Dataset Information

Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling.

ABSTRACT: Control of gambiense sleeping sickness relies predominantly on passive and active screening of people, followed by treatment.Mathematical modeling explores the potential of 3 complementary interventions in high- and low-transmission settings.Intervention strategies that included vector control are predicted to halt transmission most quickly. Targeted active screening, with better and more focused coverage, and enhanced passive surveillance, with improved access to diagnosis and treatment, are both estimated to avert many new infections but, when used alone, are unlikely to halt transmission before 2030 in high-risk settings.There was general model consensus in the ranking of the 3 complementary interventions studied, although with discrepancies between the quantitative predictions due to differing epidemiological assumptions within the models. While these predictions provide generic insights into improving control, the most effective strategy in any situation depends on the specific epidemiology in the region and the associated costs.

SUBMITTER: Rock KS

PROVIDER: S-EPMC5982708 | biostudies-other | 2018 Jun

REPOSITORIES: biostudies-other

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Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling.

Rock Kat S KS Ndeffo-Mbah Martial L ML Castaño Soledad S Palmer Cody C Pandey Abhishek A Atkins Katherine E KE Ndung'u Joseph M JM Hollingsworth T Déirdre TD Galvani Alison A Bever Caitlin C Chitnis Nakul N Keeling Matt J MJ

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20180601 suppl_4

<h4>Background</h4>Control of gambiense sleeping sickness relies predominantly on passive and active screening of people, followed by treatment.<h4>Methods</h4>Mathematical modeling explores the potential of 3 complementary interventions in high- and low-transmission settings.<h4>Results</h4>Intervention strategies that included vector control are predicted to halt transmission most quickly. Targeted active screening, with better and more focused coverage, and enhanced passive surveillance, with ...[more]

PMID: 29860287

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Project description:The number of imported Human African Trypanosomiasis (HAT) cases in non-endemic countries has increased over the last years. The objective of this analysis is to describe the clinical presentation of HAT in Caucasian travelers. Literature was screened (MEDLINE, Pubmed) using the terms "Human African Trypanosomiasis", "travelers" and "expatriates"; all European languages except Slavic ones were included. Publications without clinical description of patients were only included in the epidemiological analysis. Forty-five reports on Caucasians with T.b. rhodesiense and 15 with T.b. gambiense infections were included in the analysis of the clinical parameters. Both species have presented with fever (T.b. rhodesiense 97.8% and T.b. gambiense 93.3%), headache (50% each) and a trypanosomal chancre (T.b. rhodesiense 84.4%, T.b. gambiense 46.7%). While sleeping disorders dominate the clinical presentation of HAT in endemic regions, there have been only rare reports in travelers: insomnia (T.b. rhodesiense 7.1%, T.b. gambiense 21.4%), diurnal somnolence (T.b. rhodesiense 4.8%, T.b. gambiense none). Surprisingly, jaundice has been seen in 24.2% of the Caucasian T.b. rhodesiense patients, but has never been described in HAT patients in endemic regions. These results contrast to the clinical presentation of T.b. gambiense and T.b. rhodesiense HAT in Africans in endemic regions, where the presentation of chronic T.b. gambiense and acute T.b. rhodesiense HAT is different. The analysis of 14 reports on T.b. gambiense HAT in Africans living in a non-endemic country shows that neurological symptoms such as somnolence (46.2%), motor deficit (64.3%) and reflex anomalies (14.3%) as well as psychiatric symptoms such as hallucinations (21.4%) or depression (21.4%) may dominate the clinical picture. Often, the diagnosis has been missed initially: some patients have even been hospitalized in psychiatric clinics. In travelers T.b. rhodesiense and gambiense present as acute illnesses and chancres are frequently seen. The diagnosis of HAT in Africans living outside the endemic region is often missed or delayed, leading to presentation with advanced stages of the disease.

Dataset Information

Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling.

Publications

Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling.

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