Tsetse control and Gambian sleeping sickness; implications for control strategy

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dc.contributor.authorTirados, Inakien_ZA
dc.contributor.authorEsterhuizen, Johanen_ZA
dc.contributor.authorMangwiro, T. N. Clementen_ZA
dc.contributor.authorVale, Glyn A.en_ZA
dc.contributor.authorHastings, Ianen_ZA
dc.contributor.authorSolano, Philippeen_ZA
dc.contributor.authorLehane, Michael J.en_ZA
dc.contributor.authorTorr, Steve J.en_ZA
dc.date.accessioned2016-08-31T06:36:26Z
dc.date.available2016-08-31T06:36:26Z
dc.date.issued2015-08
dc.descriptionCITATION: Tirados, I., et al. 2015. Tsetse control and Gambian sleeping sickness; implications for control strategy. PLoS Neglected Tropical Diseases, 9(8):e0003822, doi:10.1371/journal.pntd.0003822.
dc.descriptionThe original publication is available at http://journals.plos.org/plosntds
dc.description.abstractBackground: Gambian sleeping sickness (human African trypanosomiasis, HAT) outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT. Methods and Findings: The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2). In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings. Interpretation: The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised. Author Summary: Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control technology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.en_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent22 pagesen_ZA
dc.identifier.citationTirados, I., et al. 2015. Tsetse control and Gambian sleeping sickness; implications for control strategy. PLoS Neglected Tropical Diseases, 9(8):e0003822, doi:10.1371/journal.pntd.0003822
dc.identifier.issn1935-2735 (online)
dc.identifier.otherdoi:10.1371/journal.pntd.0003822
dc.identifier.urihttp://hdl.handle.net/10019.1/99516
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectGambian sleeping sicknessen_ZA
dc.subjectTsetse flies -- Controlen_ZA
dc.subjectHuman African trypanosomiasesen_ZA
dc.subjectAfrican trypanosomiasesen_ZA
dc.subjectVector controlen_ZA
dc.titleTsetse control and Gambian sleeping sickness; implications for control strategyen_ZA
dc.typeArticleen_ZA
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