Welcome to this week on treatment control elimination predication of guys disease and sleeping sickness. These are also closer to what we talked about last week the media. And they're. Very closely related. These ones. Blood cells. As we have discussed in earlier in the other courses. There are two there are many forms of that that it matters to me as disease Africanus to me sickness Jaegers disease and even within. The African continent there are different types of clinical manifestations so what we are trying to do here is to see how the same fictions. Many. And how they are controlled. In. Africa and in diameter. So all of you discuss the global efforts to control the disease control strategies which are followed. And we tried to give some examples from the field specially that African example. Again. We see that the. Control here is mainly control in. Both. Jazz and African sleeping sickness directed. Busy screening would be screening and. Treatment so. That's why we have one. Went back and I again tried to stress. Some of the things which we discussed in earlier as part of the back nosies. Of policy in fictions H M eight and in six course. The screening and then they ignored their most to approach year he's very important for success of any control program in relation to the panel muses. So the disease significance of these in Africa shown here and the victors he says Lot and the people I three Sc are also and the species which are responsible for the disease to be part of the mobile site. And. After going to the drawing board the number of cases it was in two thousand and nine has dropped below ten thousand for the first thing fifty years so you see what type of Air Force. We're there that led to this success restraint has been maintained in two thousand and ten with seven thousand new cases the noise and treatment with disease. Are complex and. There were skilled staff and we said screening. That means that noise is is a very. Important step towards control or management of the want to muse is also it meaning this theory of the disease in early Q late because the treatment. As we. Discussed also was part of the Gnostic of course treatment or so it differs for different. According to the clinical. Phase of the disease. As for that I'm really going to be biased I mean it is not. It's not listen if you can. It has this is the choice here where it exists mainly. In America. And. Number of people. Who are affected or infected is significant and just a reminder I put the life cycles of both African tomato muses an American to buy the Sony It is so I want you to remember to compare the differences in transmission victories and how these last media we still use are effective. Between the two types of interaction so the transmission as a reminder Africa you're going to be used by Sly and. Good can again the transmission. Is really blood transfusion transmission strain Why do we mention this because if you compared these parameters to the transmission for American people you see lots of differences where whereas. Congenital and blood transfusion are important parameters you see how this has affected the control strategies so you know how many contributors on the U.S. is various species of bugs are responsible lie look transfusion board. Is significant. And. Sometimes the butterflies coming from is symptomatic the problem isn't to donors that's the that's why it has become one of the targets or one of the culmination of going to the shore to properly. CREAN No I don't applaud for to be punished for muses So I guess he's. Own. The parasite I mean because out most of any forms these are actually. Specially. Blood from those who are at risk of the infection and then there is another factor which. Can get it across mission and this is it makes it necessary to follow. We have fiction in the newborns to use him as an early as possible so let us try to see the eggs African example the control of human. African to battle music is known as heart it's U.-T. another difference which I so wish at the difference between the transmission between American and African to bunch of music is that look transfusion the community transmission the fact that it's different. But also. There are there are a lot of differences. Which we will come across as we discuss. QUANTRILL programs and their strategies. In Africa and in letting in the Americas for example. The American Taliban assume yes is there are why the ring of why resolve what So that has also an impact on the control methods which are used. It will start with the African example which is which relies mainly on King with European at. With their noses of the infection it concentrates on or so on doctor control the supply and the control of the only one result of which are mainly domesticated animals here unlike. The. American. We saw there is a hope. For. I mean I think it is a control of Africa divisiveness would be easier than controlling that medical device in it so let us see the ultimate objective of the blue sure right this is a can use and why those are not for field elimination of are going to eventually is as a public health problem stablish sustained see a variance in any countries to monitor the situation at least. In the neutral goals. So let's try to use which are used to achieve these goals so it concentrates the program was in three words I had people who are at risk of infection and for those people they are trying to provide accessibility to their noses and treatment and they are trying to string think this is where Lance and the control may years among them. To development of more by teams because see it in particular areas are very remote. And seek an active case finding series this is bigger than we can while teams maintenance of network for passive surveillance. Do you still feel unsourced not only running after. Not only immobile but you are trying to establish a method to continuously look for the presence of the infection and. With no good abort reporting all these are false where you going again you will not be. That we will not be of any use the guidelines. And policies. Also. To control or to. Have One eyes that want or is trying to use between different you can if you can look Asians without that elimination will not be achieved so. That being said there is no universal method which is now used poor the control of Africa to show me things that have programs but all the control program programs they are using one or more of the strategies which we have mentioned. Still filled out to a not so long line. Brain function was driven into certain countries. But the control programs reduce reported cases from two hundred six thousand in two thousand in two thousand to seven salad two hundred in two thousand and ten however you have we have to be careful when reading these figures because the reliance has not covered many areas of instability these those areas of C.B.I. rest war and one would expect these figures. All read these figures and. Be careful about interpretation. As the real figures might be a little bit higher than what we are seeing here because of the sports which are not covered. I want to give an example from an area Roma which is in the Democratic Republic of Congo less so than. The border of what is now in. As a father in Sudan. And this program is focusing mainly on screening and treatment. In France was found to average to be. In the average of three point six percent so of was all that five hundred seventy patients were seated in two thousand and nine and then because of similar is and the war program was interrupted and stopped and then the program was restarted again all restart again all resumed again in two thousand and ten and in the period from two thousand and ten to join eleven they were able to treat. Eight hundred patients so. The same program drama in two thousand and twelve they have started adopting a new approach. So they have tried to have started adopting the approach of them or by. Teams to reach. Those spots remote areas which we should we not normally be covered with existing health care system. These one by lack teams. They are aiming at improving the screen they are aiming at improving the screening and to screen what areas treat the infected and train personnel to help in the maintenance of the control or sustainability of the control program. So by two thousand. And. Twenty programs are running in those areas they have to screen three. Million people and they have three hundred fifty. This is not only in. But all in all the area so that gives a. Drama as an example for what is going on. What are they telling you that are facing these programs. The lack of simple the Gnostic method that can be applied easily in the field. Or. I mean sea of treatment it is not easy and complicated and it depends on the state of the disease the interruption of the programs by civil unrest the war instability and the lack of the local skilled local personnel in the remote areas this is very important for the sustainability of any control program and now there is a there is a huge shortage in the resources the finance and these are the main challenges that are facing the control programs in Africa so. Sustainable immunization if we want to sustain if if we want to eliminate the fiction you have to think in the same time about the sustainability how can we sustain that elimination this sustainability it took words improved their Gnostic and treatment methods it requires a stronger set of valence. Method to detect any future. Existing after cases for the follow up improve that exists. Existing actually one of the exciting existing health structure. And. Especially at. That risk areas. Because existing health. Facilities might not reach some of the areas. And we need to develop a list in this in staging. Methods. Tool you need us to determine the state of the disease and told that we can you. To monitor one follow up as a patient after the treatment the one which is used commonly is very invasive that currently use a number function which is. In ways if we need to develop a whole block this is easy to apply in the field or theatre to see a method simple single method that we can use for screening and for. Them is the use of disease and for as a follow up as you know that if the treatment as we discussed earlier. The treatment discussed with and there is a course that must be called the treatment or sleeping sickness. It depends on this deal of the disease if it is that you would or the chronic or that there are different types of treatment and different types of. Systems which are follow in each case. So that was the case for the. African evangelists What about all the struggles disease in America. Before that I would like to guess to go out again although we have got this before and there's I think that was called we need to. Refresh our information about the prevention treatment of the African bison meat so. We have to remember that. The animals are involved in this to get animals on a volunteer force all the control we involve your education of the victor. Treatment for inflicted. On animals. And ways to protect that to avoid the victors to the. Needs or closing or use of your sickly parents there are no we have to put in mind that there are no safe. Prophylaxis will affect me yeah he's usually have you noticed and there are NO THAT seen the present vaccine you will be a huge help towards a controlled prevention. That region which is used I said before it depends on this is the state. Of the disease. We have so I mean what happened the organic chemicals if. Anything. We have. As I said before we need to know the state of the picture to I mean. How to work it was read me we need to know about which organs are involved and this varies between different individuals and we need to know if there is a strain which is. Which has the drug resistance. Comparing we want to compare this to the situation in America Jagger's So as Joe does as you remember it is trust me and by bugs transmission is different. Blood transfusion. Going to transmission is important so many victims control in their Americas lighting up specially let anybody go. Drinking on better control and they are also screening. A lot of donor especially those who come from. Those who are at risk believe in the fiction through transfusion transplant patient so organ transplantation fiction is also a significant route here we are not. Of course organ transplant transplant the Asian in those you want to use in Africa is not of significance. Larded why I mean what reason for these also another difference from the African when it does it is that the domestic animals here get it and why anyone's So it's more difficult but aside can not be eradicated so our goals here are initial transmission and. Provide health care access for those who are actually scanned those who are infected so let us go through what is commended by the mutual for the control of the American missile Mees he said sites to space houses and surroundings to get rid of the bugs and to improve the house. The houses because these bugs they live. In particular and the City particular condition environment. Person and preventive measures such as use of. Repellent bed nets would how you practices. Preparing the food transportation and storage and consumption screening of the blood donors because we see a transfusion he's saying if you can throw this thing or don't because. All struck transplantation is important. They give it a screening of New York and other. Allegedly for infected mothers to provide it it was these things with me stressing that it would mean these. Then essentially So these are the blue sure the condition for part of the control program adopted for controlling America. Is. There there have been some success significant reduction in transmission. In. The mystic animals. Significant. Reduction in. The infections through blood transfusion What are the challenges. The Joining is. Include sustainability and. The control advances saw these how to evaluate even is a problem in proper methods for evaluating where you are standing at. Another challenge is a million subjects is it real and previously was considered to be free of the disease that's because of their. Population movements the million it is in do you know where control have been in progress such as. Child of Argentina and believe you're so. People of course doing it in particular areas but the disease appearing in another area submission mainly due to increasing pollution mobility between Latin America and the rest of the world. Again like the case in that. African music is we need to improve our there no stigma thoughts and we need to improve our treatment and make them accessible. For those who are like least in need. As far as the prevention three treatment of American depends on us is so. Strong to give. Here. Includes screening of immigrants you know you clearly there are some really this which are available and can be done in the labs identification of if you're to it's not it's not you know it's a lot more suitable for the field use and if you know the identification you treat individuals. And. Treating them to use a morbidity especially those with heart problems we know which I guess. That's causing my Does congenital infection avoid contact with. Insects or bugs. So all improving. Houses or controlling I would not activities or use of. Balance and doctors don't know vaccines you know for the treatment of American and so on here says they are. And satisfactory. Not only for democracy is one and. Any There's all is another one but however I give the State of the products I and. Which is infected. Are important if you had me here because there are different. Systems which are useful to even be used on. The stadiums in fiction also here again we need the tools we should enable us easily to differentiate between different phases of the infections so it's tools now lacking and sometimes we have to go for the relief. Measures in order to know about things fiction. This is what I wanted to preview of I would want to earning the control. Off the guys disease and sleeping sickness you know Africa in the Americas. Until we continue again after the. Next week so I wish you could buy and thank you.