The complex health seeking pathway of a human African trypanosomiasis patient in Côte d'Ivoire underlines the need of setting up passive surveillance systems.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Minayégninrin Koné, Emmanuel Kouassi N'Gouan, Dramane Kaba, Mathurin Koffi, Lingué Kouakou, Louis N'Dri, Cyrille Mambo Kouamé, Valentin Kouassi Nanan, Gossé Apollinaire Tapé, Bamoro Coulibaly, Fabrice Courtin, Bernardin Ahouty, Vincent Djohan, Bruno Bucheton, Philippe Solano, Philippe Büscher, Veerle Lejon, Vincent Jamonneau
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2020
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.1371/journal.pntd.0008588; https://doaj.org/article/93f2bf72f2614e198274faa305241494

Background Significant efforts to control human African trypanosomiasis (HAT) over the two past decades have resulted in drastic decrease of its prevalence in Côte d'Ivoire. In this context, passive surveillance, integrated in the national health system and based on clinical suspicion, was reinforced. We describe here the health-seeking pathway of a girl who was the first HAT patient diagnosed through this strategy in August 2017. Methods After definitive diagnosis of this patient, epidemiological investigations were carried out into the clinical evolution and the health and therapeutic itinerary of the patient before diagnosis. Results At the time of diagnosis, the patient was positive in both serological and molecular tests and trypanosomes were detected in blood and cerebrospinal fluid. She suffered from important neurological disorders. The first disease symptoms had appeared three years earlier, and the patient had visited several public and private peripheral health care centres and hospitals in different cities. The failure to diagnose HAT for such a long time caused significant health deterioration and was an important financial burden for the family. Conclusion This description illustrates the complexity of detecting the last HAT cases due to complex diagnosis and the progressive disinterest and unawareness by both health professionals and the population. It confirms the need of implementing passive surveillance in combination with continued sensitization and health staff training.