@article{98587,
  keywords = {Infectious Diseases, Public Health, Environmental and Occupational Health, elimination of transmission, Human African Trypanosomiasis (HAT), Ivory Coast},
  author = {Kaba D and Koffi M and Kouakou L and N’Gouan EK and Djohan V and Courtin F and N’Djetchi MK and Coulibaly B and Adingra GP and Berté D and Ta BTD and Koné M and Traoré BM and Sutherland SA and Crump RE and Huang C and Madan J and Bessell PR and Barreaux A and Solano P and Crowley EH and Rock KS and Jamonneau V},
  editor = {Matovu E},
  title = {Towards the sustainable elimination of gambiense human African trypanosomiasis in Côte d’Ivoire using an integrated approach},
  abstract = {<p><strong>Background:</strong> Human African trypanosomiasis is a parasitic disease caused by trypanosomes among which Trypanosoma brucei gambiense is responsible for a chronic form (gHAT) in West and Central Africa. Its elimination as a public health problem (EPHP) is being achieved. Côte d’Ivoire was one of the first countries to be validated by WHO in 2020 and this was particularly challenging as the country still reported around a hundred cases a year in the early 2000s. This article describes the strategies implemented including a mathematical model to evaluate the reporting results and infer progress towards sustainable elimination.</p>

<p><strong>Methods:</strong> The control methods used combined both exhaustive and targeted medical screening strategies including the follow-up of seropositive subjects considered as potential asymptomatic carriers to diagnose and treat cases as well as vector control to reduce the risk of transmission in the most at-risk areas. A mechanistic model was used to estimate the number of underlying infections and the probability of elimination of transmission (EoT) between 2000–2021 in two endemic and two hypo-endemic health districts.</p>

<p><strong>Results:</strong> Between 2015 and 2019, nine gHAT cases were detected in the two endemic health districts of Bouaflé and Sinfra in which the number of cases/10,000 inhabitants was far below 1, a necessary condition for validating the EPHP. Modelling estimated a slow but steady decline in transmission across the four health districts, bolstered in the two endemic health districts by the introduction of vector control. The decrease in underlying transmission in all health districts corresponds to a high probability that EoT has already occurred in Côte d’Ivoire.</p>

<p><strong>Conclusion:</strong> This success was achieved through a multi-stakeholder and multidisciplinary one health approach where research has played a major role in adapting tools and strategies to this large epidemiological transition to a very low prevalence. This integrated approach will need to continue to reach the verification of EoT in Côte d’Ivoire targeted by 2025.</p>
},
  year = {2023},
  journal = {PLOS Neglected Tropical Diseases},
  volume = {17},
  pages = {1-25},
  publisher = {Public Library of Science (PLoS)},
  issn = {1935-2735},
  url = {https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011514&type=printable},
  doi = {10.1371/journal.pntd.0011514},
  language = {Eng},
}