Report of a WHO meeting on elimination of human African trypanosomiasis (trypanosoma brucei gambiense)

Overview

On 3–5 December 2012, WHO convened a meeting of national sleeping sickness control programmes (NSSCPs), experts from WHO collaborating centres and a member of the STAG at its headquarters in Geneva to discuss strategies, tools and criteria for the process of eliminating HAT (Trypanosoma brucei gambiense).

There are two forms of HAT: Gambiense trypanosomiasis caused by infection with the parasite Trypanosoma brucei gambiense (prevalent in the west and central part of Africa, south of the Sahara); and Rhodesiense trypanosomiasis caused by infection with Trypanosoma brucei rhodesiense (found in the eastern part of the continent). Both forms of the disease have distinct epidemiological characteristics that require different approaches for surveillance and control. Today, Gambiense trypanosomiasis accounts for some 98% of all reported cases of HAT; thus immediate attention must be given to this form of the disease.

Rhodesiense trypanosomiasis has been shown to be a zoonotic disease with both domestic and wild hosts, which complicates control activities and the sustainability of zero cases in humans. Approaches to elimination must therefore be adapted to accommodate zoonotic transmission. Vector control will undoubtedly play a substantially more important role in achieving the elimination objective in Rhodesiense trypanosomiasis than in Gambiense HAT.

For these reasons, and given the particularities of both forms of the disease, the meeting focused on Gambiense trypanosomiasis. Elimination of Rhodesiense trypanosomiasis will be addressed more precisely at a later stage.

The objectives of the meeting were:

• To endorse WHO’s elimination objective for Gambiense trypanosomiasis.
• To define the criteria and indicators for elimination.
• To elaborate the strategies and tools for achieving the elimination objective.
• To identify the obstacles to be overcome to achieve elimination.