千葉大学真菌医学研究センター概要 1997

<p>Probabilistic sensitivity analysis (societal perspective): (a) scatter plot of incremental societal cost in US$and incremental number of appropriately treated fever episodes resulting from replacing clinical diagnosis of malaria by rapid diagnostic test, 2011 (US$1 = GHS1.51) and (b) cost-effectiveness acceptability curve.</p

Profile of time series included in the analysis, by HAT project.

<p>Profile of time series included in the analysis, by HAT project.</p

The impact of passive case detection on the transmission dynamics of gambiense Human African Trypanosomiasis

<div><p>Gambiense Human African Trypanosomiasis (HAT), or sleeping sickness, is a vector-borne disease affecting largely rural populations in Western and Central Africa. The main method for detecting and treating cases of gambiense HAT are active screening through mobile teams and passive detection through self-referral of patients to dedicated treatment centres or hospitals. Strategies based on active case finding and treatment have drastically reduced the global incidence of the disease over recent decades. However, little is known about the coverage and transmission impact of passive case detection. We used a mathematical model to analyse data from the period between active screening sessions in hundreds of villages that were monitored as part of three HAT control projects run by Médecins Sans Frontières in Southern Sudan and Uganda in the late 1990s and early 2000s. We found heterogeneity in incidence across villages, with a small minority of villages found to have much higher transmission rates and burdens than the majority. We further found that only a minority of prevalent cases in the first, haemo-lymphatic stage of the disease were detected passively (maximum likelihood estimate <30% in all three settings), whereas around 50% of patients in the second, meningo-encephalitic were detected. We estimated that passive case detection reduced transmission in affected areas by between 30 and 50%, suggesting that there is great potential value in improving rates of passive case detection. As gambiense HAT is driven towards elimination, it will be important to establish good systems of passive screening, and estimates such as the ones here will be of value in assessing the expected impact of moving from a primarily active to a more passive screening regime.</p></div

Profile of time series included in the analysis, by HAT project.

<p>Profile of time series included in the analysis, by HAT project.</p

Estimates of the human-to-human reproduction number and transmission impact of passive detection, by HAT project.

<p>95%CIs are given in parentheses.</p

Model parameters.

<p>95% CIs are given in parentheses.</p

Distribution of maximum likelihood estimates of the incidence rate, by project.

<p>Distribution of maximum likelihood estimates of the incidence rate, by project.</p

Association of incidence rate with village population size and passive case detection rate.

<p><i>Coefficient</i> is the median adjusted coefficient, and <i>p-value</i> the median adjusted p-value, both with 95% confidence intervals given in parentheses.</p

Estimates of incidence rate and detection coverage, by HAT project.

<p>95%CIs are given in parentheses.</p

MOESM1 of Adherence to treatment with artemether–lumefantrine or amodiaquine–artesunate for uncomplicated malaria in children in Sierra Leone: a randomized trial

Additional file 1:Table S1. Package availability by drug and sit