Eliminating Human African Trypanosomiasis Where Do We Stand and What Comes Next 英文参考文献.docVIP

Neglected Diseases Eliminating Human African Trypanosomiasis: Where Do We Stand and What Comes Next? Pere P. Simarro , Jean Jannin, Pierre Cattand * I n the early part of the twentieth century, human African trypanosomiasis (HAT), also known as sleeping sickness, decimated the population in many parts of sub-Saharan Africa. In the 1930s, the colonial administrations, conscious of the negative impact of the disease on its territories, established disease control programmes. Systematic screening, treatment, and follow-up of millions of individuals in the whole continent led to transmission coming to a near halt by the 1960s. With the advent of independence in most countries where HAT was endemic, the newly independent authorities had other priorities to deal with. The rarity of HAT cases, and a decline in awareness of how the disease could return, led to a lack of interest in disease surveillance. Over time the disease slowly returned, and some thirty years later, ?are-ups were observed throughout past endemic areas (Figure 1). Since 1995, the World Health Organization (WHO) has on many occasions expressed its concern about the rise in HAT cases. The World Health Assembly has passed several resolutions in an attempt to stem this rise. However, social upheavals, wars, and population movements, combined with lack of awareness and shortage of funds, prevented any progress in interrupting transmission, and the disease continued to evolve and spread. In a 1997 resolution, WHO strongly advocated access to diagnosis and treatment and the reinforcement of surveillance and control activities, concurrently setting up a network to strengthen coordination among all those actively concerned by the problem [1]. As a consequence, the public and private sector granted stronger support to HAT surveillance, control, and research. meat and milk and deprives African farmers of draught animal power, substantially minimising crop production. Therefore, both human and animal trypanosomias