02271nas a2200241   4500000000100000008004100001653004000042653001500082100001200097700001400109700001300123700001400136700001600150700001300166700001200179700001300191245010200204856009900306300001300405490000700418520159000425022001402015       2019                            d10aHuman African Trypanosomiasis (HAT)10a2020 goals1 aSelby R1 aWamboga C1 aErphas O1 aMugenyi A1 aJamonneau V1 aWaiswa C1 aTorr SJ1 aLehane M00aGambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0007550&type=printable  ae00075500 v133 a<p>In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. The findings of this study can be used to guide future HAT and tsetse management in other gHAT foci, where reduced caseloads necessitate a shift from active to passive screening.</p>
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