Abstract
BackgroundCaused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the ‘Stamp Out Sleeping Sickness’ programme.MethodsA mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews.ResultsAlthough 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km2. Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non-tsetse effective products the most effective way to increase pyrethroid use.ConclusionsConflicts of interest between veterinary business and vector control were found to constrain sleeping sickness control. While a variety of strategies could increase pyrethroid use, regulation of the insecticide market could effectively double the number of treated cattle with little cost to government, donors or farmers. Such regulation is entirely consistent with the role of the state in a privatised veterinary system and should include a mitigation strategy against the potential development of tick resistance.
Highlights
Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle
Human African Trypanosomiasis (HAT) or sleeping sickness is caused by two related trypanosome sub-species, T. b. gambiense and T. b. rhodesiense, that are geographically separated by the Great Rift Valley
Acaricide supply Veterinary drug shops were the main suppliers of acaricides in the area, procuring products in Kampala (Uganda’s capital) and selling them directly to farmers and to intermediary para-veterinarians, community-based animal health workers and government programmes
Summary
Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. African trypanosomiasis refers to a group of parasitic diseases affecting people, livestock and wildlife transmitted by infected tsetse flies, found south of the Sahara and north of the Kalahari. African animal trypanosomiasis (AAT) or nagana is one of the most significant African livestock diseases with a major impact on cattle mortality and productivity [1,2,3]. Human African Trypanosomiasis (HAT) or sleeping sickness is caused by two related trypanosome sub-species, T. b. Gambian sleeping sickness is responsible for the majority of cases through human-tsetse transmission, but the zoonotic parasite Under control in the late colonial era, HAT epidemics re-surfaced in the context of the ‘Great African Depression’ of the 1980s, but have been steadily declining since the late-1990s due to renewed global and national efforts [10,11,12]
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