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Village-scale persistence and elimination of gambiense human African trypanosomiasis
Matt J Keeling
Erick Mwamba Miaka
Kat S Rock
Christopher N Davis
Novel Coronavirus
Acceso Abierto
Gambiense human African trypanosomiasis (gHAT) is one of several neglected tropical diseases that is targeted for elimination by the World Health Organization. Recent years have seen a substantial decline in the number of globally reported cases, largely driven by an intensive process of screening and treatment. However, this infection is highly focal, continuing to persist at low prevalence even in small populations. Regional elimination, and ultimately global eradication, rests on understanding the dynamics and persistence of this infection at the local population scale. Here we develop a stochastic model of gHAT dynamics, which is underpinned by screening and reporting data from one of the highest gHAT incidence regions, Kwilu Province, in the Democratic Republic of Congo. We use this model to explore the persistence of gHAT in villages of different population sizes and subject to different patterns of screening. Our models demonstrate that infection is expected to persist for long periods even in relatively small isolated populations. We further use the model to assess the risk of recrudescence following local elimination and consider how failing to detect cases during active screening events informs the probability of elimination. These quantitative results provide insights for public health policy in the region, particularly highlighting the difficulties in achieving and measuring the 2030 elimination goal. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by the Bill and Melinda Gates Foundation ( in partnership with the Task Force for Global Health through the NTD Modelling Consortium [OPP1053230] (K.S.R. and M.J.K.), the Bill and Melinda Gates Foundation through the Human African Trypanosomiasis Modelling and Economic Predictions for Policy (HAT MEPP) project [OPP1177824] (K.S.R. and M.J.K.) and EPSRC/MRC via the MathSys Centre for Doctoral Training (C.N.D.). ### Author Declarations All relevant ethical guidelines have been followed and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Not Applicable Any clinical trials involved have been registered with an ICMJE-approved registry such as and the trial ID is included in the manuscript. Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant Equator, ICMJE or other checklist(s) as supplementary files, if applicable. Not Applicable Epidemiological data for the study were provided by the WHO in the frame of the Atlas of gHAT which may be viewed at and may be requested through Jose Ramon Franco ( [][1] [1]:
Cold Spring Harbor Laboratory Press
Appears in Collections:Artículos científicos

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