Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?
Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?
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DOI：
10.1371/journal.pntd.0007550
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发表时间：
2019-08-01
影响因子：
3.8
通讯作者：
Lehane, Michael
中科院分区：
文献类型：
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作者：
Selby, Richard;Wamboga, Charles;Lehane, Michael
1994年，主动和被动联合筛查报告了来自乌干达西尼罗河冈比亚人类非洲锥虫病（gHAT）历史疫源地的1469例病例。自2011年以来，系统的主动筛查已经停止，转而依赖被动筛查。2014年，仅被动筛查就发现了9例病例。同年，一项采采控制干预措施扩大到西尼罗河的主要gHAT疫区，以遏制gHAT的传播，有助于消除作为该地区公共卫生问题的gHAT。众所周知，仅仅依靠被动筛查来发现病例是缓慢的，并且可能低估实际的真实数字。因此，我们开展了一项积极筛查计划，旨在测试这些干预措施对gHAT传播的有效性，并澄清疾病状况。在整个研究区随机选择28个村庄进行筛查，目的是对所有居民进行抽样。使用CATT分析10963名参与者的全血，并用显微镜和锥虫酶分析97名CATT疑似患者（0.9%）。没有发现确诊病例，这证明西尼罗河gHAT预防规划是有效的。结果证实，西尼罗河研究地区gHAT的流行率低于消除阈值（每1万人口中有1例新发病例），如果保持这种状态，将在整个研究地区逐步消除gHAT。这项研究的结果可用于指导其他gHAT重点地区未来的HAT和采采管理，在这些地区，减少病例量需要从主动筛查转向被动筛查。
In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. The findings of this study can be used to guide future HAT and tsetse management in other gHAT foci, where reduced caseloads necessitate a shift from active to passive screening.