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. 2013 Jul 10:6:204.
doi: 10.1186/1756-3305-6-204.

Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda

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Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda

Kevin Bardosh et al. Parasit Vectors. .

Abstract

Background: 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. 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.

Methods: A 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.

Results: Although 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/km(2). 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.

Conclusions: Conflicts 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.

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Figures

Figure 1
Figure 1
Districts of Uganda that are either at high risk of Rhodesian sleeping sickness or are at risk of overlap between Gambian (chronic) and Rhodesian (acute) disease that should be considered as a priority for Acaricide Zoning. There are 32 districts at high risk for Rhodesian sleeping sickness (approx. 2.6 million cattle). These are districts (highlighted in green) that have been historically affected by Rhodesian sleeping sickness and districts where humans are currently at risk of infection from the animal reservoir of infection (green). There are 18 further districts of Uganda where there have not yet been reported cases of Rhodesian sleeping sickness (approx. 1.8 million cattle) but which are at risk of immigration of acute disease from livestock movements, these include districts currently affected by Gambian sleeping sickness (pink).
Figure 2
Figure 2
The acaricide market divided by product sales. Based on data from the 48 veterinary shops that exclusively imported products from Kampala. The data showed that an estimated 640.1 L of acaricide were sold during the rainy season each month in 2011.
Figure 3
Figure 3
The percentage of acaricide sold by product type per district. (Based on monthly sales data from the 62 veterinary shops during the rainy season).

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