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Table 1 Specific challenges of HAT control in conflict zones

From: Challenges of controlling sleeping sickness in areas of violent conflict: experience in the Democratic Republic of Congo

• Conflict-afflicted areas are often already remote with minimal (if any) health infrastructures and limited numbers of trained medical staff, and their often precarious state is further eroded by insecurity.
• Insecurity often hinders active case-finding activities since mobile teams are often restricted in their travel.
• Populations often move, hampering treatment provision and post-treatment monitoring and follow-up.
• Population movements can also trigger new foci or reactivate old ones.
• Community awareness and support are important factors for effective screening and treatment. Population displacement due to insecurity can rupture community networks.
• Direct attacks of treatment centres or transport trucks can lead to programme interruption or cessation, withdrawal of supporting international NGOs and key national staff, or disruption of logistic support.
• Difficult diagnosis, complex treatment, and long follow-up are especially challenging in conflict situations, because of the high technical skills and continuity of service required.