Towards the sustainable elimination of gambiense human African trypanosomiasis in Côte d'Ivoire using an integrated approach

Kaba Dramane, Koffi Mathurin, Kouakou Lingué, N'Gouan Kouassi Emmanuel, Djohan Vincent, Courtin Fabrice, N'Djetchi Martial Kassi, Coulibaly Bamoro, Adingra Guy Pacôme, Berté Djakaridja, Ta Bi Tra Dieudonné, Koné Minayégninrin, Traoré Barkissa Mélika, Sutherland Samuel A., Crump Ronald E., Huang Ching-I, Madan Jason, Bessell Paul R., Barreaux Antoine, Solano Philippe, Crowley Emily H., Rock Kat S., Jamonneau Vincent. 2023. Towards the sustainable elimination of gambiense human African trypanosomiasis in Côte d'Ivoire using an integrated approach. PLoS Neglected Tropical Diseases, 17 (7):e0011514, 25 p.

Résumé : Background: Human African trypanosomiasis is a parasitic disease caused by trypanosomes among which Trypanosoma brucei gambiense is responsible for a chronic form (gHAT) in West and Central Africa. Its elimination as a public health problem (EPHP) was targeted for 2020. Côte d'Ivoire was one of the first countries to be validated by WHO in 2020 and this was particularly challenging as the country still reported around a hundred cases a year in the early 2000s. This article describes the strategies implemented including a mathematical model to evaluate the reporting results and infer progress towards sustainable elimination. Methods: The control methods used combined both exhaustive and targeted medical screening strategies including the follow-up of seropositive subjects– considered as potential asymptomatic carriers to diagnose and treat cases– as well as vector control to reduce the risk of transmission in the most at-risk areas. A mechanistic model was used to estimate the number of underlying infections and the probability of elimination of transmission (EoT) was met between 2000–2021 in two endemic and two hypo-endemic health districts. Results: Between 2015 and 2019, nine gHAT cases were detected in the two endemic health districts of Bouaflé and Sinfra in which the number of cases/10,000 inhabitants was far below 1, a necessary condition for validating EPHP. Modelling estimated a slow but steady decline in transmission across the health districts, bolstered in the two endemic health districts by the introduction of vector control. The decrease in underlying transmission in all health districts corresponds to a high probability that EoT has already occurred in Côte d'Ivoire. Conclusion: This success was achieved through a multi-stakeholder and multidisciplinary one health approach where research has played a major role in adapting tools and strategies to this large epidemiological transition to a very low prevalence. This integrated approach will need to continue to reach the verification of EoT in Côte d'Ivoire targeted by 2025.

Mots-clés Agrovoc : modèle mathématique, surveillance épidémiologique, vecteur de maladie, santé publique, Trypanosoma brucei, épidémiologie, Trypanosoma, transmission des maladies, modèle de simulation, distribution géographique, trypanosomose, contrôle de maladies, dynamique des populations

Mots-clés géographiques Agrovoc : Côte d'Ivoire, Burkina Faso

Mots-clés libres : Infectious disease control, Trypanosomiasis, Medical risk factors, Epidemiology, Entomology

Classification Agris : S50 - Santé humaine
L72 - Organismes nuisibles des animaux

Champ stratégique Cirad : CTS 4 (2019-) - Santé des plantes, des animaux et des écosystèmes

Agences de financement européennes : European Commission

Agences de financement hors UE : Bill and Melinda Gates Foundation

Projets sur financement : (USA) Trypa-NO !, (USA) Human African Trypanosomiasis Modelling and Economic Predictions for Policy, (EU) DiTECT-HAT

Auteurs et affiliations

• Kaba Dramane, IPR (CIV)
• Koffi Mathurin, UJLG (CIV)
• Kouakou Lingué, Programme national d'élimination de la trypanosomiase humaine africaine (CIV)
• N'Gouan Kouassi Emmanuel, INSP (CIV)
• Djohan Vincent, IPR (CIV)
• Courtin Fabrice, IRD (FRA)
• N'Djetchi Martial Kassi, UJLG (CIV)
• Coulibaly Bamoro, IPR (CIV)
• Adingra Guy Pacôme, IPR (CIV)
• Berté Djakaridja, IPR (CIV)
• Ta Bi Tra Dieudonné, IPR (CIV)
• Koné Minayégninrin, IPR (CIV)
• Traoré Barkissa Mélika, UJLG (CIV)
• Sutherland Samuel A., University of Warwick (GBR)
• Crump Ronald E., University of Warwick (GBR)
• Huang Ching-I, University of Warwick (GBR)
• Madan Jason, University of Warwick (GBR)
• Bessell Paul R.
• Barreaux Antoine, CIRAD-BIOS-UMR INTERTRYP (FRA) ORCID: 0000-0001-5822-761X
• Solano Philippe, IRD (FRA)
• Crowley Emily H., University of Warwick (GBR)
• Rock Kat S., University of Warwick (GBR) - auteur correspondant
• Jamonneau Vincent, IRD (FRA) - auteur correspondant

Source : Cirad-Agritrop (https://agritrop.cirad.fr/607754/)

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