AbstractBackgroundIn the Democratic Republic of the Congo, the international support was suddenly withdrawn after the massacre of students at the Lubumbashi University in May 1990. The interruption of the international aid from 1990 to 1991 would undoubtedly have a long-lasting negative effect on case load. So, the National Sleeping Sickness Control Programme—NSSCP (Programme National de Lutte contre la Trypanosomiase Humaine Africaine) (PNLTHA) remains vulnerable without international aid. Currently, the number of reported new cases decreased. These achievements prove that the elimination of this neglected tropical disease is possible when there is a strong commitment of public authorities accompanied by scientific research centers, civil society and the private sector. Without international aid, sleeping sickness remains a formidable disease difficult to cure because it is depending on continued financial support and drug availability.ObjectivesThe objectives of this work were: 1. to profile the incidence of new cases of human African trypanosomiasis in the Democratic Republic of the Congo from 2002 to 2003, depending on the stage of disease progression (stages 1 and 2); 2. Compare the evolution of this profile from one household to another; 3. Compare the rate of confirmed parasitological diagnosis with positive CATT; 4. Calculate the discrepancy rate between CATT+ and parasitological diagnosis. All the above objectives are aiming to sustain the efforts made for the adoption of the 2018 Francophonie resolution on the ridding of human African trypanosomiasis that may renewed donor interest, including the government of the Democratic Republic of the Congo because the control of HAT is completely dependent on international aid.MethodsResearch is necessary on how to rationalize control activities so that control programs can adopt the most effective and efficient strategies. To assess it, we analyzed epidemiologic data collected by PNLTHA from 2002 to 2003.ResultsIn all endemic areas, 1,970,101 people were tested in 2002 and 2,311,507 people in 2003. The national average coverage of the total population tested (TPT) represents 16.20% of the exposed population among which 13,853 new cases were detected in 2002 and 11, 481 new cases detected in 2003 with the national average coverage of the population tested that represents 19.10 %.ConclusionIn short, we said that the number of people already infected is probably higher than the new cases reported in 2003. We are still far from the situation of 1958/60 when there was 1 new case declared by 10,000 people tested (i.e. 1,100 new cases out of 13,000,000 people screen). Therefore, the Congolese government must make long-term financial commitments to ensure the continuity of HAT control activities.Author summaryFor the past three decades, the frequency of sleeping sickness tends to become a large in the Democratic Republic of the Congo. This paper reviews the status of sleeping sickness in DRC between 2002 and 2003, with a focus on stage patterns. Epidemiological trends at the national and provincial level are presented. Today, this deadly fly-borne disease threatens more than 65 million people worldwide and most of the reported cases (more than 8 out of 10) are in the Democratic Republic of the Congo. Fortunately, after decades of hard work, we have never been so close to eradicating sleeping sickness in the Democratic Republic of the Congo. In 2009, the number of reported cases fell below 10,000, the first in half a century. In 2015, only 2,804 cases had been listed. The Democratic Republic of the Congo is determined to eradicate the disease by 2020, paving the way for its global eradication. Thanks to these decades of work. I submit this inquiry to recognize also the work that my last mentor coauthor of this search did, he hold his doctorate on this disease. This submission is an appropriate way I found to honor and keep the memory of my supervisor who passed away! In advance, many thanks for your best understanding of this particular circumstance. From my last mentor work, we have never been so close to the definitive elimination of sleeping sickness. The number of reported new cases decreased from 26,318 in 1998 to 11,481 in 2003 and later to 2,804 in 2015. These achievements prove that the elimination of neglected tropical diseases is possible when there is a strong commitment of public authorities accompanied by scientific research centers, civil society and the private sector.
Integration of Human African Trypanosomiasis Control Activities into Primary Health Services in the Democratic Republic of the Congo: A Qualitative Study of Stakeholder Perceptions
