

In an attempt to eliminate the disease, there is a great need to implement a multi-pronged approach comprising of strategies such as strengthening of the surveillance systems; ensuring coordination among various vector control measures and field activities; promoting access to the diagnosis and the best treatment; monitoring drug intake and emergence of drug resistance; conducting training of the health staff; facilitating operational research to improve diagnostic/treatment tools and better understand the epidemiological trends/determinants; promoting collaboration with different international agencies; and by facilitating public-private partnership to assist the endemic nations in their control activities and drug supply.[1],[2],[3],[4],[5] In addition, other activities like strengthening animal trypanosomiasis-related measures, and encouraging climate change research activities has also delivered encouraging results to contain the disease.[4],[6]

To conclude, human African trypanosomiasis continues to remain a public health concern across African region, and as the health sector is well equipped with the needed logistics and support, all the stakeholders should work in collaboration to eliminate the disease by the end of this decade.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. Trypanosomiasis, Human African (Sleeping Sickness); 2016. Available from: http://www.who.int/mediacentre/factsheets/fs259/en/. [Last accessed on 2016 Mar 04].  Back to cited text no. 1
    
2.
Tirados I, Esterhuizen J, Kovacic V, Mangwiro TN, Vale GA, Hastings I, et al. Tsetse control and gambian sleeping sickness; implications for control strategy. PLoS Negl Trop Dis 2015;9:e0003822.  Back to cited text no. 2
    
3.
Courtin F, Camara M, Rayaisse JB, Kagbadouno M, Dama E, Camara O, et al. Reducing human-tsetse contact significantly enhances the efficacy of sleeping sickness active screening campaigns: A promising result in the context of elimination. PLoS Negl Trop Dis 2015;9:e0003727.  Back to cited text no. 3
    
4.
Simo G, Rayaisse JB. Challenges facing the elimination of sleeping sickness in West and Central Africa: Sustainable control of animal trypanosomiasis as an indispensable approach to achieve the goal. Parasit Vectors 2015;8:640.  Back to cited text no. 4
    
5.
Pandey A, Atkins KE, Bucheton B, Camara M, Aksoy S, Galvani AP, et al. Evaluating long-term effectiveness of sleeping sickness control measures in Guinea. Parasit Vectors 2015;8:550.  Back to cited text no. 5
    
6.
World Health Organization. Sleeping Sickness Outbreaks Prevented by Climate Change Research; 2015. Available from: http://www.who.int/features/2015/climate-change-research/en/. [Last accessed on 2016 Mar 04].  Back to cited text no. 6
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur–Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.193975

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