DOI: 10.5061/dryad.036ds
title: Data from: Impact of the Ebola outbreak on Trypanosoma brucei gambiense infection medical activities in coastal Guinea, 2014-2015: a retrospective analysis from the Guinean national Human African Trypanosomiasis control program

description: Background: The 2014–2015 Ebola outbreak massively hit Guinea. The coastal
 districts of Boffa, Dubreka and Forecariah, three major foci of Human
 African Trypanosomiasis (HAT), were particularly affected. We aimed to
 assess the impact of this epidemic on sleeping sickness screening and
 caring activities. Methodology/Principal findings: We used preexisting
 data from the Guinean sleeping sickness control program, collected between
 2012 and 2015. We described monthly: the number of persons (i) screened
 actively; (ii) or passively; (iii) treated for HAT; (iv) attending
 post-treatment follow-up visits. We compared clinical data, treatment
 characteristics and Disability Adjusted Life-Years (DALYs) before
 (February 2012 to December 2013) and during (January 2014 to October 2015)
 the Ebola outbreak period according to available data. Whereas 32,221
 persons were actively screened from February 2012 to December 2013, before
 the official declaration of the first Ebola case in Guinea, no active
 screening campaigns could be performed during the Ebola outbreak.
 Following the reinforcement and extension of HAT passive surveillance
 system early in 2014, the number of persons tested passively by month
 increased from 7 to 286 between April and September 2014 and then abruptly
 decreased to 180 until January 2015 and to none after March 2015. 213
 patients initiated HAT treatment, 154 (72%) before Ebola and 59 (28%)
 during the Ebola outbreak. Those initiating HAT therapy during Ebola
 outbreak were recruited through passive screening and diagnosed at a later
 stage 2 of the disease (96% vs. 55% before Ebola, p&lt;0.0001). The
 proportion of patients attending the 3 months and 6 months post-treatment
 follow-up visits decreased from 44% to 10% (p &lt;0.0001) and from 16%
 to 3% (p = 0.017) respectively. The DALYs generated before the Ebola
 outbreak were estimated to 48.7 (46.7–51.5) and increased up to 168.7
 (162.7–174.7), 284.9 (277.1–292.8) and 466.3 (455.7–477.0) during Ebola
 assuming case fatality rates of 2%, 5% and 10% respectively among
 under-reported HAT cases. Conclusions/Significance: The 2014–2015 Ebola
 outbreak deeply impacted HAT screening activities in Guinea. Active
 screening campaigns were stopped. Passive screening dramatically decreased
 during the Ebola period, but trends could not be compared with pre-Ebola
 period (data not available). Few patients were diagnosed with more
 advanced HAT during the Ebola period and retention rates in follow-up were
 lowered. The drop in newly diagnosed HAT cases during Ebola epidemic is
 unlikely due to a fall in HAT incidence. Even if we were unable to
 demonstrate it directly, it is much more probably the consequence of
 hampered screening activities and of the fear of the population on
 subsequent confirmation and linkage to care. Reinforced program
 monitoring, alternative control strategies and sustainable financial and
 human resources allocation are mandatory during post Ebola period to
 reduce HAT burden in Guinea.
description: Passive screening and
 patients treated for HATPassive screening
 database, HAT treated patients database, thesaurus, data used for the
 article figures 3A to 3F.Dryad_Tables_30102017_bis_EO_Final.xls