scholarly journals High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo

2021 ◽  
Author(s):  
Wat’senga Tezzo Francis ◽  
Fasine Sylvie ◽  
Manzambi Emile Zola ◽  
Marquetti Maria del Carmen ◽  
Binene Mbuka Guillaume ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Rainy Season ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Dry Season ◽  
World Health ◽  
Morphological Identification ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Larval Habitats

Abstract BACKGROUND: Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts.METHODS: In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA-barcoding of the specimens to validate identifications.RESULTS: The most rural commune (Mont Ngafula) had the highest pupal index of 246 (20) pupae/100 houses and a Breteau Index of 82.2 (19.5)/100 houses, while this latter was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N’Djili in the rainy (and dry) season, respectively. The House Index was on average across all communes 27.5% (7.6%); and the Container Index 15.0% (10.0%) in rainy (and dry) season, respectively. The vast majority of Aedes positive containers were found outside the houses (adjusted OR 27.4 (95%CI 14.9-50.1)). During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. CONCLUSIONS: In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key containers, mainly located in outdoor spaces, for larval habitats destruction or reduction.

scholarly journals High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo

2020 ◽  
Author(s):  
Wat’senga Tezzo Francis ◽  
Fasine Sylvie ◽  
Manzambi Emile Zola ◽  
Marquetti Maria del Carmen ◽  
Binene Mbuka Guillaume ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Rainy Season ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Dry Season ◽  
World Health ◽  
Morphological Identification ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Larval Habitats

Abstract BACKGROUND: Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts.METHODS: In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA-barcoding of the specimens to validate identifications.RESULTS: The most rural commune (Mont Ngafula) had the highest pupal index of 246 (20) pupae/100 houses and a Breteau Index of 82.2 (19.5)/100 houses, while this latter was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N’Djili in the rainy (and dry) season, respectively. The House Index was on average across all communes 27.5% (7.6%); and the Container Index 15.0% (10.0%) in rainy (and dry) season, respectively. The vast majority of Aedes positive containers were found outside the houses (adjusted OR 27.4 (95%CI 14.9-50.1)). During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season trash and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. CONCLUSIONS: . In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target outdoor spaces for larval habitats destruction or reduction.

scholarly journals High Aedes spp. larval indices in Kinshasa, Democratic Republic of Congo

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Francis Wat’senga Tezzo ◽  
Sylvie Fasine ◽  
Emile Manzambi Zola ◽  
Maria del Carmen Marquetti ◽  
Guillaume Binene Mbuka ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Rainy Season ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Dry Season ◽  
World Health ◽  
Index Number ◽  
Immature Stages ◽  
Republic Of Congo ◽  
Larval Habitats

Abstract Background Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. In the Democratic Republic of Congo (DRC), increases in cases of dengue and outbreaks of yellow fever and chikungunya have been reported since 2010. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, have been reported in DRC, but there is a lack of detailed information on their presence and spread to guide disease control efforts. Methods In 2018, two cross-sectional surveys were conducted in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Within the peri-domestic area of each household, searches were conducted for larval habitats, which were then surveyed for the presence of Aedes larvae and pupae. A subset of the immature specimens were reared to adults for morphological identification followed by DNA barcoding of the specimens to validate identifications. Results The most rural commune (Mont Ngafula) had the highest pupal index (number of Aedes spp. pupae per 100 inspected houses) at 246 (20) pupae/100 houses, and Breteau index (BI; number of containers positive for immature stages of Aedes spp. per 100 households) at 82.2 (19.5) positive containers/100 houses for the rainy (and dry) season, respectively. The BI was 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in Kalamu, Lingwala and N’Djili in the rainy (and dry) season, respectively. The house index (number of houses positive for at least one container with immature stages of Aedes spp. per 100 inspected houses) was, on average, across all communes, 27.5% (7.6%); and the container index (number of containers positive for immature stages of Aedes spp. per 100 inspected containers) was 15.0% (10.0%) for the rainy (and dry) season, respectively. The vast majority of Aedes-positive containers were found outside the houses [adjusted odds ratio 27.4 (95% confidence interval 14.9–50.1)]. During the dry season, the most productive containers were the ones used for water storage, whereas in the rainy season rubbish and tires constituted key habitats. Both Ae. aegypti and Ae. albopictus were found. Anopheles larvae were found in different types of Aedes larval habitats, especially during the rainy season. Conclusions In both surveys and in all communes, the larval indices (BI) were higher than the arbovirus transmission threshold values established by the World Health Organization. Management strategies for controlling Aedes in Kinshasa need to target the key types of containers for Aedes larvae, which are mainly located in outdoor spaces, for larval habitat destruction or reduction.

scholarly journals Important Aedes Spp. Density Levels in Kinshasa, Democratic Republic of Congo

2020 ◽  
Author(s):  
Wat’senga Tezzo Francis ◽  
Fasine Sylvie ◽  
Manzambi Emile Zola ◽  
Marquetti Maria del Carmen ◽  
Binene Mbuka Guillaume ◽  
...  
Keyword(s):  
Species Identification ◽  
Yellow Fever ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Water Storage ◽  
Dry Season ◽  
Transmission Risk ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Breeding Sites

Abstract BACKGROUND: Dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious vector-borne diseases worldwide. Besides sporadic dengue cases, yellow fever and chikungunya outbreaks have been increasingly reported in Democratic Republic of Congo (DRC) in the last decade. The main vectors of these arboviruses, Aedes aegypti and Aedes albopictus, were reported in DRC, but there is a lack of detailed information on their presence and spread hampering transmission risk assessments in the region. METHODS: In 2018, two cross-sectional surveys were realized in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Breedings sites were recorded, larvae and pupae collected and reared to obtain adults for genus and species identification. A subset of specimens was DNA-barcoded for validation of the morphological species identification. RESULTS: The most rural commune (Mont Ngafula) had the highest density levels, with a Breteau Index of 82.2 and 19.5/100 houses in rainy and dry season, respectively. The Breteau Index in the other communes Kalamu, Lingwala and N’Djili elevated to 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in the rainy (and dry) season. The House index was on average 27.5% and 7.6%; and the Container Index 15.0% and 10.0% in rainy and dry season, respectively. The vast majority of Aedes positive containers was found outside the houses (adjusted OR 27.4 (95%CI 14.9-50.1)). The main breeding sites were used tires, water storage containers and trash. Anopheles larvae were also found in Aedes breeding sites, especially during the rainy season.CONCLUSIONS: These results show that Kinshasa is highly infested with Aedes spp. which indicates a high potential for arbovirus transmission in the area. During the dry season, the most productive containers (for Aedes pupae production) are containers used for water storage, whereas in the rainy season this is trash and tires. The present study also evidences that Aedes breeding sites are mainly located outdoors. Based on the results of this study, a contextualized Aedes control strategy can be designed for Kinshasa.

scholarly journals Important Aedes Spp. Infestation Levels In Kinshasa, Democratic Republic Of Congo

2020 ◽  
Author(s):  
Wat’senga Tezzo Francis ◽  
Fasine Sylvie ◽  
Manzambi Emile Zola ◽  
Marquetti Maria del Carmen ◽  
Binene Mbuka Guillaume ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Rainy Season ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Water Storage ◽  
Dry Season ◽  
Transmission Risk ◽  
Republic Of Congo ◽  
Breeding Sites ◽  
Storage Containers

Abstract BACKGROUND Arboviruses such as dengue, yellow fever, chikungunya and Zika are among the most important emerging infectious diseases worldwide. Yellow fever and chikungunya outbreaks, and few dengue cases have been reported in Democratic Republic of Congo (DRC) in recent years. Although the main vectors of these arboviruses, Aedes aegypti and Aedes albopictus , were reported in DRC, the lack of detailed information on their presence and spread hampers transmission risk assessments in this region. METHODS In 2018, two cross-sectional surveys were realized in Kinshasa province (DRC), one in the rainy (January/February) and one in the dry season (July). Four hundred houses were visited in each of the four selected communes (N’Djili, Mont Ngafula, Lingwala and Kalamu). Breedings sites were recorded, larvae and pupae collected and reared to obtain adults for genus and species identification. A subset of specimen was DNA-barcoded for species validation. RESULTS The most rural commune (Mont Ngafula) had the highest infestation levels, with a Breteau Index of 82.2 and 19.5/100 houses in rainy and dry season, respectively. The Breteau Index in the other communes Kalamu, Lingwala and N’Djili elevated to 21.5 (4.7), 36.7 (9.8) and 41.7 (7.5) in the rainy (and dry) season respectively. The House index was on average 27.5% and 7.6%; and the Cotainer Index 15.0% and 10.0% in rainy and dry season, respectively. The vast majority of Aedes positive containers were found outside the houses (aOR 27.3 (95%CI 14.9-50.0)). The main breeding sites were used tires, water storage containers and trash. Anopheles larvae were also found in Aedes breeding sites in all four communes in the rainy season. CONCLUSIONS These results show that Kinshasa is highly infested with Aedes spp. which indicates a high potential for arbovirus transmission in the area. The present study evidences that Aedes breeding sites are mainly located outdoors. The most productive containers (for Aedes pupae production) during the dry season are the water storage containers, while over the rainy season these are the artificial containers, especially tires. This will have an impact on the design of control strategies for these vectors in Kinshasa.

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

scholarly journals Symptoms of acute transfusion reactions at a general referral hospital in Kinshasa, Democratic Republic of Congo: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045081
Author(s):  
Patou Masika Musumari ◽  
Samclide Mutindu Mbikayi ◽  
Kriengkrai Srithanaviboonchai ◽  
Teeranee Techasrivichien ◽  
Arunrat Tangmunkongvorakul ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Respiratory Distress ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Data Set ◽  
Republic Of Congo ◽  
Transfusion Reactions

ObjectivesBlood transfusion is a life-saving procedure and is also associated with a range of risks including the occurrence of symptoms of acute transfusion reactions (ATRs). Very few studies in sub-Saharan Africa have reported on ATRs. The present study addresses this gap in the literature by documenting the prevalence of and factors associated with ATRs in the Democratic Republic of Congo (DRC).DesignThis is a cross-sectional descriptive and analytical study using blood bank data from a general referral hospital.SettingCentre Hospitalier Mère-Enfant (CHME) Monkole, a general referral hospital in Kinshasa, DRC.ParticipantsGeneral population who have received blood transfusion in CHME Monkole between 2014 and 2019.ResultsThe data set included a total of 7166 patients; 3153 (44%) men and 4013 (56%) women. The overall prevalence of symptoms of ATRs was 2.6%; the lowest prevalence was in 2017 (2.34%) and highest in 2018 (2.95%) and 2019 (2.94%). The documented symptoms included 74 (39.6%) cases of dyspnoea/respiratory distress, 60 (32.1%) cases of fever, 36 (19.2%) cases of pruritus/urticaria and 17 (9.1%) cases of vomiting. None of the studied factors was associated with symptoms of ATRs.ConclusionSymptoms of ATRs were not uncommon in the studied population. Dyspnoea and respiratory distress, fever and pruritus/urticaria were the most common symptoms of ATRs. This study highlights the need for a clinical and biological surveillance to detect, prevent and manage ATRs in the context of the DRC.

scholarly journals Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Célestin Ndosimao Nsibu ◽  
Célestin Manianga ◽  
Serge Kapanga ◽  
Esther Mona ◽  
Philippe Pululu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Male Partner ◽  
First Trimester ◽  
Reproductive Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Republic Of Congo

Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services.Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women.Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28–0.95),p<0.04), the educational level (OR: 0.41,95% CI(0.17–0.97),p<0.04), the nearby health center (OR: 0.43, 95% CI(0.2–0.92),p<0.03), and the presence of a male partner (OR: 10.48, 95% CI(2.1–52.23),p<0.001). The barriers to early booking were (i) the cost of service; (ii) the appearance or individual income; (iii) the geographical inaccessibility or distance to health facilities; (iv) social and religious prohibitions; (v) the stigmatization from other women when conceiving in the late ages or young or while still lactating (parity); (vi) the time for waiting for services.Conclusion. The early ANC attendance is delayed among poor women with little education and living alone.

scholarly journals Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dalau Mukadi Nkamba ◽  
Roland Vangu ◽  
Moyene Elongi ◽  
Laura A. Magee ◽  
Gilbert Wembodinga ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Primary Health Centres ◽  
Hypertensive Disorders In Pregnancy ◽  
Prophylactic Use ◽  
Facility Readiness

Abstract Background Hypertensive disorders in pregnancy are the second most common cause of maternal mortality in the Democratic Republic of Congo (DRC), accounting for 23% of maternal deaths. This study aimed to assess facility readiness, and providers’ knowledge to prevent, diagnose, and treat pre-eclampsia. Methods A facility-based cross-sectional study was conducted in 30 primary health centres (PHCs) and 28 referral facilities (hospitals) randomly selected in Kinshasa, DRC. In each facility, all midwives and physicians involved in maternal care provision (n = 197) were included. Data on facility infrastructure and providers’ knowledge about pre-eclampsia were collected using facility checklists and a knowledge questionnaire. Facility readiness score was defined as the sum of 13 health commodities needed to manage pre-eclampsia. A knowledge score was defined as the sum of 24 items about the diagnosis, management, and prevention of pre-eclampsia. The score ranges from 0 to 24, with higher values reflecting a better knowledge. The Mann-Witney U test was used to compare median readiness scores by facility type and ownership; and median knowledge scores between midwives in hospitals and in PHCs, and between physicians in hospitals and in PHCs. Results Overall, health facilities had 7 of the 13 commodities, yielding a median readiness score of 53.8%(IQR: 46.2 to 69.2%). Although all provider groups had significant knowledge gaps about pre-eclampsia, providers in hospitals demonstrated slightly more knowledge than those in PHCs. Midwives in public facilities scored higher than those in private facilities (median(IQR): 8(5 to 12) vs 7(4 to 8), p = 0.03). Of the 197 providers, 91.4% correctly diagnosed severe pre-eclampsia. However, 43.9 and 82.2% would administer magnesium sulfate and anti-hypertensive drugs to manage severe pre-eclampsia, respectively. Merely 14.2 and 7.1% of providers were aware of prophylactic use of aspirin and calcium to prevent pre-eclampsia, respectively. Conclusion Our study showed poor availability of supplies to diagnose, prevent and treat pre-eclampsia in Kinshasa. While providers demonstrated good knowledge regarding the diagnosis of pre-eclampsia, they have poor knowledge regarding its prevention and management. The study highlights the need for strengthening knowledge of providers toward the prevention and management of pre-eclampsia, and enhancing the availability of supplies needed to address this disease.

scholarly journals Quantifying epidemiological drivers of gambiense human African Trypanosomiasis across the Democratic Republic of Congo

2020 ◽  
Author(s):  
Ronald E Crump ◽  
Ching-I Huang ◽  
Ed Knock ◽  
Simon E F Spencer ◽  
Paul Brown ◽  
...  
Keyword(s):  
Human African Trypanosomiasis ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Model Fitting ◽  
Case Finding ◽  
World Health ◽  
Model Parameters ◽  
African Trypanosomiasis ◽  
Republic Of Congo ◽  
Case Data

AbstractGambiense human African trypanosomiasis (gHAT) is a virulent disease declining in burden but still endemic in West and Central Africa. Although it is targeted for elimination of transmission by 2030, there remain numerous questions about the drivers of infection and how these vary geographically.In this study we focus on the Democratic Republic of Congo (DRC), which accounted for 84% of the global case burden in 2016, to explore changes in transmission across the country and elucidate factors which may have contributed to the persistence of disease or success of interventions in different regions. We present a Bayesian fitting methodology, applied to 168 endemic health zones (∼ 100,000 population size), which allows for calibration of mechanistic gHAT model to case data (from the World Health Organization HAT Atlas) in an adaptive and automated framework.It was found that the model needed to capture improvements in passive detection to match observed trends in the data within former Bandundu and Bas Congo provinces indicating these regions have substantially reduced time to detection. Health zones in these provinces generally had longer burn-in periods during fitting due to additional model parameters.Posterior probability distributions were found for a range of fitted parameters in each health zone; these included the basic reproduction number estimates for pre-1998 (R0) which was inferred to be between 1 and 1.19, in line with previous gHAT estimates, with higher median values typically in health zones with more case reporting in the 2000s.Previously, it was not clear whether a fall in active case finding in the period contributed to the declining case numbers. The modelling here accounts for variable screening and suggests that underlying transmission has also reduced greatly – on average 96% in former Equateur, 93% in former Bas Congo and 89% in former Bandundu – Equateur and Bandundu having had the highest case burdens in 2000. This analysis also sets out a framework to enable future predictions for the country.Author summaryGambiense human African trypanosomiasis (gHAT; sleeping sickness) is a deadly disease targeted for elimination by 2030, however there are still several unknowns about what factors influence continued transmission and how this changes with geographic location.In this study we focus on the Democratic Republic of Congo (DRC), which reported 84% of the global cases in 2016 to try and explain why some regions of the country have had more success than others in bringing down case burden. To achieve this we used a state-of-the-art statistical framework to match a mathematical gHAT model to reported case data for 168 regions with some case reporting during 2000–2016.The analysis indicates that two former provinces, Bandundu and Bas Congo had substantial improvements to case detection in fixed health facilities in the time period. Overall, all provinces were estimated to have reductions in (unobservable) transmission including ∼ 96% in former Equateur. This is reassuring as case finding effort has decreased in that region.The model fitting presented here will allow predictions of gHAT under future strategies to be performed in the future.

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