Prevalence of Human African Trypanosomiasis in the Democratic Republic of the Congo

Human African Trypanosomiasis (HAT) is a major public health problem in the Democratic Republic of the Congo (DRC). Active and passive surveillance for HAT is conducted but may underestimate the true prevalence of the disease. We used ELISA to screen 7,769 leftover dried blood spots from a nationally representative population-based survey, the 2007 Demographic and Health Survey. 26 samples were positive by ELISA. Three of these were also positive by trypanolysis and/or PCR. From these data, we estimate that there were 18,592 people with HAT (95% confidence interval, 4,883–32,302) in the DRC in 2007, slightly more than twice as many as were reported. Author Summary: Because of weak health surveillance infrastructures in poor countries, estimates of the burdens (numbers of infections) of many tropical diseases may be inaccurate. In particular, current estimates for the global burden of Human African Trypanosomiasis (Sleeping Sickness, HAT) vary widely. Most of the reported HAT cases occur in the Democratic Republic of the Congo, where many barriers to surveillance exist. The best way to generate accurate burden estimates is to use a survey sampled to be representative of the general population. Demographic and Health Surveys (DHS) are a widely used tool to obtain nationally representative health data and have been conducted hundreds of times in developing countries, In this report, we use samples from the 2007 Democratic Republic of the Congo DHS to estimate the burden of HAT. ELISA tests were conducted on 7,769 leftover dried blood spots followed by confirmatory trypanolysis and PCR tests. Our data suggest that there are approximately 18,592 cases of Human African Trypanosomiasis (Sleeping Sickness) in the DRC, close to WHO estimates.