Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.
OBJECTIVE
To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008.


METHODS
Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database.


RESULTS
Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%).


CONCLUSIONS
High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes.
Epidemiology and Disease Control Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. ehasker@itg.be
E
E
Hasker
A
A
Mpanya
J
J
Makabuza
F
F
Mbo
C
C
Lumbala
J
J
Kumpel
Y
Y
Claeys
V
V
Kande
R
R
Ravinetto
J
J
Menten
P
P
Lutumba
M
M
Boelaert
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003223:Congo; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000627:therapeutic use*; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D055815:Young Adult
D014344:Trypanocidal Agents