@article{fdi:010083972,
  title = {{U}pdate of transmission modelling and projections of gambiense human {A}frican trypanosomiasis in the {M}andoul focus, {C}had},
  author = {{R}ock, {K}. {S}. and {H}uang, {C}. {I}. and {C}rump, {R}. {E}. and {B}essell, {P}. {R}. and {B}rown, {P}. {E}. and {T}irados, {I}. and {S}olano, {P}hilippe and {A}ntillon, {M}. and {P}icado, {A}. and {M}bainda, {S}. and {D}arnas, {J}. and {C}rowley, {E}. {H}. and {T}orr, {S}. {J}. and {P}eka, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n recent years, a programme of vector control, screening and treatment of gambiense human {A}frican trypanosomiasis (g{HAT}) infections led to a rapid decline in cases in the {M}andoul focus of {C}had. {T}o represent the biology of transmission between humans and tsetse, we previously developed a mechanistic transmission model, fitted to data between 2000 and 2013 which suggested that transmission was interrupted by 2015. {T}he present study outlines refinements to the model to: (1) {A}ssess whether elimination of transmission has already been achieved despite low-level case reporting; (2) quantify the role of intensified interventions in transmission reduction; and (3) predict the trajectory of g{HAT} in {M}andoul for the next decade under different strategies. {M}ethod: {O}ur previous g{HAT} transmission model for {M}andoul was updated using human case data (2000-2019) and a series of model refinements. {T}hese include how diagnostic specificity is incorporated into the model and improvements to the fitting method (increased variance in observed case reporting and how underreporting and improvements to passive screening are captured). {A} side-by-side comparison of fitting to case data was performed between the models. {R}esults: {W}e estimated that passive detection rates have increased due to improvements in diagnostic availability in fixed health facilities since 2015, by 2.1-fold for stage 1 detection, and 1.5-fold for stage 2. {W}e find that whilst the diagnostic algorithm for active screening is estimated to be highly specific (95% credible interval ({CI}) 99.9-100%, {S}pecificity = 99.9%), the high screening and low infection levels mean that some recently reported cases with no parasitological confirmation might be false positives. {W}e also find that the focus-wide tsetse reduction estimated through model fitting (95% {CI} 96.1-99.6%, {R}eduction = 99.1%) is comparable to the reduction previously measured by the decline in tsetse catches from monitoring traps. {I}n line with previous results, the model suggests that transmission was interrupted in 2015 due to intensified interventions. {C}onclusions: {W}e recommend that additional confirmatory testing is performed in {M}andoul to ensure the endgame can be carefully monitored. {M}ore specific measurement of cases, would better inform when it is safe to stop active screening and vector control, provided there is a strong passive surveillance system in place.},
  keywords = {{G}ambiense human {A}frican trypanosomiasis (g{HAT}) ; {M}odelling ; {E}limination of transmission ; {V}alidation ; {T}setse ; {V}ector control ; {G}lossina ; {D}iagnostics ; {TCHAD} ; {MANDOUL} {REGION}},
  booktitle = {},
  journal = {{I}nfectious {D}iseases of {P}overty},
  volume = {11},
  numero = {1},
  pages = {11 [13 p.]},
  ISSN = {2095-5162},
  year = {2022},
  DOI = {10.1186/s40249-022-00934-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083972},
}