@article{fdi:010070935,
  title = {{A}dding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the {M}andoul focus ({C}had)},
  author = {{M}ahamat, {M}. {H}. and {P}eka, {M}. and {R}ayaisse, {J}. {B}. and {R}ock, {K}. {S}. and {T}oko, {M}. {A}. and {D}arnas, {J}. and {B}rahim, {G}. {M}. and {A}lkatib, {A}. {B}. and {Y}oni, {W}. and {T}irados, {I}. and {C}ourtin, {F}abrice and {B}rand, {S}. {P}. {C}. and {N}ersy, {C}. and {A}lfaroukh, {I}. {O}. and {T}orr, {S}. {J}. and {L}ehane, {M}. {J}. and {S}olano, {P}hilippe},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {G}ambian sleeping sickness or {HAT} (human {A}frican trypanosomiasis) is a neglected tropical disease caused by {T}rypanosoma brucei gambiense transmitted by riverine species of tsetse. {A} global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. {I}n the {S}outh of {C}had, the {M}andoul area is a persistent focus of {G}ambian sleeping sickness where around 100 {HAT} cases were still diagnosed and treated annually until 2013. {P}re-2014, control of {HAT} relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of {HAT} due to annual screening of the population. {M}ethods {B}ecause of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of {HAT} in {M}andoul. {I}n particular, we investigated the impact of deploying 'tiny targets' which attract and kill tsetse. {B}efore tsetse control commenced, a census of the human population was conducted and their settlements mapped. {A} pre-intervention survey of tsetse distribution and abundance was implemented in {N}ovember 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. {I}mpact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. {M}athematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. {F}indings {T}he census indicated that a population of 38674 inhabitants lived in the vicinity of the {M}an-doul focus. {W}ithin this focus in {N}ovember 2013, the vector is {G}lossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0-26). {T}he catch of tsetse from 44 sentinel biconical traps declined after target deployment with only five tsetse being caught in nine surveys giving a mean catch of 0.005 tsetse/trap/day. {M}odelling indicates that 70.4% (95% {CI}: 51-95%) of the reduction in reported cases between 2013 and 2015 can be attributed to vector control with the rest due to medical intervention. {S}imilarly tiny targets are estimated to have reduced new infections dramatically with 62.8% (95% {CI}: 59-66%) of the reduction due to tsetse control, and 8.5% (95% 8-9%) to enhanced passive detection. {M}odel predictions anticipate that elimination as a public health problem could be achieved by 2018 in this focus if vector control and screening continue at the present level and, furthermore, there may have been virtually no transmission since 2015. {C}onclusion {T}his work shows that tiny targets reduced the numbers of tsetse in this focus in {C}had, which may have interrupted transmission and the combination of tsetse control to medical detection and treatment has played a major role in reducing in {HAT} incidence in 2014 and 2015.},
  keywords = {{TCHAD}},
  booktitle = {},
  journal = {{PLOS} {N}eglected {T}ropical {D}iseases},
  volume = {11},
  numero = {7},
  pages = {e0005792 [16 p.]},
  ISSN = {1935-2735},
  year = {2017},
  DOI = {10.1371/journal.pntd.0005792},
  URL = {https://www.documentation.ird.fr/hor/fdi:010070935},
}