Checchi, F., Filipe, J.A., Haydon, D.T., Chandramohan, D. and Chappuis, F. (2008) Estimates of the duration of the early and late stage of gambiense sleeping sickness. BMC Infectious Diseases, 8(16), (doi: 10.1186/1471-2334-8-16)
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Publisher's URL: http://dx.doi.org/10.1186/1471-2334-8-16
Abstract
Background: The durations of untreated stage 1 (early stage, haemo-lymphatic) and stage 2 (late stage, meningo-encephalitic) human African trypanosomiasis (sleeping sickness) due to Trypanosoma brucei gambiense are poorly quantified, but key to predicting the impact of screening on transmission. Here, we outline a method to estimate these parameters. Methods: We first model the duration of stage 1 through survival analysis of untreated serological suspects detected during Medecins Sans Frontieres interventions in Uganda and Sudan. We then deduce the duration of stage 2 based on the stage 1 to stage 2 ratio observed during active case detection in villages within the same sites. Results: Survival in stage 1 appears to decay exponentially (daily rate = 0.0019; mean stage 1 duration = 526 days [ 95% CI 357 to 833]), possibly explaining past reports of abnormally long duration. Assuming epidemiological equilibrium, we estimate a similar duration of stage 2 (500 days [ 95% CI 345 to 769]), for a total of nearly three years in the absence of treatment. Conclusion: Robust estimates of these basic epidemiological parameters are essential to formulating a quantitative understanding of sleeping sickness dynamics, and will facilitate the evaluation of different possible control strategies
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Haydon, Professor Daniel |
Authors: | Checchi, F., Filipe, J.A., Haydon, D.T., Chandramohan, D., and Chappuis, F. |
Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
College/School: | College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine |
Journal Name: | BMC Infectious Diseases |
ISSN: | 1471-2334 |
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