Stop transmission of gambiense human African trypanosomiasis (StrogHAT)
Summary
Gambiense human African trypanosomiasis (gHAT) is a neglected tropical disease caused by trypanosome parasites which is fatal if left untreated. So far, treatment options for gHAT were limited and toxic, forcing control programmes to avoid overtreatment through complex diagnostic procedures, including screening with a serological test, laborious microscopic confirmation of seropositives and lumbar puncture for disease stage determination. This resulted in loss of up to 50% of gHAT cases, which remained untreated.
Recently, a non-toxic single dose oral drug, acoziborole, has shown 98.1% efficacy in a phase III trial, irrespective of gHAT disease stage. Acoziborole removes the need for lumbar puncture and appears safe enough to treat serological suspects without microscopic confirmation (screen & treat).
StrogHAT intends to provide the first evidence for recommending screen & treat to national HAT control programmes for gHAT elimination. Through facilitated diagnosis, increased acceptability and access to treatment, StrogHAT will contribute to achieving the goal of stopping gHAT transmission by 2030, as defined by the World Health Organization.
Project
Stop transmission of gambiense human African trypanosomiasis (StrogHAT)
Period
July 2023 – June 2028
Contact
Elena Nicco
Principal Investigator
Key actors
Programme National de Lutte contre Trypanosomiase Humaine Africaine
(DRC)
Participant
Objectives
Primary objective:
To evaluate if a screen & treat strategy can lead to interruption of gHAT transmission in a mainland focus
Secondary objectives:
To provide further evidence for safety of acoziborole in seropositive gHAT suspects
To provide an accurate cost estimate for a screen & treat strategy
To achieve these objectives, screen & treat will be implemented, actively and passively, for three consecutive years in the gHAT focus of Nord Equateur in the Democratic Republic of the Congo (DRC). Available geographical information will be exploited to specifically target villages where gHAT is present or recently was. Detection at a reference laboratory, of the trypanosomes nucleic acids in blood collected before treatment, will retrospectively identify true gHAT cases among the treated serological suspects. After 3 years of intervention, the gHAT prevalence in the focus will be re-estimated.
StrogHAT kick-off
On 29 August 2023, ITM hosted the kick-off meeting of the StrogHAT project. Representatives from the WHO, the EU and the Bill & Melinda Gates Foundation, as well as various HAT experts, joined us for the launch of this exciting and innovative project.
Funding
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