02367nas a2200277   4500000000100000008004100001653002200042653004000064653001600104653001400120653000900134653001100143100001400154700001300168700001300181700001700194700001500211700001300226700001600239245011000255856008600365300000700451490000700458520161000465022001402075       2019                            d10aSleeping sickness10aHuman African Trypanosomiasis (HAT)10aElimination10aGeography10aRisk10aGuinea1 aCourtin F1 aCamara O1 aCamara M1 aKagbadouno M1 aBucheton B1 aSolano P1 aJamonneau V00aSleeping sickness in the historical focus of forested Guinea: update using a geographically based method.  uhttps://www.parasite-journal.org/articles/parasite/pdf/2019/01/parasite190042.pdf  a610 v263 a<p>In 2017, 1447 new cases of Human African Trypanosomiasis (HAT) were reported, which reflects considerable progress towards the World Health Organisation's target of eliminating HAT as a public health problem by 2020. However, current epidemiological data are still lacking for a number of areas, including historical HAT foci. In order to update the HAT situation in the historical focus of forested Guinea, we implemented a geographically based methodology: Identification of Villages at Risk (IVR). The methodology is based on three sequential steps: Desk-based IVR (IVR-D), which selects villages at risk of HAT on the basis of HAT archives and geographical items; Field-based IVR (IVR-F), which consists in collecting additional epidemiological and geographical information in the field in villages at risk; and to be Medically surveyed IVR (IVR-M), a field data analysis through a Geographic Information System (GIS), to compile a list of the villages most at risk of HAT, suitable to guide active screening and passive surveillance. In an area of 2385&nbsp;km with 1420,530 inhabitants distributed in 1884 settlements, 14 villages with a population of 11,236 inhabitants were identified as most at risk of HAT and selected for active screening. Although no HAT cases could be confirmed, subjects that had come into contact with Trypanosoma brucei gambiense were identified and two sentinel sites were chosen to implement passive surveillance. IVR, which could be applied to any gambiense areas where the situation needs to be clarified, could help to reach the objective of HAT elimination.</p>
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