@article{fdi:010079763,
  title = {{T}he complex health seeking pathway of a human {A}frican trypanosomiasis patient in {C}ote d'{I}voire underlines the need of setting up passive surveillance systems},
  author = {{K}one, {M}. and {N}'{G}ouan, {E}. {K}. and {K}aba, {D}. and {K}offi, {M}. and {K}ouakou, {L}. and {N}'{D}ri, {L}. and {K}ouame, {C}. {M}. and {N}anan, {V}. {K}. and {T}ape, {G}. {A}. and {C}oulibaly, {B}. and {C}ourtin, {F}abrice and {A}houty, {B}. and {D}johan, {V}. and {B}ucheton, {B}runo and {S}olano, {P}hilippe and {B}uscher, {P}. and {L}ejon, {V}eerle and {J}amonneau, {V}incent},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {S}ignificant efforts to control human {A}frican trypanosomiasis ({HAT}) over the two past decades have resulted in drastic decrease of its prevalence in {C}ote d'{I}voire. {I}n this context, passive surveillance, integrated in the national health system and based on clinical suspicion, was reinforced. {W}e describe here the health-seeking pathway of a girl who was the first {HAT} patient diagnosed through this strategy in {A}ugust 2017. {M}ethods {A}fter definitive diagnosis of this patient, epidemiological investigations were carried out into the clinical evolution and the health and therapeutic itinerary of the patient before diagnosis. {R}esults {A}t the time of diagnosis, the patient was positive in both serological and molecular tests and trypanosomes were detected in blood and cerebrospinal fluid. {S}he suffered from important neurological disorders. {T}he first disease symptoms had appeared three years earlier, and the patient had visited several public and private peripheral health care centres and hospitals in different cities. {T}he failure to diagnose {HAT} for such a long time caused significant health deterioration and was an important financial burden for the family. {C}onclusion {T}his description illustrates the complexity of detecting the last {HAT} cases due to complex diagnosis and the progressive disinterest and unawareness by both health professionals and the population. {I}t confirms the need of implementing passive surveillance in combination with continued sensitization and health staff training. {A}uthor summary {H}uman {A}frican trypanosomiasis ({HAT}) or sleeping sickness is a parasitic disease caused by{T}rypanosoma bruceithat is transmitted by tsetse flies. {I}n 2012, {HAT} was included in the {W}orld {H}ealth {O}rganization roadmap for the control of neglected tropical diseases with the objective of elimination as a public health problem by 2020. {I}n {C}ote d'{I}voire, {HAT} prevalence has dropped sharply the last decade. {A} passive {HAT} surveillance was therefore integrated in the national health system, which allowed to detect a first patient in 2017. {T}his article describes the complex health seeking pathway and suffering before diagnosis of this patient, an 11 years old girl, and illustrates the challenge when health agents and population no longer consider {HAT} as a threat in an elimination context. {O}ur results show the need to install a solid surveillance system, in combination with continued sensitization and repeated health staff training.},
  keywords = {{COTE} {D}'{IVOIRE}},
  booktitle = {},
  journal = {{PL}o{S} {N}eglected {T}ropical {D}iseases},
  volume = {14},
  numero = {9},
  pages = {e0008588 [14p.]},
  ISSN = {1935-2735},
  year = {2020},
  DOI = {10.1371/journal.pntd.0008588},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079763},
}