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1.
Clin Infect Dis ; 66(suppl_4): S286-S292, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29860287

RESUMO

Background: Control of gambiense sleeping sickness relies predominantly on passive and active screening of people, followed by treatment. Methods: Mathematical modeling explores the potential of 3 complementary interventions in high- and low-transmission settings. Results: 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. Conclusions: 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.


Assuntos
Controle de Insetos , Insetos Vetores/parasitologia , Modelos Teóricos , Trypanosoma brucei gambiense/isolamento & purificação , Tripanossomíase Africana/prevenção & controle , Moscas Tsé-Tsé/parasitologia , Animais , Monitoramento Epidemiológico , Humanos , Programas de Rastreamento , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/transmissão
2.
Lancet Glob Health ; 10(11): e1600-e1611, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36240827

RESUMO

BACKGROUND: In line with movement restrictions and physical distancing essential for the control of the COVID-19 pandemic, WHO recommended postponement of all neglected tropical disease (NTD) control activities that involve community-based surveys, active case finding, and mass drug administration in April, 2020. Following revised guidance later in 2020, and after interruptions to NTD programmes of varying lengths, NTD programmes gradually restarted in the context of an ongoing pandemic. However, ongoing challenges and service gaps have been reported. This study aimed to evaluate the potential effect of the programmatic interruptions and strategies to mitigate this effect. METHODS: For seven NTDs, namely soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis, trachoma, visceral leishmaniasis, and human African trypanosomiasis, we used mathematical transmission models to simulate the effect of programme interruptions on the dynamics of each of these diseases in different endemic settings. We also explored the potential benefit of implementing mitigation strategies, primarily in terms of minimising the delays to control targets. FINDINGS: We show that the effect of the COVID-19-induced interruption in terms of delay to achieving elimination goals might in some cases be much longer than the duration of the interruption. For schistosomiasis, onchocerciasis, trachoma, and visceral leishmaniasis, a mean delay of 2-3 years for a 1-year interruption is predicted in areas of highest prevalence. We also show that these delays can largely be mitigated by measures such as additional mass drug administration or enhanced case-finding. INTERPRETATION: The COVID-19 pandemic has brought infectious disease control to the forefront of global consciousness. It is essential that the NTDs, so long neglected in terms of research and financial support, are not overlooked, and remain a priority in health service planning and funding. FUNDING: Bill & Melinda Gates Foundation, Medical Research Council, and the UK Foreign, Commonwealth & Development Office.


Assuntos
COVID-19 , Leishmaniose Visceral , Oncocercose , Esquistossomose , Tracoma , Medicina Tropical , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Leishmaniose Visceral/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Oncocercose/prevenção & controle , Pandemias , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Solo , Tracoma/epidemiologia
3.
Trans R Soc Trop Med Hyg ; 115(3): 245-252, 2021 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-33611586

RESUMO

Many control programmes against neglected tropical diseases have been interrupted due to the coronavirus disease 2019 (COVID-19) pandemic, including those that rely on active case finding. In this study we focus on gambiense human African trypanosomiasis (gHAT), where active screening was suspended in the Democratic Republic of Congo (DRC) due to the pandemic. We use two independent mathematical models to predict the impact of COVID-19 interruptions on transmission and reporting and achievement of the 2030 elimination of transmission (EOT) goal for gHAT in two moderate-risk regions of the DRC. We consider different interruption scenarios, including reduced passive surveillance in fixed health facilities, and whether this suspension lasts until the end of 2020 or 2021. Our models predict an increase in the number of new infections in the interruption period only if both active screening and passive surveillance were suspended, and with a slowed reduction-but no increase-if passive surveillance remains fully functional. In all scenarios, the EOT may be slightly pushed back if no mitigation, such as increased screening coverage, is put in place. However, we emphasise that the biggest challenge will remain in the higher-prevalence regions where EOT is already predicted to be behind schedule without interruptions unless interventions are bolstered.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Tripanossomíase Africana/epidemiologia , Tripanossomíase Africana/prevenção & controle , República Democrática do Congo/epidemiologia , Humanos , Modelos Teóricos , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Pandemias , Vigilância da População , SARS-CoV-2 , Trypanosoma brucei gambiense
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