Resolving the apparent transmission paradox of African sleeping sickness

Capewell, P. et al. (2019) Resolving the apparent transmission paradox of African sleeping sickness. PLoS Biology, 17(1), e3000105. (doi: 10.1371/journal.pbio.3000105) (PMID:30633739) (PMCID:PMC6345479)

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Human African trypanosomiasis (HAT), or African sleeping sickness, is a fatal disease found throughout sub-Saharan Africa. The disease is close to elimination in many areas, although it was similarly close to elimination once before and subsequently reemerged, despite seemingly low rates of transmission. Determining how these foci persisted and overcame an apparent transmission paradox is key to finally eliminating HAT. By assessing clinical, laboratory, and mathematical data, we propose that asymptomatic infections contribute to transmission through the presence of an overlooked reservoir of skin-dwelling parasites. Our assessment suggests that a combination of asymptomatic and parasitaemic cases is sufficient to maintain transmission at foci without animal reservoirs, and we argue that the current policy not to treat asymptomatic HAT should be reconsidered.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Weir, Professor Willie and Garside, Professor Paul and Clucas, Dr Caroline and MacLeod, Professor Annette and Capewell, Dr Paul
Authors: Capewell, P., Atkins, K., Weir, W., Jamonneau, V., Camara, M., Clucas, C., Swar, N.-R. K., Ngoyi, D. M., Rotureau, B., Garside, P., Galvani, A. P., Bucheton, B., and MacLeod, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:PLoS Biology
Publisher:Public Library of Science
ISSN (Online):1545-7885
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in PLOS Biology 17(1):e3000105
Publisher Policy:Reproduced under a Creative Commons License

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