New face of sleeping sickness epidemiology highlights need for new tools

Recent developments have rekindled hopes of eliminating human African trypanosomiasis (HAT), more familiarly known as sleeping sickness, as a public health problem in those areas of sub-Saharan Africa where the disease is endemic. In the February 2011 issue of the open-access journal PLoS Neglected Tropical Diseases, Simarro and colleagues at the WHO report in "The Human African Trypanosomiasis Control and Surveillance Programme of the World Health Organization 2000-2009: The Way Forward" that new cases of sleeping sickness fell below the symbolic number of 10,000 in 2009, setting the stage for a possible elimination of sleeping sickness in sub-Saharan Africa – a prospect that was unthinkable a decade ago. In order to highlight the existing literature that PLoS NTDs authors have contributed to the field, PLoS Neglected Tropical Diseases Deputy Editor-in-Chief Serap Aksoy has compiled a collection of articles on HAT with a specific emphasis on potential applications for disease control.

While previous efforts to curb the disease throughout the early twentieth century had met with some success, the subsequent loss of effective control programs in the 1960s resulted in a steep increase in sleeping sickness within endemic countries. According to Dr. Simarro, these more recent encouraging signs are the result of "leadership from the WHO and coordination of control activities in endemic countries, as well as the unfaltering commitment and determination of teams of National Sleeping Sickness Control Programmes, research institutions, bilateral cooperation, NGOs and the private sector. In the 2000s the objective was largely to hold sleeping sickness at bay, using systematic screening of at-risk populations and providing early treatment, followed by a decisive phase which focused on shrinking the map of endemic areas. In addition to generous drug donations and continuing research, funding for control activities, training, logistical improvement and infrastructure all contributed in helping to make diagnosis and treatment more accessible, safer and less cumbersome."

In the same issue, Serap Aksoy also elaborates on these findings in her editorial, "Sleeping Sickness Elimination in Sight: Time to Celebrate, Reflect but not Relax," in which she provides a historical perspective to HAT epidemics and emphasizes the need for continued vigilance in preventing future re-emergence of the disease.

Both Drs. Simarro and Aksoy conclude that the future for HAT elimination is promising, but only if donors continue to maintain their commitment to control and research, stressing that a sustainable strategy for elimination must be implemented and that an awareness of the threat of re-emergence of the disease be maintained.

PLEASE ADD THIS LINK TO THE PUBLISHED COLLECTION IN ONLINE VERSIONS OF YOUR REPORT: http://www.ploscollections.org/sleepingsickness2011 (link will go live upon embargo lift)

The Human African Trypanosomiasis Control and Surveillance Programme of the World Health Organization 2000�: The Way Forward

FINANCIAL DISCLOSURE: No specific funding was received for this work.

COMPETING INTERESTS: The authors have declared that no competing interests exist.

PLEASE ADD THIS LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.plos.org/10.1371/journal.pntd.0001007 (link will go live upon embargo lift)

CITATION: Simarro PP, Diarra A, Ruiz Postigo JA, Franco JR, Jannin JG (2011) The Human African Trypanosomiasis Control and Surveillance Programme of the World Health Organization 2000�: The Way Forward. PLoS Negl Trop Dis 5(2): e1007. doi:10.1371/journal.pntd.0001007

CONTACT:
Dr Pere Simarro
SimarroP@who.int
World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland

Sleeping Sickness Elimination in Sight: Time to Celebrate and Reflect, but Not Relax

FINANCIAL DISCLOSURE: No specific funding was received for this work.

COMPETING INTERESTS: The author has declared that no competing interests exist.

PLEASE ADD THIS LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.plos.org/10.1371/journal.pntd.0001008 (link will go live upon embargo lift)

CITATION: Aksoy S (2011) Sleeping Sickness Elimination in Sight: Time to Celebrate and Reflect, but Not Relax. PLoS Negl Trop Dis 5(2): e1008. doi:10.1371/journal.pntd.0001008

CONTACT:

Dr. Serap Aksoy
Serap.Aksoy@yale.edu
Yale School of Public Health

LIST OF PAPERS INCLUDED IN THE HAT COLLECTION

1. Yun O, Priotto G, Tong J, Flevaud L, Chappuis F, 2010 NECT Is Next:Implementing the New Drug Combination Therapy for Trypanosoma brucei gambiense Sleeping Sickness. PLoS Negl Trop Dis 4(5): e720. doi:10.1371/journal.pntd.0000720

2. Njiru ZK, Mikosza ASJ, Armstrong T, Enyaru JC, Ndung'u JM, et al. 2008 Loop-Mediated Isothermal Amplification (LAMP) Method for Rapid Detection of Trypanosoma brucei rhodesiense. PLoS Negl Trop Dis 2(2): e147. doi:10.1371/journal.pntd.0000147

3. Wastling SL, Picozzi K, Kakembo ASL, Welburn SC 2010 LAMP for Human African Trypanosomiasis: A Comparative Study of Detection Formats. PLoS Negl Trop Dis 4(11): e865. doi:10.1371/journal.pntd.0000865

4.Ndung'u JM, Bieler S, Roscigno G 2010 "Piggy-Backing" on Diagnostic Platforms Brings Hope to Neglected Diseases: The Case of Sleeping Sickness. PLoS Negl Trop Dis 4(5): e715. doi:10.1371/journal.pntd.0000715

5. Büscher P, Mumba Ngoyi D, Kaboré J, Lejon V, Robays J, et al. 2009 Improved Models of Mini Anion Exchange Centrifugation Technique (mAECT) and Modified Single Centrifugation (MSC) for Sleeping Sickness Diagnosis and Staging. PLoS Negl Trop Dis 3(11): e471. doi:10.1371/journal.pntd.0000471

6. Matovu E, Mugasa CM, Ekangu RA, Deborggraeve S, Lubega GW, et al. 2010 Phase II Evaluation of Sensitivity and Specificity of PCR and NASBA Followed by Oligochromatography for Diagnosis of Human African Trypanosomiasis in Clinical Samples from D.R. Congo and Uganda. PLoS Negl Trop Dis 4(7): e737. doi:10.1371/journal.pntd.0000737

7. Vodnala SK, Ferella M, Lundén-Miguel H, Betha E, van Reet N, et al. 2009 Preclinical Assessment of the Treatment of Second-Stage African Trypanosomiasis with Cordycepin and Deoxycoformycin. PLoS Negl Trop Dis 3(8): e495. doi:10.1371/journal.pntd.0000495

8. Jamonneau V, Bucheton B, Kaboré J, Ilboudo H, Camara O, et al. 2010 Revisiting the Immune Trypanolysis Test to Optimise Epidemiological Surveillance and Control of Sleeping Sickness in West Africa. PLoS Negl Trop Dis 4(12): e917. doi:10.1371/journal.pntd.0000917

9. Hainard A, Tiberti N, Robin X, Lejon V, Ngoyi DM, et al. 2009 A Combined CXCL10, CXCL8 and H-FABP Panel for the Staging of Human African Trypanosomiasis Patients. PLoS Negl Trop Dis 3(6): e459. doi:10.1371/journal.pntd.0000459

10. Batchelor NA, Atkinson PM, Gething PW, Picozzi K, Fèvre EM, et al. 2009 Spatial Predictions of Rhodesian Human African Trypanosomiasis (Sleeping Sickness) Prevalence in Kaberamaido and Dokolo, Two Newly Affected Districts of Uganda. PLoS Negl Trop Dis 3(12): e563. doi:10.1371/journal.pntd.0000563

11.Wardrop NA, Atkinson PM, Gething PW, Fèvre EM, Picozzi K, et al. 2010 Bayesian Geostatistical Analysis and Prediction of Rhodesian Human African Trypanosomiasis. PLoS Negl Trop Dis 4(12): e914. doi:10.1371/journal.pntd.0000914

12. Lindh JM, Torr SJ, Vale GA, Lehane MJ, 2009 Improving the Cost-Effectiveness of Artificial Visual Baits for Controlling the Tsetse Fly Glossina fuscipes fuscipes. PLoS Negl Trop Dis 3(7): e474. doi:10.1371/journal.pntd.0000474

13. Solano P, Kaba D, Ravel S, Dyer NA, Sall B, et al. 2010 Population Genetics as a Tool to Select Tsetse Control Strategies: Suppression or Eradication of Glossina palpalis gambiensis in the Niayes of Senegal. PLoS Negl Trop Dis 4(5): e692. doi:10.1371/journal.pntd.0000692

14. Beadell JS, Hyseni C, Abila PP, Azabo R, Enyaru JCK, et al. 2010 Phylogeography and Population Structure of Glossina fuscipes fuscipes in Uganda: Implications for Control of Tsetse. PLoS Negl Trop Dis 4(3): e636. doi:10.1371/journal.pntd.0000636

15. Rayaisse JB, Tirados I, Kaba D, Dewhirst SY, Logan JG, et al. 2010 Prospects for the Development of Odour Baits to Control the Tsetse Flies Glossina tachinoides and G. palpalis s.l.. PLoS Negl Trop Dis 4(3): e632. doi:10.1371/journal.pntd.0000632

16. Omolo MO, Hassanali A, Mpiana S, Esterhuizen J, Lindh J, et al. 2009 Prospects for Developing Odour Baits To Control Glossina fuscipes spp., the Major Vector of Human African Trypanosomiasis. PLoS Negl Trop Dis 3(5): e435. doi:10.1371/journal.pntd.0000435

17. Torreele E, Bourdin Trunz B, Tweats D, Kaiser M, Brun R, et al. 2010 Fexinidazole ¬ A New Oral Nitroimidazole Drug Candidate Entering Clinical Development for the Treatment of Sleeping Sickness. PLoS Negl Trop Dis 4(12): e923. doi:10.1371/journal.pntd.0000923

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