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Programme Against African Trypanosomosis (PAAT)

Stage 1: Laying the Groundwork

The focus of Stage 1 is to develop technical capacities and to gain a sufficient understanding of AAT distribution, risk and impact for an evidence-based planning of field activities. The latter will be implemented in Stage 2 and beyond.

Capacity development

Essential capacities include project management, veterinary and entomological competencies in parasitological and serological surveillance, trapping and identification of vector species, and AAT and vector control. Skills in data management and geographic information systems (GIS) to enable mapping, risk assessment and monitoring are also needed [1, 2].

Essential capacities must be built within the SNS, but more advanced ones (e.g. molecular diagnosis [3], geospatial modelling [4]), can be available from national or regional centres and laboratories, as well as from international institutions.

Understanding AAT risk and impact

The establishment of a national-level information system is another pillar of Stage 1. All recent epidemiological and entomological data should be assembled, harmonized, geo-referenced and centralized. National atlases can be developed [1], also using methodologies from the FAO continental Atlas of tsetse and AAT [5, 6]. Targeted field investigations should be conducted where gaps exist or where available information is too old to inform decision making. More generally, all necessary data for an evidence-based, rational selection of intervention areas and strategies need to be collected in Stage 1. In particular, if a fast-tracking to the elimination pathway is envisaged (Stage 3 and beyond), genetics studies are likely to be needed to establish the degree of isolation of the target tsetse populations [7, 8] and the related risk of reinvasion.

Socio-economic information on the burden of AAT is essential to justify investment and to prioritize areas for intervention. Spatially-explicit benefit-cost analyses [9, 10, 11], tsetse and AAT distribution maps [1, 5, 6] and models of tsetse distribution and isolation [4, 12] are tools that should support a rational selection of intervention areas and strategies. The occurrence and risk of HAT [13-15] should be considered, as interventions promoting One Health bring broader benefits and are more likely to attract resources [16, 18]. Security constraints (i.e. civil strife, armed conflicts, etc.) should not be overlooked.                

Pilot field interventions

While substantive field interventions are the focus of subsequent stages, pilot field activities against tsetse and AAT should be carried out in Stage 1. Their aim is to develop national capacities, fine-tune and optimize intervention tools, and motivate donors. Furthermore, throughout the PCP, field interventions may be needed to tackle possible AAT epidemics [19], including in Stage 1.

Steering committee

Stage 1 should also look at coordination. A steering committee should be set up, for orientation and supervision of the SNS and its activities. Membership should include national stakeholders (i.e., all concerned ministries such as livestock, agriculture, health, environment, etc.), as well as regional and international actors (e.g., regional economic communities (RECs), international organizations, and research institutions).

Selection of priority intervention areas and interventions strategies

Stage 1 culminates in the choice of priority intervention areas [20] and most appropriate strategies for the selected areas (AAT sustainable reduction or elimination). Importantly, the most likely strategy for subsequent stages can, to some extent, influence activities in Stage 1. For example, requirements in terms of data and capacities differ between the sustainable reduction and elimination scenarios, and this could affect activities and duration of Stage 1.T

References

  1. Ahmed, S.K. et al., An atlas of tsetse and bovine trypanosomosis in Sudan. Parasit. Vectors. 2016; 9: 194
  2. Cecchi, G. and Mattioli, R., Geospatial Datasets and Analyses for an Environmental Approach to African Trypanosomiasis.
  3. Seck, M. et al., The prevalence of African animal trypanosomoses and tsetse presence in Western Senegal. Parasite. 2010; 17: 257–265
  4. Dicko, A.H. et al., Using species distribution models to optimize vector control in the framework of the tsetse eradication campaign in Senegal. Proc. Natl. Acad. Sci. U.S.A. 2014; 111: 10149–10154
  5. Cecchi, G. et al., Developing a continental atlas of the distribution and trypanosomal infection of tsetse flies (Glossina species). Parasit. Vectors. 2015; 8: 284
  6. Cecchi, G. et al., Assembling a geospatial database of tsetse-transmitted animal trypanosomosis for Africa. Parasit. Vectors. 2014; 7: 39
  7. Solano, P. et al., Population genetics as a tool to select tsetse control strategies: suppression or eradication of Glossina palpalis gambiensis in the Niayes of Senegal. PLoS Negl. Trop. Dis. 2010; 4: e692
  8. Adam, Y. et al., Genetic comparison of Glossina tachinoides populations in three river basins of the Upper West Region of Ghana and implications for tsetse control. Infect. Genet. Evol. 2014; 28: 588–595
  9. Shaw, A. et al., Mapping the economic benefits to livestock keepers of intervening against bovine trypanosomosis in Eastern Africa. Prev. Vet. Med. 2014; 113: 197–210
  10. Shaw, A. et al., Mapping the benefit–cost ratios of interventions against bovine trypanosomosis in Eastern Africa. Prev. Vet. Med. 2015; 122: 406–416
  11. Shaw, A.P. et al., Estimating the costs of tsetse control options: an example for Uganda. Prev. Vet. Med. 2013; 110: 290–303
  12. Bouyer, J. et al., Mapping landscape friction to locate isolated tsetse populations that are candidates for elimination. Proc. Natl. Acad. Sci. U.S.A. 2015; 112: 14575–14580
  13. Simarro, P.P. et al., The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases. Int. J. Health Geogr. 2010; 9: 57
  14. Simarro, P.P. et al., Estimating and mapping the population at risk of sleeping sickness. PLoS Negl. Trop. Dis. 2012; 6: e1859
  15. Simarro, P.P. et al., Monitoring the progress towards the elimination of gambiense human African trypanosomiasis. PLoS Negl. Trop. Dis. 2015; 9: e0003785
  16. WHO. Control and Surveillance of Human African Trypanosomiasis. 2013
  17. Simarro, P.P. et al., Monitoring the progress towards the elimination of gambiense human African trypanosomiasis. PLoS Negl. Trop. Dis. 2015; 9: e0003785
  18. Grant, C. et al., Stakeholder narratives on trypanosomiasis, their effect on policy and the scope for One Health. PLoS Negl. Trop. Dis. 2015; 9: e0004241
  19. Van den Bossche, P. and Delespaux, V., Options for the control of tsetse-transmitted livestock trypanosomosis. An epidemiological perspective. Vet. Parasitol., 181 (2011), pp. 37-42
  20. Mattioli, R. et al., Tsetse and trypanosomiasis intervention policies supporting sustainable animal-agricultural development. J. Food Agr. Environ., 2 (2004), pp. 310-314.