@article{26591,
  keywords = {Vector control, Trypanosomiasis, Sleeping sickness},
  author = {Tirados I and Esterhuizen J and Kovacic V and Mangwiro CT N and Vale GA and Hastings I and Solano P and Lehane M and Torr SJ},
  title = {Tsetse control and Gambian sleeping sickness; Implications for control strategy.},
  abstract = {<p><strong>BACKGROUND: </strong>Gambian sleeping sickness (human African trypanosomiasis, HAT) outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT.</p>

<p><strong>METHODS AND FINDINGS: </strong>The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve &gt;90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2). In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings.</p>

<p><strong>INTERPRETATION: </strong>The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised.</p>
},
  year = {2015},
  journal = {PLoS neglected tropical diseases},
  volume = {9},
  pages = {e0003822},
  issn = {1935-2735},
  url = {http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003822 },
  doi = {10.1371/journal.pntd.0003822},
  language = {eng},
}