Côte d’Ivoire has become the second African country to be validated by the World Health Organization (WHO) as having successfully eliminated human African trypanosomiasis, also known as “sleeping sickness”, as a public health problem.
The country’s health minister Aka Aouele said focus will now shift to maintaining the status and keeping the disease out.
“I dedicate this milestone to decades of hard work and the individual contribution of every single health worker who braved some of the toughest challenges in reaching populations, often in remote rural areas,” said Aouele.
“Our challenge now is to maintain the required level of surveillance and, with the help of everyone, to achieve interruption of transmission by 2030.”
The human African trypanosomiasis is a vector-borne parasitic disease caused by infection with protozoan parasites belonging to the genus Trypanosoma. The causative parasite is transmitted to humans through the bite of a tsetse fly, which has acquired the infection from humans or animals harbouring the human pathogenic parasites.
According to the WHO, the prevalence of sleeping sickness in Côte d’Ivoire has seen a steady decline over the years, from hundreds of cases annually in the 1990s to fewer than 10 cases per year in the recent past.
The agency attributes the achievement to robust control and surveillance measures, active (and passive) screening of people at risk, and targeted vector control, which helped to strongly decrease the number of cases in areas of transmission. Hospitals and health centres checked patients using specific diagnostic tests, while laboratory mobile units screened people in villages.
“Côte d’Ivoire’s achievement marks an important step that brings Africa closer to eliminating sleeping sickness,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Sustained control measures over the past 2 decades have brought a significant decline in cases – a positive sign that many countries will soon be crossing this landmark.”
Two other countries – Benin and Equatorial Guinea – have also submitted their dossiers to WHO, requesting validation for elimination of sleeping sickness as a public health problem
For any country to receive the WHO validation as having successfully eliminated the human African trypanosomiasis, it must show evidence of effective, ongoing surveillance to prove that the capacity of detecting the disease is strong. The figures must be below the specific thresholds required by WHO – that is below 1 case per 10 000 inhabitants in all districts – during a 5-year period.
