02500nas a2200337   4500000000100000008004100001260001200042653002100054653001500075653001600090653003400106653001400140653001900154100001300173700001400186700001100200700001300211700001700224700001500241700001600256700001500272700001100287700001600298700001200314245006000326856007100386300000800457490000600465520167700471022001402148       2023                            d  c03/202310aAlphonse Laveran10aDiagnostic10aElimination10aHuman African Trypanosomiasis10aTreatment10aVector control1 aSolano P1 aCourtin F1 aKaba D1 aCamara C1 aKagbadouno M1 aRayaisse J1 aJamonneau V1 aBucheton B1 aBart J1 aThévenon S1 aLejon V00a[Towards elimination of human African trypanosomiasis].  uhttp://51.210.148.129/index.php/bspe-articles/article/view/317/259  a1-90 v33 a<p>Human African Trypanosomiasis (HAT) is caused by which is transmitted by the tsetse fly insect vector ( spp). It is one of the 20 Neglected Tropical Diseases (NTD) listed by the WHO. These diseases affect the poorest and most vulnerable communities, for which the WHO has established a dedicated 2021-2030 roadmap. At the time of Alphonse Laveran, HAT devastated the African continent. In the 1960s, the disease was nearly under control, but it strongly re-emerged in the 1990s. A coordinated effort of all stakeholders, with national control programs as the main actors, a strong contribution of research and important donations by the private sector, allowed to decrease the HAT burden significantly. Since 2018, less than 1000 cases are detected annually. We here review new diagnostics, treatments and vector control tools that have been implemented jointly and successfully in several endemic countries.The next key challenge will be to sustain the gains. Newly emerging research questions include long-term carriage of trypanosomes and adaptation of tools to low prevalence contexts. Challenges out of the research area comprise the continued need of funding, maintenance of dedicated human resources, and the key question of access. Sustainable elimination as "interruption of transmission", which is the 2030 NTD roadmap target, can be reached, if these challenges are solved. We stress the importance of continuing to combine the efforts in the fight against the disease, because sustainable elimination of HAT is the best long-term prevention strategy against re-emergence. As such, HAT elimination can serve as an example for other infectious diseases.</p>
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