Human African Trypanosomiasis in the Democratic Republic of the Congo: A Looming Emergency?

Authors: Epco Hasker, Pascal Lutumba, Francois Chappuis, Victor Kande, Julien Potet, Anja De Weggheleire, Charles Kambo, Evelyn Depoortere, Bernard Pecoul, Marleen Boelaert

After a major upsurge in the 1990s, HAT is now under control in most endemic regions. To prevent resurgence from re-occurring, which we know will happen if control efforts are relaxed, the continuation of control activities is crucial. In the DRC the knowledge, expertise and capacity are in place; continued funding of the national HAT control programme would allow for these to be utilized and the epidemiological situation to be kept under control.

With new, easy to perform diagnostic tests and an oral treatment regimen in the pipeline, integration of HAT control into general healthcare services can be considered. However, integration will not be sufficient to prevent HAT resurgence in the longer term. Continued strong surveillance, covering at least the historically known HAT foci, is crucial, and cannot rely on passive case finding alone. At the same time, under the current circumstances of lowering prevalence, active surveillance using mobile teams is neither effective nor sustainable. Possible alternative approaches to surveillance have been identified but still need to be field tested and optimized.