The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases

International Journal of Health Geographics, Sep 2018

Background Following World Health Assembly resolutions 50.36 in 1997 and 56.7 in 2003, the World Health Organization (WHO) committed itself to supporting human African trypanosomiasis (HAT)-endemic countries in their efforts to remove the disease as a public health problem. Mapping the distribution of HAT in time and space has a pivotal role to play if this objective is to be met. For this reason WHO launched the HAT Atlas initiative, jointly implemented with the Food and Agriculture Organization of the United Nations, in the framework of the Programme Against African Trypanosomosis. Results The distribution of HAT is presented for 23 out of 25 sub-Saharan countries having reported on the status of sleeping sickness in the period 2000 - 2009. For the two remaining countries, i.e. Angola and the Democratic Republic of the Congo, data processing is ongoing. Reports by National Sleeping Sickness Control Programmes (NSSCPs), Non-Governmental Organizations (NGOs) and Research Institutes were collated and the relevant epidemiological data were entered in a database, thus incorporating (i) the results of active screening of over 2.2 million people, and (ii) cases detected in health care facilities engaged in passive surveillance. A total of over 42 000 cases of HAT and 6 000 different localities were included in the database. Various sources of geographic coordinates were used to locate the villages of epidemiological interest. The resulting average mapping accuracy is estimated at 900 m. Conclusions Full involvement of NSSCPs, NGOs and Research Institutes in building the Atlas of HAT contributes to the efficiency of the mapping process and it assures both the quality of the collated information and the accuracy of the outputs. Although efforts are still needed to reduce the number of undetected and unreported cases, the comprehensive, village-level mapping of HAT control activities over a ten-year period ensures a detailed and reliable representation of the known geographic distribution of the disease. Not only does the Atlas serve research and advocacy, but, more importantly, it provides crucial evidence and a valuable tool for making informed decisions to plan and monitor the control of sleeping sickness.

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The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases

International Journal of Health Geographics The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases Pere P Simarro 0 Giuliano Cecchi 2 Massimo Paone 2 Jos R Franco 0 Abdoulaye Diarra 1 Jos A Ruiz 5 Eric M Fvre 4 Fabrice Courtin 3 Raffaele C Mattioli 2 Jean G Jannin 0 0 World Health Organization, Control of Neglected Tropical Diseases , Innovative and Intensified Disease Management, 1211 Geneva 27 , Switzerland 1 World Health Organization , Regional Office for Africa, Brazzaville , Congo 2 Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Viale delle Terme di Caracalla , 00153, Rome , Italy 3 Institut de Recherche pour le Developpement - UMR 177, Centre International de Recherche Developpement sur l'Elevage en zone Subhumide , Bobo-Dioulasso , Burkina Faso 4 Centre for Infectious Diseases, University of Edinburgh, Ashworth Laboratories , Kings Buildings, West Mains Road, Edinburgh EH9 3JT , UK 5 World Health Organization, Regional Office for the Eastern Mediterranean , Cairo 11371 , Egypt Background: Following World Health Assembly resolutions 50.36 in 1997 and 56.7 in 2003, the World Health Organization (WHO) committed itself to supporting human African trypanosomiasis (HAT)-endemic countries in their efforts to remove the disease as a public health problem. Mapping the distribution of HAT in time and space has a pivotal role to play if this objective is to be met. For this reason WHO launched the HAT Atlas initiative, jointly implemented with the Food and Agriculture Organization of the United Nations, in the framework of the Programme Against African Trypanosomosis. Results: The distribution of HAT is presented for 23 out of 25 sub-Saharan countries having reported on the status of sleeping sickness in the period 2000 - 2009. For the two remaining countries, i.e. Angola and the Democratic Republic of the Congo, data processing is ongoing. Reports by National Sleeping Sickness Control Programmes (NSSCPs), Non-Governmental Organizations (NGOs) and Research Institutes were collated and the relevant epidemiological data were entered in a database, thus incorporating (i) the results of active screening of over 2.2 million people, and (ii) cases detected in health care facilities engaged in passive surveillance. A total of over 42 000 cases of HAT and 6 000 different localities were included in the database. Various sources of geographic coordinates were used to locate the villages of epidemiological interest. The resulting average mapping accuracy is estimated at 900 m. Conclusions: Full involvement of NSSCPs, NGOs and Research Institutes in building the Atlas of HAT contributes to the efficiency of the mapping process and it assures both the quality of the collated information and the accuracy of the outputs. Although efforts are still needed to reduce the number of undetected and unreported cases, the comprehensive, village-level mapping of HAT control activities over a ten-year period ensures a detailed and reliable representation of the known geographic distribution of the disease. Not only does the Atlas serve research and advocacy, but, more importantly, it provides crucial evidence and a valuable tool for making informed decisions to plan and monitor the control of sleeping sickness. - Background Efficient collection, management and dissemination of information are essential to intervene effectively against neglected tropical diseases and to monitor and evaluate strategies and actions towards their control. However, the neglect suffered by many diseases that affect the worlds poorest people manifests itself in many guises, not least in the paucity of reliable information on their incidence and geographic distribution [1,2]. Evidence on the number and location of infections is badly needed to bring these neglected diseases out of the shadow [3] and, most crucially, to tackle them efficiently [4,5]. Disease maps are required for planning, managing and monitoring interventions across the whole spectrum of neglected tropical diseases. For conditions such as helminthiases and trachoma, against which safe and affordable drugs are available, baseline maps of endemicity are used to plan mass drug administration (MDA) campaigns [6-8]. As campaigns progress, spatially-explicit data enable implementation to be monitored and ultimately contribute to assessing the degree of success of the initiatives [9]. Geo-spatial information also plays a role in the post-MDA phase when surveillance aims at providing early-warning of the possible disease resurgence or reintroduction in freed areas. A different group of diseases such as human African trypanosomiasis (HAT), Chagas disease and leishmaniasis, are characterized by the limited availability of safe and cost-effective control tools. This group includes infections of complex epidemiology, which, if untreated, can result in very high death rates. Strategies to control t (...truncated)


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Pere P Simarro, Giuliano Cecchi, Massimo Paone, José R Franco, Abdoulaye Diarra, José A Ruiz, Eric M Fèvre, Fabrice Courtin, Raffaele C Mattioli, Jean G Jannin. The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases, International Journal of Health Geographics, 2010, pp. 57, 9, DOI: 10.1186/1476-072X-9-57