Predicting the impact of COVID-19 interruptions on transmission of gambiense human African trypanosomiasis in two health zones of the Democratic Republic of Congo

Predicting the impact of COVID-19 interruptions on transmission of gambiense human African trypanosomiasis in two health zones of the Democratic Republic of Congo
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预测 COVID-19 中断对刚果民主共和国两个卫生区冈比亚人类非洲锥虫病传播的影响

DOI:
10.1101/2020.10.26.20219485
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发表时间:
2020
期刊:
--
影响因子:
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通讯作者:
Aliee M
Aliee M
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作者:
Aliee M

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由于 2019 年冠状病毒病 (COVID-19) 大流行,许多针对被忽视的热带病的控制计划已被中断,包括那些依赖于主动病例发现的控制计划。在这项研究中,我们重点关注非洲人类锥虫病 (gHAT),由于该流行病,刚果民主共和国 (DRC) 暂停了主动筛查。我们使用两个独立的数学模型来预测 COVID-19 中断对刚果民主共和国两个中等风险地区的传播和报告以及 2030 年 gHAT 消除传播 (EOT) 目标的影响。我们考虑了不同的中断情景,包括减少固定卫生设施的被动监测,以及这种暂停是否持续到 2020 年底或 2021 年。我们的模型预测,只有主动筛查和被动监测都暂停时,中断期间新感染人数才会增加,如果被动监测仍然充分发挥作用,则新感染人数会缓慢减少,但不会增加。在所有情况下,如果不采取缓解措施(例如增加筛查覆盖率),EOT 可能会略有推迟。然而,我们强调,最大的挑战仍将存在于流行率较高的地区,除非加强干预措施,否则预计 EOT 将持续落后于计划。
Many control programmes against neglected tropical diseases have been interrupted due to the coronavirus disease 2019 (COVID-19) pandemic, including those that rely on active case finding. In this study we focus ongambiensehuman African trypanosomiasis (gHAT), where active screening was suspended in the Democratic Republic of Congo (DRC) due to the pandemic. We use two independent mathematical models to predict the impact of COVID-19 interruptions on transmission and reporting and achievement of the 2030 elimination of transmission (EOT) goal for gHAT in two moderate-risk regions of the DRC. We consider different interruption scenarios, including reduced passive surveillance in fixed health facilities, and whether this suspension lasts until the end of 2020 or 2021. Our models predict an increase in the number of new infections in the interruption period only if both active screening and passive surveillance were suspended, and with a slowed reduction—but no increase—if passive surveillance remains fully functional. In all scenarios, the EOT may be slightly pushed back if no mitigation, such as increased screening coverage, is put in place. However, we emphasise that the biggest challenge will remain in the higher-prevalence regions where EOT is already predicted to be behind schedule without interruptions unless interventions are bolstered.
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