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Tytuł pozycji:

Development and implementation of a strategy for intensified screening for gambiense human African trypanosomiasis in Kongo Central province, DRC.

Tytuł :
Development and implementation of a strategy for intensified screening for gambiense human African trypanosomiasis in Kongo Central province, DRC.
Autorzy :
Lumbala C; Directorate of Disease Control, Ministry of Public Health, Democratic Republic of the Congo.; Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Kayembe S; Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland.
Makabuza J; Programme National de Lutte Contre la Trypanosomiase Humaine Africaine, Kinshasa, République Démocratique du Congo.
Lutumba P; Kinshasa University, Kinshasa, Democratic Republic of the Congo.
Van Geertruyden JP; Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Bessell PR; Epi Interventions, Edinburgh, United Kingdom.
Ndung'u JM; Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland.
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Źródło :
PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2020 Oct 15; Vol. 14 (10), pp. e0008779. Date of Electronic Publication: 2020 Oct 15 (Print Publication: 2020).
Typ publikacji :
Evaluation Study; Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms :
Mass Screening/*methods
Trypanosoma brucei gambiense/*isolation & purification
Trypanosomiasis, African/*diagnosis
Animals ; Democratic Republic of the Congo/epidemiology ; Diagnostic Tests, Routine ; Humans ; Molecular Diagnostic Techniques ; Nucleic Acid Amplification Techniques ; Trypanosoma brucei gambiense/classification ; Trypanosoma brucei gambiense/genetics ; Trypanosomiasis, African/epidemiology ; Trypanosomiasis, African/parasitology
References :
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SCR Protocol :
LAMP assay
Entry Date(s) :
Date Created: 20201015 Date Completed: 20210208 Latest Revision: 20210208
Update Code :
20210211
PubMed Central ID :
PMC7591064
DOI :
10.1371/journal.pntd.0008779
PMID :
33057341
Czasopismo naukowe
Background: The Democratic Republic of the Congo (DRC) accounts for the majority of the reported gambiense human African trypanosomiasis (HAT) cases. Kongo Central province in the DRC reports a relatively low, yet steady number of cases, and forms a transboundary focus with Angola and the Republic of Congo. This paper describes an intervention aimed at reducing the case burden in Kongo Central by improving passive case detection, complemented with reactive screening.
Methodology/principal Findings: At the initiation of this programme in August 2015, 620 health facilities were identified and equipped with Rapid Diagnostic Tests (RDTs) for HAT screening. Of these, 603 (97%) reported use of RDTs, and 584 (94%) that continued to use RDTs to the last quarter of 2016 were used in the analysis going forward. Among all health facilities involved, 23 were equipped to confirm HAT by microscopy, and 4 of the latter were equipped to perform molecular testing with loop-mediated isothermal amplification (LAMP). Patients clinically suspected of HAT were tested with an RDT and those with a positive RDT result were referred to the nearest microscopy facility for confirmatory testing. If RDT positive patients were negative by microscopy, they were tested by LAMP, either on fresh blood or blood that was dried on filter paper and transported to a facility performing LAMP. This network of diagnostic facilities reduced the median distance for a patient to travel to a screening facility from 13.7km when the classical card agglutination test for trypanosomiasis (CATT) was used as a screening test in the past, to 3.4km. As a consequence, passive case detection was improved by between 30% and 130% compared to the period before. Furthermore, the proportion of HAT cases detected in early stage disease by passive screening increased from 27% to 64%. Reactive screening took place in 20 villages where cases were reported by passive screening, and in 45 villages in the neighbourhood of these villages. Reactive screening was responsible for detection of 40% of cases, of which, 90% were in first stage of the disease.
Conclusions: This programme has demonstrated that it is possible to deploy passive screening for HAT at sub-country or country levels in the DRC, and this is made more effective when supplemented with reactive screening. Results and achievements showed an increase in the number of HAT cases detected, the majority of them in early disease, demonstrating that this strategy enables better population coverage and early detection of cases, which is critical in removing the HAT reservoir and interrupting transmission, and could contribute to HAT elimination in regions where it is implemented.
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