[show abstract][hide abstract] ABSTRACT: This paper describes the development, design, dissemination and evaluation of a communication intervention designed to promote appropriate usage of trypanocidal drugs in trypanosomiasis endemic areas of western and coastal Kenya. Following a baseline study on current trypanosomiasis knowledge, attitudes and practices by smallholder farmers, a communication intervention strategy was developed involving dissemination through school children, village elders, animal health centres and Agrovet shops, and using layered messages in posters and leaflets. A participatory research approach was used to develop, design and assess the impact of animal health messages on the control of bovine trypanosomiasis for smallholder farmers in tsetse and trypanosomiasis endemic areas in Busia (two administrative divisions) and Kwale Districts (two administrative divisions) of Kenya. Communication intervention materials (in poster and leaflet formats) were developed and disseminated to residents in villages in one administrative division in each district (intervention area) while those from the other division in each district were not deliberately exposed to the animal health messages (control area). Several communication impact indicators were derived and these were measured 4–6 weeks after dissemination of the print media through questionnaires on trypanosomiasis knowledge administered to school children and cattle-keeping smallholders in the intervention and control study sites.School children’s post-communication intervention trypanosomiasis signs knowledge was much higher than that observed during the pre-communication intervention survey. More trypanocides were named by school children during the post-intervention questionnaire survey compared to those known during the pre-intervention survey.The trypanosomiasis signs knowledge score obtained by the smallholder farmers exposed to the extension materials was higher than that obtained by those not exposed to them. Similarly, farmers’ exposure to extension materials resulted in higher trypanocidal drug knowledge scores among exposed farmers than among those not exposed.These results indicate that over the period monitored, the routes (i.e. school children, village elders, animal health centres and Agrovet shops) and media (posters and leaflets) selected were effective in promoting a significant increase in knowledge of trypanosomiasis, its causes and ways of dealing with it among livestock keepers.
Agricultural Systems 02/2007; · 2.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Sleeping sickness is a parasitic, vector-borne disease, carried by the tsetse fly and prevalent in sub-Saharan Africa. The disease continues to pose a public health burden in Uganda, which experienced a widespread outbreak in 1900-1920, and a more recent outbreak in 1976-1989. The disease continues to spread to uninfected districts.
This paper compares the spatial distributions of sleeping in Uganda for the 1900-1920 outbreak period with current disease foci, and discusses information gaps and implications arising for future research, prevention and control.
Population census records for 1911 and sleeping sickness records from Medical and Sanitary Reports of the Ugandan Protectorate for 1905-1936 were extracted from the Uganda Archives. Current sleeping sickness distribution data were provided by the Ministry of Health, Uganda. These were used to develop sleeping sickness distribution maps for comparison between the early 1900s and the early 2000s.
The distribution of sleeping sickness from 1905-1920 shows notable differences compared to the current distribution of disease. In particular, archival cases were recorded in south-west and central Uganda, areas currently free of disease. The disease focus has moved from lakeshore Buganda (1905-1920) to the Busoga and south-east districts.
Archival sleeping sickness distributions indicate the potential for a much wider area of disease risk than indicated by current disease foci. This is compounded by an absence of tsetse distribution data, continued political instability in north-central Uganda, continued spread of disease into new districts, and evidence of the role of livestock movements in spreading the parasite. These results support concerns as to the potential mergence of the two disease foci in the south-east and north-west of the country.
[show abstract][hide abstract] ABSTRACT: Sleeping sickness re-emerged in southeastern Uganda in the 1970s and remains a public health problem. It has continued to spread north into new districts, and gaps remain in the understanding of the causes of its spread and distribution. We report the distribution and magnitude of sleeping sickness in southeastern Uganda from 1970 to 2003. Data were collected from records of the Ugandan Ministry of Health, individual sleeping sickness treatment centers, and interviews with public health officials. Data were used to develop incidence maps over time, conduct space-time cluster detection analyses, and develop a velocity vector map to visualize spread of sleeping sickness over time in southeastern Uganda. Results show rapid propagation of sleeping sickness from its epicenter in southern Iganga District and its spread north into new districts and foci.
[show abstract][hide abstract] ABSTRACT: Geographic information systems (GIS) and remote sensing were used to identify villages at high risk for sleeping sickness, as defined by reported incidence. Landsat Enhanced Thematic Mapper (ETM) satellite data were classified to obtain a map of land cover, and the Normalised Difference Vegetation Index (NDVI) and Landsat band 5 were derived as unclassified measures of vegetation density and soil moisture, respectively. GIS functions were used to determine the areas of land cover types and mean NDVI and band 5 values within 1.5 km radii of 389 villages where sleeping sickness incidence had been estimated. Analysis using backward binary logistic regression found proximity to swampland and low population density to be predictive of reported sleeping sickness presence, with distance to the sleeping sickness hospital as an important confounding variable. These findings demonstrate the potential of remote sensing and GIS to characterize village-level risk of sleeping sickness in endemic regions.
Transactions of the Royal Society of Tropical Medicine and Hygiene 05/2006; 100(4):354-62. · 1.82 Impact Factor
[show abstract][hide abstract] ABSTRACT: Four Trypanosoma (T.) congolense reference clones with known isometamidium sensitivity and 16 T. congolense stocks from cattle in Kénédougou in south-western Burkina Faso, an area with known history of drug resistance, were characterised with the standard mouse test (SMT) and the drug incubation infectivity test (DIIT). All field stocks from Kénédougou were resistant to 1.0 mg/kg bw isometamidium in the SMT. Fourteen stocks (87.5%) also proved to be refractory to 10 mg/kg bw. Testing with the DIIT confirmed the results of the SMT. By comparison to reference clones, all the Kénédougou populations expressed high levels of resistance to isometamidium.
[show abstract][hide abstract] ABSTRACT: This paper analyses the strategies of farmers in the Kénédougou province to control African Animal Trypanosomosis (AAT). Using economic, entomological, and parasitological data collected by a multidisciplinary team, we operated a binary Logit model to evaluate the probability of choice between animal health professionals and non-professionals. The results show that economic and environmental variables contributed jointly to explain the choice between professionals and non-professionals in the study area. The prevalence of trypanosomosis, and farm size affect positively and significantly the choice of farmers to use an animal health professional. However, farmers in crop production systems, and distance both negatively affect the willingness to use the services of an animal health professional. Pastoral development policies should pay attention to improving economic and geographical access to veterinary drugs in order to mitigate the impact of AAT on the productivity of farms. JEL Classification: D01, D21
Revue d’économie du développement. 01/2006; 20(5):93-111.
[show abstract][hide abstract] ABSTRACT: This paper analyzes the strategies of farmers in Kénédougou province to tackle African Animal Trypanosomosis (AAT). Using economic, entomological, and parasitological data collected by multidisciplinary team, we operate a binary Logit model to evaluate the probability of choice between animal health professionals and non professionals. The results show that economic and environmental variables contribute jointly to explain the choice between professional and non professional. The prevalence of trypanosomosis, and farm size affect positively the choice of farmers. However, farmers in crop production systems and producers who are far from the location of animal health professionals are slightly willing to choose their services for AAT control. Animal development policy should pay attention to physically and economic access to trypanocides in order to mitigate the impact of AAT on the productivity of farms.
Revue d’économie du développement. 01/2006; 20(1):99-119.
[show abstract][hide abstract] ABSTRACT: As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in central Kenya and screened for antibodies to Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli) O157:H7. The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli O157:H7 was assessed by culture, biochemical characterisation, serological testing for production of verocytotoxin one (VT1) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins. The prevalence of antibodies to B. abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli O157:H7 was isolated from two samples (0.8%), one of which produced VT1. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus greatly reducing chances of exposure to live pathogens and potential health risks.
[show abstract][hide abstract] ABSTRACT: Sleeping sickness continues to be a significant public health burden in southeastern Uganda. Continued spread of the disease into new areas of Uganda highlights our inability to understand and predict the distribution of infection. Multiple factors influence the distribution of sleeping sickness, including climate, land cover, cattle movements, prevention and control activities, and social conflict. We draw on a systems approach to conceptualize and characterize the multiple interacting forces and processes that influence the spatial and temporal dynamics of sleeping sickness in Uganda. This synthesis reveals a complex system of interactions among human and biophysical systems, feedback, and scale dependence. We identify some common analytical modeling approaches relative to our system characterization and identify opportunities for sleeping sickness research and improved understanding of disease dynamics in Uganda.
[show abstract][hide abstract] ABSTRACT: The objective of this study was to apply transition models to distinguish between factors associated with both incident and persistent trypanosome infections. Data collected from 1561 cattle were analyzed from a long-term study involving 8 herds in which both trypanosome infections (a total of 56,931 cattle sampling-months) and tsetse (Glossina spp.) challenge were monitored monthly from March 1986 to March 1998. Both pour-on and insecticide-target tsetse control programs and mass treatment with diminazene aceturate before tsetse control were associated with significant decreases in both incidence and persistence of trypanosome infection relative to noncontrol periods, as were seasonal and sex effects. The magnitudes of the effects were, however, often different for new and persistent infections. For persistence of infection, there were 2 trends. In general, the duration of infection increased during the study, despite the regular treatment with diminazene aceturate. The transition model had 2 major benefits. The first was to identify an increasing duration of infections with time, taking into account other factors associated with increasing infection risk. The second was to highlight different patterns in the effects of certain factors on new and persistent trypanosome infections.
Journal of Parasitology 01/2005; 90(6):1279-87. · 1.32 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to assess, whether polymerase chain reaction (PCR) allows sensitive screening of treatment failure suspicions in areas, where drug resistance against African animal trypanosomosis (AAT) appears to be a problem. PCR was used to detect trypanosome infections prior to, 14 and 28 days after controlled treatment of 738 cattle from 10 villages in Kénédougou, Burkina Faso with isometamidium chloride and diminazene aceturate. Using three sets of primers, PCR was three-four times more sensitive and better at species identification, than standard microscopic examination. The better sensitivity and species specificity of PCR have important advantages for drug resistance studies in the field.
[show abstract][hide abstract] ABSTRACT: In a tsetse-infested area of Kenya, we characterised veterinary-drug outlets based on personnel and business characteristics to assess their capacities to provide clinical veterinary services. Structured questionnaires were administered to the retailers and sought information on the characteristics of the owners, salespersons and businesses. A total of 41 retail outlets (20 agro-veterinary, 11 pharmacy, and 10 general shops) were identified. There was poor response to questions on owner characteristics. Proprietors, who had no more than secondary education owned 15 out of 28 shops. Few shops (4/29) were owned by proprietors, who had professional qualifications (in animal health). Most salespersons had only secondary education but no qualifications. Animal-health assistants (AHAs), veterinarians and manufacturer's package inserts (drug leaflets) were the preferred information sources for the retailers. We concluded that drug retailers were poorly equipped with the technical knowledge necessary for drug dispensation and advice.
Preventive Veterinary Medicine 05/2004; 63(1-2):29-38. · 2.39 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study assessed the degree of isometamidium resistance of trypanosomes infecting cattle in the upper Didessa valley of western Ethiopia. An initial prevalence study was conducted to identify sites with a high risk of trypanosmosis in cattle. The trypanosome prevalence varied widely, with two sites, Kone (21.3%) and Village 1 settlement (15%) having a relatively high prevalence based on the phase-contrast buffy-coat technique (BCT). In the highest risk area, the Kone settlement, an isometamidium block treatment study was conducted from April to June 2001. A total of 300 cattle were included in this study, 100 from each of three villages (Cheleleki, Kolu and Burka). At day minus 14 of the study, all 300 cattle were treated with diminazene aceturate at 7 mg/kg body weight. Subsequently, these cattle were ear-tagged and randomly assigned into two groups, 50 controls and 50 for isometamidium treatment in each village. Fourteen days later (day 0), the 50 treatment cattle were given isometamidium chloride at 1 mg/kg body weight. Both groups of cattle were then examined for trypanosome parasites using BCT every 14 days until 84 days. The two indices used in assessing isometamidium resistance, namely the proportion of infections during an 8-week follow-up period and the ratio of mean hazards in an isometamidium treated versus untreated group, provided consistent results across the three villages. In Burka village, both indices demonstrated the presence of isometamidium resistance trypanosome infections while in Cheleleki and Kolu villages, both indices did not indicate significant levels of resistance. There were significant differences between the Kaplan-Meier survival estimates of the control and treatment groups in Cheleleki (P < 0.01) and Kolu (P < 0.05) but not in Burka (P > 0.05).
[show abstract][hide abstract] ABSTRACT: The risk of consuming marketed milk containing antimicrobial residues was investigated by testing 854 unpasteurized and 110 pasteurized milk samples collected from contrasting locations, market outlets and consumer households in Kenya during 1999 and 2000. The Charm-AIM screening kit used detected antimicrobial residues in up to 16% of marketed milk samples, suggesting an average risk of exposure by consumers of up to five times every month. Higher prevalence levels of the residues were mainly associated with samples obtained lower in the market chain before bulking. Agreement between the Charm-AIM and Charm-SL test, that was used to specifically confirm the presence of β-lactams and tetracyclines, was poor beyond 72 h following drug administration due to differences in detectable limits of the tests.
[show abstract][hide abstract] ABSTRACT: The goal of this paper is to highlight the use and interpretation of statistical techniques that account for correlation in epidemiological data. A conceptual statistical background is provided, and the main types of regression models for correlated data are highlighted. These models include marginal models, random effect models and transitional regression models. For each model type an example with data from the veterinary literature is provided. The examples are specifically used to highlight estimation procedures for parameters, and the interpretation of the estimated parameters. This paper emphasizes that statistical techniques and software to fit them are more widely available now, but that parameters have different interpretations in different model types. Consequently, we stress the importance of focusing on choosing the most appropriate model for the specific purpose of the analysis.
Preventive Veterinary Medicine 07/2003; 59(4):223-40. · 2.39 Impact Factor
[show abstract][hide abstract] ABSTRACT: Field studies were conducted to assess the occurrence of resistance to isometamidium chloride and diminazene aceturate in trypanosomes infecting cattle in Kénédougou Province of Burkina Faso. Forty-five of the 166 villages in Kénédougou were randomly sampled and visited to assess livestock numbers, trypanosomosis risk, and tsetse challenge. The proportion of cattle infections associated with drug-resistant trypanosomes was assessed in the nine villages with the highest trypanosome infection prevalence and one village with a confirmed history of drug-resistant infections. These studies showed that resistance to both isometamidium and diminazene was widespread. However, there was considerable variation between villages in drug-resistance parameters, with the proportion of treated cattle with trypanosome infections 3 months after isometamidium prophylaxis varying from 6.9 to 63.8% and the proportion of cattle having infections 2 weeks after treatment with diminazene varying from 0 to 36.8%. The demonstration of widespread resistance to both isometamidium and diminazene has important implications, as administration of trypanocides is the most commonly employed method to control trypanosomosis in this area.
[show abstract][hide abstract] ABSTRACT: A study using a structured questionnaire was conducted in Busia District, Western Kenya and Kwale District, Coastal Kenya to obtain qualitative and quantitative information from 256 cattle owners about their production systems, their perceptions of the diseases encountered in their cattle, the drugs used, and other measures adopted to control trypanosomiasis in cattle. The predominant production system was mixed crop-livestock with farmers owning 2-11 local cattle on holdings between 2 and 5 ha. Approximately 15% of disease episodes in cattle were perceived to be trypanosomiasis, although the farmers' ability to make diagnoses was limited in that over half of the diagnoses were inconsistent with the clinical signs described. Drugs were generally obtained from agro-veterinary shops, and the farmers themselves administered slightly more than half of these. One third of drug treatments given to sick cattle were trypanocides, but over half of these trypanocidal treatments were given to cattle believed to have diseases other than trypanosomiasis.
[show abstract][hide abstract] ABSTRACT: Brucellosis is an important disease among livestock and people in sub-Saharan Africa. In general, the incidence is the highest in pastoral production systems and decreases as herd size and size of landholding decreases. The prevalence of risk factors for infections are best understood for bovine brucellosis and to a lesser extent for ovine and caprine brucellosis. The occurrence and epidemiology of brucellosis in pigs is poorly understood. This species bias is also reflected in control activities. As with other public-sector animal health services, the surveillance and control of brucellosis in sub-Saharan Africa is rarely implemented outside southern Africa. Brucellosis is even more ignored in humans and most cases go undiagnosed and untreated, leading to considerable suffering for those affected. Decision-making to determine the importance of brucellosis control relative to other public concerns and what brucellosis control strategies should be applied is urgently required. A strategy for how brucellosis decision-making might be considered and applied in future is outlined.
[show abstract][hide abstract] ABSTRACT: Cattle from 50 farms in Mukono County, Uganda, were monitored for trypanosomes every second month over an 18-month period (1995-1996) by mini-anion exchange chromatography and haematocrit centrifugation techniques. Eighteen trypanosome isolates collected from cattle during this period were characterised in cattle, goats and mice for their sensitivity to homidium, isometamidium and diminazene; 10 of the isolates were selected randomly, 8 were from animals that had the highest serum isometamidium concentrations at the time the isolates were collected. All the isolates contained only Trypanosoma brucei and/or T. vivax. In nai;ve Boran (Bos indicus) cattle the isolates exhibited low pathogenicity and were sensitive to diminazene aceturate at 3.5 mg/kg body weight (bw) and isometamidium chloride at 0.5 mg/kg bw. In goats, 5 of 8 isolates were highly pathogenic, producing clinical signs indicative of central nervous system involvement within 60 days of infection; all such isolates contained T. brucei. However, all 8 populations were sensitive in goats to diminazene aceturate at 3.5 mg/kg bw. In contrast, 4 populations were refractory to treatment with isometamidium chloride at 0.5 mg/kg bw in at least 1 out of 3 goats each. Furthermore, 5 populations were refractory to treatment with homidium chloride at 1.0 mg/kg bw in a minimum of 2 out of 3 goats each. In mice, the 50% curative dose values for 11 Mukono isolates that contained T. brucei ranged from 0.30 to 1.89 mg/kg bw for diminazene aceturate, from 0.02 to 0.17 mg/kg bw for isometamidium chloride and from 0.90 to 4.57 mg/kg bw for homidium chloride. Thus, by comparison to reference drug-sensitive populations, all the stabilates were highly sensitive to diminazene and isometamidium, while some expressed low levels of resistance to homidium.
[show abstract][hide abstract] ABSTRACT: Demographic and epidemiological field data were used in a deterministic model to describe dog rabies transmission in Machakos District, Kenya and to predict the impact of potential vaccination strategies for its control. The basic reproduction number (R0) was estimated to be 2.44 (1.52-3.36, 95% confidence limits). There were three key model predictions. The first was that a threshold dog density (K(T)) of 4.5 dogs km(-2) (3.8-5.2 dogs km(-2), 95% confidence limits) was required to maintain transmission. The second was that the estimated annual vaccination rate of 24% failed to decrease incidence and actually increased the stability of transmission and may be counter-productive. Thirdly, to control rabies, it was predicted that 59% (34%-70%, 95% confidence limits) of dogs should be vaccinated at any one time. This requires approximately 70% coverage for annual but only 60% coverage for semi-annual vaccination campaigns. Community-level vaccination trials are needed to test these predictions.
Epidemiology and Infection 09/2002; 129(1):215-22. · 2.87 Impact Factor