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Active screening was completely interrupted and passive screening could only be maintained in a few health facilities. At the end of the epidemic, medical interventions were progressively intensified to mitigate the risk of HAT resurgence and progress towards disease elimination.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>A retrospective analysis was performed to evaluate the medical activities that were implemented in the three most endemic prefectures of Guinea (Boffa, Dubreka and Forecariah) between January 2016 and December 2018. Passive screening using rapid diagnostic tests (RDTs) was progressively resumed in one hundred and one health facilities, and active screening was intensified by visiting individual households and performing RDTs, and by conducting mass screening in villages by mobile teams using the Card Agglutination Test for Trypanosomiasis. A total of 1885, 4897 and 8023 clinical suspects were tested in passive, while 5743, 14442 and 21093 people were actively screened in 2016, 2017 and 2018, respectively. The number of HAT cases that were diagnosed first went up from 107 in 2016 to 140 in 2017, then subsequently decreased to only 73 in 2018. A progressive decrease in disease prevalence was observed in the populations that were tested in active and in passive between 2016 and 2018.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>Intensified medical interventions in the post-Ebola context first resulted in an increase in the number of HAT cases, confirming the fear that the disease could resurge as a result of impaired control activities during the Ebola epidemic. On the other hand, the decrease in disease prevalence that was observed between 2016 and 2018 is encouraging, as it suggests that the current strategy combining enhanced diagnosis, treatment and vector control is appropriate to progress towards elimination of HAT in Guinea.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009163","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T22:22:19Z","timestamp":1613514139000},"page":"e0009163","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Accelerating elimination of sleeping sickness from the Guinean littoral through enhanced screening in the post-Ebola context: A retrospective analysis"],"prefix":"10.1371","volume":"15","author":[{"given":"Oumou","family":"Camara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6994-9853","authenticated-orcid":true,"given":"Sylvain","family":"Bi\u00e9ler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-5426","authenticated-orcid":true,"given":"Bruno","family":"Bucheton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo\u00efse","family":"Kagbadouno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Mathu Ndung\u2019u","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4351-3506","authenticated-orcid":true,"given":"Philippe","family":"Solano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Camara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"issue":"12","key":"pntd.0009163.ref001","doi-asserted-by":"crossref","first-page":"e0006890","DOI":"10.1371\/journal.pntd.0006890","article-title":"Monitoring the elimination of human African trypanosomiasis: Update to 2016","volume":"12","author":"JR Franco","year":"2018","journal-title":"PLoS neglected tropical diseases"},{"issue":"10110","key":"pntd.0009163.ref002","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/S0140-6736(17)31510-6","article-title":"Human African trypanosomiasis","volume":"390","author":"P Buscher","year":"2017","journal-title":"Lancet"},{"key":"pntd.0009163.ref003","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1051\/parasite\/2019061","article-title":"Sleeping sickness in the historical focus of forested Guinea: update using a geographically based method","volume":"26","author":"F Courtin","year":"2019","journal-title":"Parasite"},{"key":"pntd.0009163.ref004","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1476-072X-9-57","article-title":"The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases","volume":"9","author":"PP Simarro","year":"2010","journal-title":"International journal of health geographics"},{"key":"pntd.0009163.ref005","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1186\/s13071-015-1121-x","article-title":"Evaluating long-term effectiveness of sleeping sickness control measures in Guinea.","volume":"8","author":"A Pandey","year":"2015","journal-title":"Parasites & vectors"},{"issue":"11","key":"pntd.0009163.ref006","doi-asserted-by":"crossref","first-page":"e0006060","DOI":"10.1371\/journal.pntd.0006060","article-title":"Impact of the Ebola outbreak on Trypanosoma brucei gambiense infection medical activities in coastal Guinea, 2014\u20132015: A retrospective analysis from the Guinean national Human African Trypanosomiasis control program","volume":"11","author":"M Camara","year":"2017","journal-title":"PLoS neglected tropical diseases"},{"issue":"12","key":"pntd.0009163.ref007","doi-asserted-by":"crossref","first-page":"e1949","DOI":"10.1371\/journal.pntd.0001949","article-title":"Epidemiology of sleeping sickness in Boffa (Guinea): where are the trypanosomes?","volume":"6","author":"MS Kagbadouno","year":"2012","journal-title":"PLoS neglected tropical diseases"},{"issue":"8","key":"pntd.0009163.ref008","doi-asserted-by":"crossref","first-page":"e0003727","DOI":"10.1371\/journal.pntd.0003727","article-title":"Reducing Human-Tsetse Contact Significantly Enhances the Efficacy of Sleeping Sickness Active Screening Campaigns: A Promising Result in the Context of Elimination","volume":"9","author":"F Courtin","year":"2015","journal-title":"PLoS neglected tropical diseases"},{"issue":"3","key":"pntd.0009163.ref009","first-page":"169","article-title":"A card-agglutination test with stained trypanosomes (C.A.T.T.) for the serological diagnosis of T. 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