The impact and outcomes of recent control interventions against trypanosomiasis in eastern Uganda

• Main Author: Fyfe, Jenna
• Published: University of Edinburgh 2007
• Subjects: 636.089
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.651171

Appreciation of the neglected burden of trypanosomiasis led to a European Union funded programme called Farming in Tsetse Controlled Areas (FITCA); within Uganda this programme put in place measures to attempt the control of both animal and human trypanosomiasis. This thesis begins by examining the history of the trypanosomiasis control in Uganda over the past century before exploring a contemporary control treatment programme implemented in four districts of Uganda by FITCA in 2002. The impact of this programme was monitored over the course of a year by the determination of trypanosome prevalence in cattle using molecular diagnostic techniques (PCR) at a number of sites in the treated districts of Uganda. In addition, incidence of sleeping sickness in the human population before and after the intervention programme were monitored by recording and analysing sleeping sickness cases reported to district health centres. Prior to the implementation of the control programme, the prevalence of trypanosome infection in cattle across the study area was 16%; post-intervention, trypanosome infection levels had fallen to 9%. In particular, post-intervention levels of <i>T. brucei</i> s.l. dropped in all districts and overall the proportion of these infections that were attributed to human infective <i>T. b. rhodesiense</i> reduced from 33% to less than 10%. Analysis indicates that the cost per percentage decrease in the prevalence of cattle trypanosomiasis achieved by the programme was US$2,193. Statistical and spatial analysis observed no impact of the FITCA intervention on either the incidence or distribution of reported sleeping sickness cases, although different patterns were observed in epidemic and endemic areas. The efficacy of the FITCA Uganda Programme is discussed with reference to how the programme may be improved, and whether the cattle treatment represents the best long-term strategy for trypanosomiasis control in Uganda.