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The efforts behind the elimination of a deadly disease

ITM’s Head of Communications Roeland Scholtalbers reports from a field trip to an endemic sleeping sickness area in the Democratic Republic of the Congo (DRC)

09-02-18 - Roeland Scholtalbers

Image 1/1 : Modisi Meli (left) and Bernadin Mokuba screening people at Bangumi

On the 31 January I had the pleasure to assist on the first National HAT Day (Human African Trypanosomiasis, or sleeping sickness) in Kinshasa, capital of the DRC. The following day we left for a two-day field trip to villages around the city of Bandundu where the disease is endemic.
Roeland Scholtalbers interviewing Erick Miaka

The initiative of the Minister of Health Oly Ilunga aims to raise awareness on sleeping sickness and catalyse action towards eliminating the disease in the DRC by 2020. ITM is coordinating the international support to the elimination efforts, with funding by the Belgian Development Cooperation and the Bill and Melinda Gates Foundation.

Our Congolese partners, and in primis the national sleeping sickness programme PNLTHA, are in the frontline against this deadly disease. The mobile screening teams of PNLTHA travel to even the most remote villages in this enormous country, 77 times the size of Belgium.

Dr. Erick Miaka is the Director of PNLTHA. While visiting screening activities in the small village of Bangumi he tells me that: “the Minister’s initiative of the National HAT Day raises awareness about sleeping sickness and support for active screening among opinion leaders in the communities.”

82-year old Luketu Salamboko

Going on the amount of people that have gathered, it seems the entire village has mobilised itself for the screening and the rare visit of a national Minister. Eighty-two year old Luketu Salamboko lines up in the snake-like row of seats which leads to the screening equipment. She looks me straight in the eye and says defiantly: “I have already been screened 40 times throughout my life.” Luckily for her, the lively lady has tested negative each and every time.

While Bernadin Mokuba grabs the finger of the next person in line to prick for blood, his colleague Modisi Meli uses the Card Agglutination Test for Tryopanosomiasis (CATT) to screen the blood samples of 10 villagers at once. The CATT was developed over 40 years ago at ITM and is still indispensable to screen millions of people each year. If somebody tests positive, the diagnosis is confirmed with a second laboratory test at the next table.

Inge van Cauwenberg surrounded by the girls of Bangumi

When we are about to leave Bangumi, girls gather around ITM’s DRC project officer Inge Van Cauwenberg. Inge tells me she asked a few of them about sleeping sickness: “They all knew about the disease. They knew the tsetse fly transmits it and that it is important to screen, even if you are feeling healthy.”

Small mobile screening teams on motorcycles are part of the new elimination strategy being tested by ITM and PNLTHA. The strategy is currently being rolled out across the country. The new approach also uses tiny targets developed by the Liverpool School of Tropical Medicine to attract and kill tsetse flies. Yves Claeys, HAT programme coordinator, shows his appreciation for the work of the mobile teams in this short video from the village of Ombali.

Tiny target at the riverside in Wombali

With just over 2000 new cases per year in the DRC, where an estimated 85% of the total cases occur, elimination of the disease (defined as less than 1 case per 10.000 in endemic areas and less than 2000 cases worldwide) is in sight. As cases continue to decline, health centres will have to take over screening activities. The integration of screening in the health system is crucial for the sustainability of elimination efforts, as the past has shown that sleeping sickness flares up again if we loosen our grip.

Marianne van der Sande at the hospital of Bandundu

Marianne Van Der Sande, Head of ITM’s Department of Public Health, is also part of the Ministerial delegation. “I am very impressed by the skilful efforts of our Congolese partners to find and treat patients first hand,” she says, “we are glad we can boost their work by coordinating the international support for the elimination initiative. Contributing to the elimination of neglected tropical diseases such as sleeping sickness is one of ITM’s core tasks.”

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