EUROPEAN UNION (EU)

            The European Union has been supporting tsetse and trypanosomosis (T & T) interventions in the context of rural development for more than 25 years.  In the early 1980s the European Commission initiated the Regional Tsetse and Trypanosomiasis Control Programme (RTTCP) in Malawi, Mozambique, Zambia and Malawi.  The RTTCP focused on a community-based approach and aimed at covering an area of more than 300 000 km².  This programme, financed by the European Commission for about 15 years (1986-2000), had somewhat mixed results, which was partly due to the magnitude of the programme.  One lesson learned from the RTTCP was that an approach towards T&T should focus on regional, national and local capacity building and, particularly, at empowering local communities.

            Building on the experience of the RTTCP, in 1986 the Commission formed the regional programme FITCA (Farming in Tsetse Controlled Areas) in five Eastern African countries (Ethiopia, Kenya, Rwanda, Uganda and the United Republic of Tanzania).  The programme initially was scheduled to last four years (up to 2000) but delays caused by bureaucratic and other problems made it necessary to extend the programme to 2004. FITCA established that T&T control works best when based on active partnerships in which control measures are carried out with full community involvement and aims at generating resources for the development of sustainable rural incomes. In early 2005 an evaluation of FITCA concluded that – although the results of the programme were different in the five participating countries – FITCA had led to many innovative and positive approaches.

            The presenter highlighted that the 28th meeting of the ISCTRC took place at an auspicious time, as the European Commission was then developing a new overall-EU vision on how best to address Africa’s development needs. A proposal regarding this vision was expected to be approved by the European Commission on October 12th and was anticipated to be a key discussion point at a high level meeting between the EU and the AU Commissions later that  year

AFRICAN DEVELOPMENT BANK (ADB)

           The African Development Bank Group was committed to be a partner in the suppression, control and eradication of Tsetse and Trypanosomiasis in Africa. Currently the Bank was funding a multinational project covering 6 countries namely Ethiopia, Kenya and Uganda in East Africa and Burkina Faso, Ghana and Mali in West Africa. So far the Bank and the Regional Member Countries involved in phase I had commited UA54.96 million (about US$82 million). The goal of the Tsetse and Trypanosomiasis Control programme was to contribute to poverty reduction, food security and sustainable development in Africa. This would be achieved through the creation of sustainable Tsetse and Trypanosomiasis free countries in Africa by integrating suppression, control and eradication technologies while ensuring the reclaimed areas are equitably, sustainably and economically exploited and maintaining environmentally friendliness and sustainability. The Bank was committed to the continued support of the programme of Tsetse and Trypanosomiasis suppression, control and eradication by making available more resources to cover more countries. This will depend on preparedness and commitment of the beneficiary countries. The Bank’s participation in the ISTRC conference was to show its commitment and willingness to provide more resources to Regional Member Countries to address the problems of Tsetse and Trypanosomiasis. The Bank delegation was hoping to benefit from the discussions that would ensue during the deliberations with a view to help in the design and execution of an expanded Bank funded programme. The Bank was willing to collaborate with other development partners in the fight against Tsetse and Trypanosomiasis.

FOOD AND AGRICULTURE ORGANIZATION (FAO)

           FAO’s 2004 report on “State of Food Insecurity in the World” specified the scale of economic costs of hunger then at US$ 30 billion and about US$ 0.5-1 trillion per year in terms of direct costs and lost productivity and incomes, respectively. Countries in sub-Saharan Africa were the most severely affected. Two broad strategies can be used to address the causes and the consequences of hunger and poverty : improvement of food availability and income of the poor through enhancing food productivity ; and provision of direct and immediate access to food for those most in need.  The UN and internationally established Millennium Development Goals (MDGs), which are reflected in the objectives of the Programme Against African Trypanosomiasis (PAAT), aim at halving the number of hungry and poor by 2015 and at rolling back environmental degradation.  This can only be attained through sustainable agriculture and rural development, which is severely constrained by and necessitates the removal of the tsetse and trypanosomosis problem.  The response of FAO Member Countries to this interdependent problem is reflected in the formation of PAAT, which produces relevant technical and scientific information for policy makers, planners, the public and private sector and various other stakeholders concerned with T&T research and control.  FAO also provides direct assistance in the formulation of field programmes that focus on area-wide intervention against the tsetse fly and the disease in areas, where there is significant potential for sustainable agricultural development.  An example for this is the assistance by FAO and IAEA to Ethiopian efforts regarding the development and the submission of a proposal to the Japan “security fund” (United Nations Trust Fund for Human Security) for supporting T&T intervention and rural development in the Southern Rift Valley of Ethiopia.  A similar initiative was anticipated to be undertaken in collaboration with colleagues in Burkina Faso and Mali for the “cotton belt zone”. FAO also supports efforts to assess the impact of the disease burden and the benefits of intervention.  An FAO/IFAD initiative seeks to assess the overall development constraints posed by various human, animal and plant diseases.  Furthermore, an initiative by FAO, the United Nations Industrial Development Organization (UNIDO) and the International Federation of Animal Health (IFAH) aims at the development of systems and establishment of national capacities for quality control and quality assurance for trypanocidal and other veterinary drugs.FAO and The World Bank’s Africa Partnership for Livestock Development (Alive) were seeking an enhanced cooperation, aiming at field interventions and respective investments.  The presenter emphasized the importance of consensus between FAO/PAAT and AU/PATTEC regarding integrated area-wide approaches against the T&T problem and he welcomed the approved AfDB support.

WORLD HEALTH ORGANIZATION (WHO)

           In 1999 an overall strategy, based on full access to health systems, diagnosis and treatment, was established to address the particularly difficult situation that Human African Trypanosomiasis (HAT) control efforts were facing:  Epidemics were flaring-up in major affected countries; existing diagnostics were not widely used; availability of drugs was not assured, and there was very poor support from the international community for HAT control. Today, considering a) that the number of new cases is decreasing constantly, combined with lowered estimates regarding unknown cases; b) an increasing portion of the population being screened; c) the total availability of drugs; d) the increasing number of trained technicians in the countries concerned; and e) the commitment of the international community; it is reasonable to regard sleeping sickness under control.  This has been accomplished with partners that enabled WHO to establish, develop, and lead a coherent control programme, which has covered the entire spectrum of activities needed for controlling the disease.  It has been enhanced by a successful approach to expand access to drugs including drug donations, targeted distribution, training and restoration of treatment centres. Therefore, it appears possible to propose launching an elimination programme of HAT.

           Today the eradication of sleeping sickness must be considered a goal that is achievable by making use of existing diagnostic tools and drugs. However, due to the complexity of applying some of the tools, it is impossible to integrate them together with the requited drugs into the peripheral health capacities. Under such conditions there is a risk that elimination may not be sustainable. Consequently, simple diagnostic tools and oral/safe drug(s) were needed for both stages of HAT to ensure a cost effective and sustainable elimination.

           The future of sleeping sickness control currently faces a critical and decisive period. As the disease may no longer be considered a major and widely distributed public health problem, NGOs are about to leave, countries are giving lower priority to the disease, the international community is less and less interested, trained technicians are at risk of being lost, and no incentives exist for drug and diagnostic development.  As a consequence, although we may be close to the elimination of the disease, there is a real risk of creating conditions for major re-emergences of HAT.

           On 26th August 2005 the regional committee for Africa urged WHO to implement a strategy aiming to eradicate the disease as a public health problem.

INTERNATIONAL ATOMIC ENERGY AGENCY (IAEA)

            Besides the key mandate of the International Atomic Energy Agency as the UN’s nuclear ‘watchdog’, the Agency also seeks to contribute nuclear and related techniques to poverty reduction and sustainable rural and agricultural development.

           In 2004 a major internal and external review exercise of the Agency’s tsetse “programme” confirmed that the SIT can – in some situations – make a decisive difference as part of an integrated area-wide campaign.  However, SIT should not be regarded as the panacea for all tsetse and trypanosomosis problem scenarios. The review emphasised that ownership and development of an overall roadmap for the creation of tsetse-free zones is formally a matter for the Member States concerned. The Agency’s support activities would largely be restricted to the SIT component of area-wide integrated pest management, i.e. the “SIT-package”. Other activities such as conventional suppression activities using insecticides on livestock or artificial baits need to be conducted by the Member States and/or other partners / stakeholders. The Agency would support Member States’ efforts in four phases, whereby advancement from one phase to the next would be subject to achieving pre-agreed targets. The four phases are:  a) existence of a national / sub-regional policy and strategy and level of Member State commitment; b) feasibility assessment; c) capacity building; and d) support to operational area-wide intervention against T&T.  In all phases the Agency would provide support on aspects that are relevant to the “SIT-package”.  Enhanced partnerships with other mandated UN agencies and other organizations, institutions and stakeholders would be essential to attain the overall development objective.

           Relevant services to Member States would continue to be conducted using both the Agency’s Regular Budget resources and the IAEA Technical Cooperation Funds.  Support to Member States wiould continue to be provided through three main mechanisms, namely “normative” activities, research and methods development and technical cooperation.

           “Normative” activities include the development of standards, guidelines, manuals, etc.  A recent example is a draft consultants’ report on “Criteria for Declaring a Zone Free of Tsetse Flies and Tsetse-Transmitted (Animal) Trypanosomosis”.  Another, ongoing, effort aims at drafting a manual on the “Principles of Entomological Baseline Data Collection” in preparation of area-wide integrated PATTEC programmes.

           Research and Methods development is the second of three major pillars of the Agency’s tsetse “programme”.  This includes in-house research at the FAO/IAEA Agriculture Laboratory and Coordinated Research Projects (CRPs) and technical contracts. 

            With regards to IAEA-TC supported T&T activities in Member States, the Agency currently provides technical assistance through nine national projects in Botswana, Burkina Faso, Ethiopia, Kenya, Mali, Senegal, South Africa, Uganda and the United Republic of Tanzania.  All national projects are in different phases of feasibility assessment, capacity building and pre-operational support, with the Ethiopian project being the currently most advanced one.  In addition one regional project supports the overall objectives of the AU-PATTEC initiative, under which one regional training course on the Principles of Baseline Data Collection and two sub-regional workshops in East and West Africa on standardized sampling and processing of flies for subsequent DNA-based population genetic investigations would be organized in 2006.

INTERNATIONAL CENTRE  FOR INSECT  PHYSIOLOGY AND ECOLOGY (ICIPE)

            ICIPE has a long history as centre of excellence for research and capacity building in insect science and its applications.  ICIPE has multidisciplinary teams of scientists – biologists, ecologists, molecular biologists, social scientists, etc. – working on its 4-‘H’ paradigm, involving human, plant, animal and environmental health.

           In the Animal Health Division the objective is to increase livestock productivity by effectively managing tsetse and ticks.  In this connection ICIPE’s work on the development of baits – olfactory and visual – is well known.  ICIPE identified two repellents for savannah tsetse, one a synthetic repellent and the other being the repellent blend from un-preferred animals like waterbucks.  Work is in progress to field test the repellents in large field trials and to optimize the dispensers.  Work is also in progress at ICIPE to identify the molecular basis for parasite survival in the flies and factors important in vectocompetence. Adaptive management of tsetse populations is also being undertaken in the lake region of Ethiopia by identifying hot-spots of high tsetse densities using GIS for strategic placement of traps. Work is in progress on developing simple on-farm integrated tick management methods using botanicals and behaviour-modifying secio-chemicals.

            ICIPE’s work in capacity building at all levels is well known and the institute has trained farmers, communities and a cadre of vector control specialists and researchers in large numbers.

           ICIPE supports the area-wide projects in which integrated vector and disease management strategies are employed for control / eradication of T&T.  ICIPE is willing to assist these countries by undertaking ecological studies (dispersal / distribution of vectors), vector suppression, barrier development, tsetse mass-rearing, backstopping R&D, socio-economic studies and capacity building at all levels.

WORLD HEALTH ORGANIZATION / TROPICAL DISEASES RESEARCH (WHO/TDR):

            The Tropical Disease Research programme (TDR), established in 1974/75, has two objectives:  a) undertake research and development of new and improved tools for the control of major groups of tropical diseases; and b) strengthen research capabilities in countries, where these diseases are endemic, through training in biomedical and social sciences research, and through institutional support. TDR-funded research involves various disciplines, including parasitology, entomology, molecular biology and molecular pathology.  The work aims at the discovery of new or improved drugs or diagnostic techniques and it supports drug development and evaluation, as well as, vector control research. A TDR initiative to strengthen research capacity resulted in the formation of a consortium of African research institutions, with one coordinating institution, i.e. KETRI / KARI-TRC. At a recent meeting the consortium developed a strategy for training, to which all member institutions will contribute their competences.  TDR is supporting the coordination of an IGGI research group for Glossina genome sequencing.  Activities of the research group so far include the estimation of genome size for G. m. morsitans (613 Mbp) and G. p. palpalis (479 Mbp ), and the construction of ESTs and BAC libraries. 

           With regards to new opportunities for funding vector research on Human African Trypanosomiasis (HAT), the TDR Molecular Entomology Committee will begin in May 2006 screening proposals for research on HAT vectors for possible funding.  The presenter highlighted that the deadline for receipt of research proposals applications was 17 February, 2006.  Funding proposals for research projects should focus on the following areas:

PROGRAMME AGAINST AFRICAN TRYPANOSOMIASIS (PAAT)

           The Programme Against African Trypanosomiasis (PAAT) is a consortium of mandated organizations within the UN family, namely FAO, IAEA and WHO, along with AU-IBAR and other international agencies and institutions working in the field of tsetse and trypanosomosis (T&T).  Through harmonious interactions of the partners, PAAT aims at fostering focused research and investments to remove the constraint of T&T, particularly in the rural population, improve human and animal welfare and livelihoods, promote sustainable agriculture and rural development, ensure food security and poverty alleviation and facilitate achievement of rural cash economy.  The PAAT secretariat is hosted by FAO Rome.

            PAAT supports the overall objectives of the AU-PATTEC initiative.  At the last meeting of the ISCTRC a report on the harmonization of activities of PAAT and PATTEC was reported.  This effort generated guidelines/criteria for the selection of priority areas for joint international activities against T&T. Six countries, namely Burkina Faso, Ethiopia, Ghana, Kenya, Mali and Uganda, benefited from this PAAT–PATTEC harmonization effort and were successful in obtaining grants and loans from the ADB to fight T&T under the PATTEC initiative.  PAAT will continue to provide expertise to Member States in the context of the objectives of the PATTEC initiative.

           A major activity of PAAT is the provision of relevant information, publications and access to required expertise through the PAAT information system (PAAT-IS).  PAAT urges its mandated institutions as well as other stakeholders to maintain the momentum of the PATTEC programme by assisting the current activities in Member States and contributing to the design of concrete support strategies, evaluating programme needs, assisting in capacity building, standardizing preparatory and operational techniques, such as baseline data collection, progress monitoring and land use planning and rural development.

INTERNATIONAL LIVESTOCK RESEARCH INSTITUTE (ILRI)

           Over the past few years ILRI has expanded its geographical reach from Africa into Asia and Latin America. ILRI’s focus is on livestock research that contributes to improving the livelihoods of poor people, including livestock keepers, market agents and consumers. ILRI’s livestock research, including research in trypanosomiasis, addresses five thematic areas of a) market opportunities, b) biotechnology and c) livestock systems (i.e. people, livestock and the environment), as well as, two cross-cutting themes on d) targeting research and development activities and e) enabling innovations.  National, regional and international research institutions have been ILRI’s main partners, and there is increasing collaboration with civil society organizations, NGOs and the private sector.

           Trypanosomosis research at ILRI covers the areas of molecular genetics, breeding for trypanotolerance, diagnostics and molecular biology, epidemiology, socio-economics, environmental monitoring, the decision support tools and delivery of services in the field.  With regards to trypanotolerance, a focus is on the mechanisms and degree of tolerance through field and laboratory studies, particularly in N’dama cattle. Shorter-term goals are to identify health and production traits for selection and to understand the mechanisms that confer tolerance.  Currently there is research in Ethiopia to assess trypanotolerance in indigenous Ethiopian breeds.  Efforts for exploiting genes from indigenous breeds for improving livestock production in West Africa, (supported by Global Environment Facility and the African Development Bank) are scheduled to commence in 2006.

           ILRI is in the process of developing the Bioscience East and Central Africa (BecA) research platform, which is a joint venture of African research institutions with a research hub at ILRI and nodes to be established in different national institutions.  Construction activities will be initiated in 2006. BecA will provide a state-of-the-art shared research facility for genomics, functional genomics and plant and animal biosciences.

           Epidemiological research has focussed on three areas: assessment of alternative control options, drug resistance and cattle-human transmission of rhodesiense sleeping sickness. Diagnostic research has focused on developing tools for epidemiological field studies.

           Socio-economic research addresses economic impact (cost-benefit).  Some efforts in this field aim at better delivery systems, estimate transaction costs and assess the economic issues associated with collective action in tsetse and trypanosomiasis control. One important project in recent years has investigated options for reducing the impact of resistance to trypanocidal drugs in Mali, Burkina Faso and Guinea in collaboration with national and regional institutions.

           Increasing importance is being placed on environmental monitoring and impact assessment, including ecological impacts of disease control programmes and changes in agricultural activity.  Site-specific assessments have been made in West and East Africa and are being integrated as impact assessment tools for national PATTEC programmes.

           Over the years ILRI’s research focus has evolved with an increased emphasis on the broader epidemiological, socio-economic and environmental impacts of trypanosomiasis in sub-Saharan Africa.  The presenter highlighted that laboratory research is more targeted, that there is an increasing number of field-based studies, and that there is a greater reliance on collaborations and linkages with national, regional and international partners.

CENTRE INTERNATIONAL DE RECHERCHE-DEVELOPPEMENT SUR L’ELEVAGE EN ZONE SUBHUMIDE (CIRDES)

           Since the 27th meeting of ISCTRC, CIRDES pursued research on a) improved diagnostics; b) regional aspects of epidemiology; c) improved chemotherapy while minimizing the risk of chemo-resistance; d) improved techniques and strategies for vector control; e) vector ecology; and f) genetic markers to investigate resistance to trypanocidal drugs. 

           CIRDES aims at putting in place a system for disseminating scientific results that permits reaching all relevant stakeholders in the field. For this, a package of awareness development was developped, and a series of national workshops were held in Benin, Burkina Faso, Ghana, Mali, Niger and Togo between September 2004 and February 2005.

           Under a regional CORAF/WECARD project on awareness generation and dissemination of improved livestock rearing techniques, CIRDES and various regional partners aim at developing a) new tick control techniques; b) ELISA based diagnostics for trypanosomiasis; c) innovative techniques for Glossina control; d) integrated livestock / cropping systems; and e) livestock breed characterization and selection.  Furthermore, CIRDES produced a series of relevant technical files and manuals. 

           Using flies from the CIRDES tsetse colonies, which currently are maintained at a level between 100, 000 and 150, 000 female flies, CIRDES has also been providing assistance to pre-operational tsetse intervention activities in Mali.  The work included mating competitiveness studies between the mass-reared strain of G. palpalis gambiensis from the CIRDES tsetse colony and flies from the target area in Mali, irradiation studies and experiments aiming at the provision of high-quality male flies for future SIT operations, as well as, the provision of marked sterile males for a series of test releases in Mali. 

           Under a Wellcome Trust project on tsetse habitat fragmentation and resulting consequences to epidemiology and tsetse control, CIRDES aims at contributing to the development of improved control strategies. The project involves GIS-supported ecological and molecular genetic studies, which compare different tsetse populations in separate fragmented habitats.  Other newly initiated activities at CIRDES include work on immunization and on markers for disease resistance.

EASTERN AFRICA NETWORK FOR TRYPANOSOMIASIS (EANETT)

           The Eastern Africa Network for Trypanosomiasis (EANETT) is a joint effort by countries in Eastern Africa and aims at effective management and control of sleeping sickness.  EANETT is comprised of national institutes that are directly involved in research and control of trypanosomiasis.  EANETT is supported by the Swiss Agency for Development and Cooperation (SDC) and started its activities in 2000.  The first phase of EANETT ended in March 2004, phase II currently runs though the end 2006. 

            Members of EANETT include: a) the Swiss Tropical Institute (STI), Basel, Switzerland; b) the Tropical Medicine Research Institute (TMRI), Khartoum, Sudan; c) Livestock Health Research Institute (LIRI), Tororo, Uganda; d) the Kenya Trypanosomiasis Research Institute (KETRI), Kikuyu, Kenya; e) National Institute of Medical Research (NIMR) Tabora, Research Station, Tabora, Tanzania; f) Tsetse and Trypanosomiasis Research Institute (TTRI), Tanga, Tanzania; and g) the Ministry of Health, Malawi.  Neighbouring countries with endemic HAT are invited to join the Network.

           The research collaboration addressed under EANETT includes a) active surveillance of humans (and livestock); b) identification of the most endemic areas (villages); c) treatment of HAT patients; d) Geo-referencing of endemic villages and human cases; e) updating tsetse distribution and density in endemic areas; f) establishing colonies of G. swynertoni and G. fuscipes for studies on vectorial capacity and transmission; g) characterising tsetse flies genetically; h) improving techniques for the isolation of T. b. gambiense from patients; i) collecting new T. b. gambiense isolates; and j) establishing of a T. b. gambiense monkey model at KARI-TRC.

           EANETT enhanced the improvement of laboratory facilities for research and diagnosis and of information exchange channels (internet access; establishment of a homepage www.eanett.org; new flyer).  The Network provides support to selected MSc and PhD fellowships and has organised training events / workshops on the following themes: geographical information system (10 participants); molecular biology and entomology (10 participants); and scientific writing and presentation (15 participants).  EANETT maintains close links with WHO’s “Sleeping Sickness Treatment and Drug Resistance Network”, PAAT, MSF, the Institute of Tropical Medicine, Antwerp, Belgium, Yale University, School of Medicine, New Haven, USA, and the Royal Tropical Institute, Amsterdam, The Netherlands.

            EANETT’s planned near-future events include the Annual Conference 2005 in Mombasa, Kenya, November 16-18 and a workshop on “Standardisation” in Mombasa, Kenya, November 14-16, aiming at the cryo-preservation, propagation, isolation, drug sensitivity of T. b. gambiense, sampling / collecting field samples, application of GIS and reflecting socio-economic considerations.

INTERNATIONAL TRYPANOTOLERANT CENTRE (ITC)

           As an autonomous, non-profit oriented regional livestock-based agricultural research institution the International Trypanotolerant Centre (ITC), located in Banjul, The Gambia, initially fostered research and multiplication of trypanotolerant cattle, namely the unique N’Dama.  This is done in an effort to contribute to increasing livestock productivity and utilisation in the West African region through optimal and sustainable exploitation of genetic resistance of indigenous breeds of livestock for the welfare of the human populations.  With the aim to impact on poverty reduction and food security, ITC targets at the formulation, implementation and introduction of sustainable socio-economically and environmentally acceptable integrated packages at farmer level, for improved livestock health, production and exploitation.  Immediate partner countries include The Gambia, Guinea Bissau, Guinea Conakry, Senegal and Sierra Leone.

           Current ITC R&D takes place through three programmes:  a) low-input systems programme; b) market-oriented systems improvement programme; and c) systems overlap and linkages programme.  The outputs from these three institutional projects in turn strengthen the four pillars that support the centre’s R&D agenda:  a) improving local resources including animal and feed resources; b) introducing innovative changes including exploitation of local and exotic crossbreeds and the deployment if improved diagnostic techniques; c) collaborating and networking; and d) human resources development and institutional capacity building.  Recent R&D advances included work on trypanocide drug resistance among trypanotolerant cattle, which revealed that drug resistance in the test areas in Mandiana region and Haute Guinée may not be existent.  Furthermore, genetic characterisation was undertaken among goat populations in West Africa.

           The Centre – in consultation with national partners has developed a 12 year long term strategic plan, in which strategic alliances will be sought with NARS and CG Centres in undertaking research in applied, strategic and adaptive domains to tackle the problems associated with tsetse and trypanosomosis with the view to reducing poverty among people living in tsetse infested areas.

RECOMMENDATIONS

1.         National PATTEC Projects:

The meeting

            WELCOMES the ongoing efforts by several tsetse and trypanosomosis affected countries which aim at raising  further financial support from the African Development Bank Group for national PATTEC projects. The meeting also

            UNDERLINES that in several countries major technical and other issues should be resolved, before the nationalprojects become operational. The meeting therefore

            PROPOSES the adoption of a phased, conditional planning and implementation approach to the national PATTEC projects. In particular national PATTEC projects should only enter the operational intervention phase, after having appropriately addressed the key components in earlier phases (i.e. feasibility assessment, capacity building, efficient management structures).  The meeting further proposes that the Council offers its scientific assistance to the national PATTEC projects in advancing along the phased, conditional approach towards the objective of the PATTEC initiative. 

2.         Human African Trypanosomiasis (HAT):

 Considering the achievements made in the area of control of sleeping sickness, leading to a current reduction of new cases and increase of surveillance activities, the ISCTRC:

RECOMMENDS

3.         Standards, Manuals and Field Guides:

Manuals like the one being developed by IAEA on “Principles of Entomological Baseline Data Collection” are expected to provide useful contributions to national and sub-regional efforts under the PATTEC initiative. The meeting

ENCOURAGES specialized institutions to contribute similar standards / manuals for the collection of relevant veterinary, environmental and socio-economic data.  It is, furthermore, recommended that additional guidelines or manuals be developed that may target, for example, at area-wide tsetse suppression or standardized entomological and veterinary monitoring and respective data assessment, reporting routines and facilitation of day-to-day decision making in operational intervention programmes.

I.2        COUNTRY REPORTS

A total of 10 papers were presented by the following countries, Angola, Cote D’voire, Democratic Republic of Congo, Ethiopia, Kenya, Mali, Nigeria, Sudan, Tanzania. and Uganda.

ANGOLA

           Human Animal Trypanosomiasis was reported to have been detected in 1871 in Angola and was controlled towards the end of the colonial era.  The detection rate was reduced to 0.001% in 1974 when only 3 new cases were diagnosed in both T.b. gambiene and T. b. rhodesiense endemic areas. 

           The situation has continued to deteriorate in the post independence period.  A National strategy has been put in place to address the situation.  Researches have looked into issues of low rates of parasitological confirmations, treatment failures and relapses.  Angola has agreed to collaborate with regional neighbours to strengthen the existing national strategy.

           Operational and logistical problems including insufficient staff were highlighted. The Trypanosomiasis Research Centre (ICCT) has 20 centres for screening and treating HAT and has 23 mobile teams. Financial support needed includes US$700,000 for expenses of staff, 20 vehicles and US$ 1,320,000 for equipment. 

COTE D’IVOIRE

            Results of study on the Human Animal Trypanosomiasis (HAT) situation in Cote d’Ivoire from 2000 to 2004 were discussed. It was noted that the war which took place from September 2002, resulted in an upsurge of trypanosomiasis infections in humans.

           A total of 65,897 people were screened and 284 were diagnosed to be positive of HAT during the period 2000 to 2004. The survey showed that 51% of patients were infected in the Western and South – Eastern areas of the country.

           It was RECOMMENDED that surveillance programmes be strengthened. The need to raise awareness among the communities and stakeholders was emphasised

DEMOCRATIC REPUBLIC OF CONGO (DRC)

            The presentation highlighted past and present efforts to reduce the incidence of Human African Trypanosomiasis (HAT). The paper examined recent records of HAT in DRC and evaluated control efforts undertaken including epidemiological and financial data from previous operations during the period 1993 to 2003.

           The DRC consists of a human population of 60 million people and 12.5 million are at risk to Human African Trypanosomiasis (HAT).

           Financial support was received from the Belgium Government, WHO, and from the French and Danish Co-operation. WHO is supporting by providing trypanocides.  Some additional support has also been obtained from Non-Governmental Organisations. In the last 5 years, 70,000 new cases had been diagnosed. There was however a drastic decrease from 26,000 new cases in 1998 to 11,000 new cases in 2001. In 2004 the prevalence of trypanosomiasis was on the increase.  Cessation of control efforts will result in a further deterioration of the situation with tsetse populations rising to pre-control levels. Trypanosomiasis is prevalent in most areas which were affected by the war. The distribution includes the capital Kinshasa as well as the Kasai Province, which is recording one of the highest cases. The problem in the DRC is that the budget is too small compared to the problem to be solved.

ETHIOPIA

            Tsetse flies infest up to 200,000 km2  of Ethiopia.  Five tsetse fly species are present and these are; G.m. submorsitans, G. tachinoides, G. f. fuscipes, G. pallidipes and G. longipennis.  About 88% of the human population and 70% of livestock are found on highland areas which constitute 36.6% of the total area of 1.2 million km2.  There are 44 million cattle in Ethiopia. 

           National objectives in tsetse control are designed to ensure sustainable development and poverty reduction, to facilitate resettlement of people in low lying areas and to ensure food security and rural development. The problem caused by tsetse and trypanosomiasis was outlined.

           Surveys are one of the major activities in order to update records on the distribution of both the vector and parasite.  Some of the problems encountered include, lack of co-ordination and duplication of efforts, shortage of skilled personnel and infrastructure, inadequate budget and lack of sustainability

KENYA

            The development of the livestock Industry is Kenya is severely constrained by ticks and tsetse flies.  Tsetses control therefore under the Ministry of Livestock and a Fisheries Development. 

           Tsetse occur from sea level to an altitude of about  2000m above sea level. All three groups of tsetse are present and are represented by eight (8) species.There are G. pallidipes, G.morsitans, G. austeni, G. swynnertoni, G. longipennis, brevipalpis, G. fuscipleuris, G. fuscipes fuscipes.  G. pallidipes is the most widely distributed species. About ⅔ of Kenya is under tsetse infestation causing huge losses arising due to reduced livestock productivity. The major trypanosomes in Kenya are T. congolense, T. vivax, T. Simiae and T. evansi. Cattle have been found to be reservoir hosts of T. b. rhodensiense in sleeping sickness endemic areas of Nyanza and the Western Province of Kenya. Sleeping sickness cases in Kenya however exceeded 500 in a year and since 1968 there have been less than 100 cases reported each year. Sleeping sickness areas are in the Lake Victoria basin and Busia and does not occur anywhere else in Kenya.

           The ultimate objective in tsetse control in Kenya is to eradicate tsetse from the entire country in order to promote agricultural and rural development. Decision has been taken to undertake tsetse control using environmentally accepted techniques. Control programmes are to involve the component of community participation. The PATTEC programme has already been launched in Kenya and the initial phase of the project will focus on the Lambwe Valley tsetse belt where eradication is envisaged. The project will also cover the Lake Bogoria fly belt and Embu – Mwea Tsetse belt.

MALI

            A paper was presented on the experimental releases of sterile male tsetse flies in the peri-urban areas of Bamako.  Trypanosomiasis is a major constraint in that area, limiting the full exploitation of the natural resources in this area and hinders agricultural development. Baseline data was collected.

           Vector control is perceived in Mali as the most efficient way to control trypanosomiasis.  A decision was therefore taken to integrate tsetse suppression techniques using baits with the release of sterile flies. The releases gave crucial information on the survival, dispersal and mating success of the flies. A total of ten releases were made at weekly intervals with each release containing ten thousand sterilised.flies. Sterilised flies were flown from Bobo-Dioulasso to Bamako for release. Survival of the flies was good. 5000 flies were released at 59 sites on either side of the Niger River. The flies survived in the natural environment for 35.5 days and were detected a distance of  6 km from release point. Mortality of sterilised flies was caused by high humidity within the containers during transport.

NIGERIA

            Trypanosomiasis has a severe impact on livestock, humans and other agricultural production system in Nigeria. There are 11 tsetse fly species in Nigeria. Four of these (G. p. palpalis, G. tachinoides, G. m submorsitans and G. longipennis) are of great economic importance.  The limits of distribution of the fly species was discussed. The report also covered the historical aspects of tsetse control in Nigeria.

           Economic losses due to tsetse and trypanosomiasis are enormous and have never been fully quantified. It has been estimated that US$70 million is lost annually in cattle alone in six northern states.

           Previous methods of tsetse control included, game elimination, bush clearing and ground spraying. More recently the bait technology, involving the use of traps and insecticide impregnated screens have been used as well as cattle dipped in pyrethroids.  SIT was also used in the past.

           The use of curative and prophylactic drugs are the most widely accepted means of controlling the disease and reducing losses in livestock. Trypanotolerant cattle have also been used.

           Research into tsetse and trypanosomiasis has been undertaken by the Nigerian Institute for Trypanosomiasis Research (NITR). The plan of action and strategy for the eradication of tsetse and trypanosomiasis was recently approved following the inauguration of PATTEC.

SUDAN

            The Tsetse and Trypanosomiasis situation in the Sudan was outlined. About 12% of the total land surface of Sudan is tsetse infested and trypanosomiasis presents a major constraint to the pastoralists who own more that 80% of the livestock.  About 8 million cattle and 5 million humans are at risk of contracting trypanosomiasis in Southern Sudan.

           Currently tsetse and trypanosomiasis control activities in the Sudan include the collection of base-line data. All cattle rearing areas inside and outside the tsetse belts are endemic to trypanosomiasis. Only one species of Trypanosome (T.vivax) was found to be pathogenic to cattle and goats.

           Tsetse surveys were carried out in the Bhar Al Arab tsetse belt.  Tsetse survey has been initiated in the Sudan – Ethiopia border area. Only one tsetse fly species namely G.m. submorsitan occurs in the Sudan. It was demonstrated in that there was resistance against all trypanocides available.  Trypanosomiasis prevalence in camels in Eastern Sudan, was 4% in Kordofan and 42% in South Darfur.

           Local communities were trained in 2002 in tsetse control techniques under an FAO Technical Co-operation project in South Darfur. Political support for tsetse and trypanosmiasis is high in the Sudan.

TANZANIA

            Tryapnosomiasis is a major constraint to livestock and crop production in Tanzania. About 4 million people and 7 million cattle are at risk.  Livestock  population figures were presented and the human population is 34.5 million.  Three trypanosome species are more commonly reported.  These are T. congolense , T. vivax and T. brucei.  The strategy and policy for tsetse control was presented.  Tsetse control could lead to improved food security, increased income to farmers and reduced poverty in rural areas.  Control  would be based on co-ordinated and integrated approach involving stakeholders.

           On-going control activities include the deployment of 3226 targets at Serengeti, Mikumi, Katavi and Ruaha National Parks.  Awareness campaigns and training of communities have been undertaken and communities have been involved with the development of targets.

           Tsetse survey were undertaken in six (6) regions namely; Tanga, Kilimanjaro, Arusha, Manyara, Mara and Shinyanga. Trypanosomiasis survey indicated that the disease incidence had increased drastically in 2004.

           Research is continuing in Tanzania on trypanosomiasis prevalence in cattle on Majia island and on drug resistance. Further plans include range development through land use plans, community participation for sustainability of tsetse and trypanosomiasis control, use of SIT for eradication and implementation of PATTEC programmes.

UGANDA

           The contribution of FITCA Uganda to tsetse and trypanosomiasis control in Uganda was outlined.  The project had generated comprehensive data on tsetse, sleeping sickness, Nagana and on socio-economics. Zones of low, medium and high risk to tryapnosomiasis were delineated and control programmes were implemented to support appropriate farming practices. Livestock figures for cattle, goats, sheep, pigs and chicken were presented.  About 3,124,474 cattle are at risk to trypanosomiasis, and 300,000 cases of trypanosomiasis were diagnosed and treated. There was some reduction in the prevalence and incidence of trypanosomiasis following the implementation of tsetse control intervention. A 75 – 90% reduction in the number of flies caught in a trap per day was recorded.

           In North – West Uganda tsetse control activities were undertaken to reduce T.b. gambiense infections in humans. Over 1000 cases were diagnosed and treated.  Tsetse control activities were also undertaken in the T. b. rhodesiense area in Eastern Uganda where 793 new cases were reported and treated although 52 deaths were reported between years 2000 to 2004.  There was a northward expansion of the human trypanosomiasis belt towards the T.b. gambiense area to the north.

           The need to re-centralise and harmonise tsetse control programmes was emphasised as the current decentralisation of services was hampering implementation.  Uganda supports the implementation of area-wide tsetse and trypanosomiasis control programmes.

           A request for the extension of FITCA Uganda had been approved; the second phase of the project will therefore run for 42 months from 2005 – 2007 for the consolidation of achievements in the past.  A suggestion was made to expedite the launching of PATTEC in Uganda.

RECOMMENDATIONS

1. Recognizing the shortage of well trained and experienced staff in the region, PATTEC is requested to urgently co-ordinate the assessment of training needs at the middle and senior staff training curriculum and implement training causes.

2. Recognizing the need to expedite the implementation of PATTEC programmes Regional/PATTEC Co-ordination offices should draft national and regional action plans.

Two major issues dominated this session, namely:

1. The refinement of techniques for diagnosis of both human and animal trypanosomiasis based on molecular and serological approaches; and

2. Genetic markers as tools for determining genetic diversity between and within tsetse fly species.

            Previous work assumed the potential of PCR-based techniques for improved trypanosome detection. A paper presented showed the value of PCR in the detection of isometamidium resistant Trypanosoma congolense. While this approach promises to be more sensitive, less laborious and less expensive than conventional methods, questions still remain on its applicability to diminazene resistant T.congolense and the mechanism of resistance.

            A modified PCR-based technique (Amplified Fragment Lenght Polymorphism) was used to study the population structure of T.brucei gambiense as a means of understanding the upsurge and clinical evaluation of sleeping sickness. This method though did not achieve the desired objectives, and therefore there is a need for further studies.

            During discussion it became clear that these studies can only be beneficial in the field if they provide more reliable epidemiological information for addressing field and clinical interventions, both for humans and animals, and supporting the formulation of disease management policies and strategies.

            The work on tsetse genetics is at the root of the strategies for fly ecology and eradication. The papers presented indicated that the ongoing work is promising and emphasises the need for identification of additional specific molecular and morphometric markers. They also underline the need for additional studies since most results are of preliminary nature. The establishment of a network should facilitate progress in this area.

RECOMMENDATIONS

This session RECOMMENDS:

1. Further refinement of the molecular based techniques for diagnosis, both for human and animal trypanosomiasis;

2. Further work on using PCR-based technology for detecting drug resistance strains of trypanosomes; and

3. To consider the application of laboratory-based studies (both on diagnosis and tsetse genetics) to field situations for tsetse and trypanosomiasis intervention, and explore the possibility of private sector participation on diagnosis.

4. It is noted that ongoing research on African trypanosomiasis has generated numerous data and compounds with potential for application in diagnostics. This knowledge has remained in the academic/research environment. Subsequent development into diagnostic tests is seldom achieved due to lack of appropriate technology among researchers. The ISCTRC encourages the establishment of collaboration between researchers and the industry, such as public-private-partnership, to translate the available research data and candidate compounds into validated diagnostic tools for application in the field.

           Fourteen papers were presented during three sessions. Two papers described epidemiological findings. Two papers described diagnostic test sequences.

Four papers were related to encephalopatic reaction following melarsoprol or genetic mutation related to melarsoprol resistance treatment. Three papers discussed new drugs development or combination of drugs. Two referred to genetic predisposition to the disease or the role of cytokines.  Finally one was related to human infection by T.evansi.

           In the papers on epidemiological findings, one described the achievements of a control programme in Yei (South Sudan). After three years continuous decrease of prevalence has been observed in most endemic areas. However these achievements are hampered by the weak local system that is unable at the moment to take over the control activities. The second one described the network set-up to monitor drug resistance based on 9 hospital-sentinel network in 5 countries. Treatment failures have been reported in many hospitals ranging from 16% to 30% with a significant risk in patient showing more than 100 cells in CSF. The treatment failure rate that should prompt a change and which alternative first line therapy should be adopted was discussed.

           In the papers describing diagnostic test sequences, one was performed in South Sudan. In a low endemic area CATT performed on diluted blood was found the most cost-efficient method. In DRC, CATT as screening method was found to be most efficient compared to lymph node palpation.

           Among the papers about melarsoprol-related encephalopathy,  a comprehensive study of risk factors and HLA association was performed in 6 HAT treatment centres in Angola and DRC between June 2002 and November 2003. A total of 69 cases of encephalopathy syndrome and 207 controls were analysed. Whereas oedema, bone pain, apathy and depressed humour were associated to risk of developing an encephalopathy syndrome when present in anamnesis, abdominal pain and diarrhoea were associated with higher mortality. The haplotype C 14/B15 was significantly associated with the encephalopathy syndrome. In the Centro de Viana in Angola, the encephalopathy syndromes that occurred between January 2001 and December 2004 were retrospectively studied. A total of 78 cases of encephalopathy syndrome were observed among the 1353 patients treated. Encephalopathy syndrome appeared after day six of treatment and was preceded with intense pruritus, urticaria, hyperthermia, severe headaches and vomiting.  In two studies undertaken in South Sudan and Uganda, the role of P2 nucleotide transporters, coded by TbATI gene, on the resistance of trypanosomes to melarsoprol when mutations occur was discussed. It seems that other genes could be involved in refractoriness of trypanosomes to melarsoprol.

           Of the papers concerning drugs, one provided an update on the development of DB289 for the treatment of the first stage T.b.gambiense sleeping sickness. The treatment dose level assessment was carried out in phase IIb, The results so obtained would be used to initiate the phase III treatment , which will involve 250 patients and will be developed in Angola, DRC and South Sudan. One paper provided preliminary data regarding the results obtained treating 52 patients combining nifurtimox 15mg/kg/day 8-hourly for 10 days with eflornithine 400mg/kg/day 12 hourly for seven days. This regimen was compared with 51 patient treated with the standard eflornithine regime  400mg/kg/day 6 hourly for fourteen days. Preliminary pharmacokinetics, and follow-up results indicate that the combination regimen of nifurtimox-eflornithine which is shorter and less cumbersome than standard eflornitine, appears as safe and effective as the standard eflornitine one is. One last paper was presented in this section showing pharmacokinetics of ¼ and ½ of standard oral eflornithine-nifurtimox dose in African green monkeys.

           The paper on the genetic predisposition to HAT, did not find the same risk effects of TNFα IL10 in Ivory Coast and DRC. However it found an association between IL6 polymorphism and HAT. Six cytokines were studied in confirmed sleeping sickness cases, seropositive individuals and controls. All sleeping sickness cases showed significantly higher plasma levels of six cytokines whereas IL-2 and IL-10 were significantly lower in plasma of seropositive than in the controls. Immunity is suggested to play a role.

           Finally a presentation was made of the first human case of trypanosomiasis cased by T.evansi. A 45 years old male Indian farmer living in Shivani village (Central India) without history of travelling out of the country was admitted in the hospital presenting with intermittent fever and altered consciousness. Several assays, including parasitological, serological and molecular biological tests confirmed Trypanosoma (Trypanozoon) evansi  HIV test were negative. Tangier' Disease was discarded.  CSF analysis clearly indicated no CNS invasion by trypanosomes. The patient was successful treated with 5 doses of suramin.

RECOMMENDATIONS:

            Gambiense endemic countries are RECOMMENDED to strength active case-finding detection in order to detect cases as soon as possible and to avoid toxicity and relapses risk when melarsoprol is the first line option to treat second stage

            Countries are ENCOURAGED to opt for the use eflornithine for treatment of late stage T.b.gambiense sleeping sickness where possible until combination treatments have been adequately validated

           Countries where NGO’s undertake HAT control should MAKE EFFORTS to ensure the capacity to take over NGO’s activities.

           Countries are ENCOURAGED to give full support to clinical trials aimed at finding new tools for the improvement of diagnostic and treatment.

            Countries are ENCOURAGED to develop protocols for the diagnosis and treatment of melarsoprol-related encephalopahic syndrome. In addition further research are needed to understand factors acting in the pathogenesis of HAT

            Thirteen presentations were made which addressed issues relating to the epidemiology of animal trypanosomiasis, chemotherapy, animal reservoirs of  HAT and haematological changes in trypanosomiasis infection. 

            Cross-sectional and longitudinal studies of  animal trypanosomiasis and its vectors in different zones of showed that prevalence of the disease varied according to tsetse challenge. Mechanical vectors were incriminated as the vectors of trypanosomiasis in tsetse-free areas. Management was also shown to  be an important determinant of disease prevalence. Another paper showed that productivity in sheep was adversely affected by trypanosomiasis but that there were other parasitic diseases of equal importance in the environment including helminthiasis and heart water.

            Standard parasitological diagnostic methods and the use of molecular techniques showed the occurrence of  T. brucei gambiense in domestic animals. Other studies showed the occurrence of  T. b rhodensiense in livestock. This observation has implications for the control of  HAT

            A paper was presented on the development of a rapid diagnostic test for the  assessment of drug resistance in the cotton belt zone of  Guinea, Burkina Faso and Mali. The test which was based on a  modification of a previous test developed by other workers was able to  confirm the presence of the phenomenon  and showed that there were variations in its occurrence across the area. The test has prospects for use as a relatively inexpensive pen-side test  for  the diagnosis of  drug resistance.

            Two papers presented on the assessment of the efficacy and local tolerance of Cymelarsan® in horses and the efficacy of the drug in experimentally infected cattle, showed that at the recommended dosage, the drug is capable of curing both early and chronic infections.

            A novel method for tsetse suppression using protein extracts from the midgut of tsetse flies for the vaccination of rabbits was described. Mortality in tsetse flies feeding on vaccinated rabbits indicates that this approach could be used for tsetse suppression. The vaccine also elicited immune responses that impeded the development of  trypanosome infection in tsetse that fed on the rabbits.

            Haematological changes observed in monkeys and horses after infection with T.b.rhodensiense and T. evansi  respectively, revealed patterns that could serve as indicators for diagnosing infections due to these species of trypanosomes.

RECOMMENDATIONS

a)         ON ANIMAL RESERVOIRS OF HAT

• Noting with concern the reported occurrence of trypanosome species infective for man in domestic animals
• Recognizing the role domestic animals may play in the transmission of HAT,

The ISCTRC RECOMMENDS to Research Institutions

1. to conduct detailed studies in order to characterise and determine the pathological significance, in man, of T. brucei gambiense and T. brucei rhodesiense  found in livestock.

2. to assess the  epidemiological significance of  the occurrence of  human-infective trypanosomes in livestock using a multi-disciplinary approach involving AAT and HAT specialists

3. to encourage the sampling of a wide range of domestic animals in epidemiological investigations.

b)         ON CHEMOTHERAPY

• Noting with concern the widespread occurrence of  drug resistant trypanosomes reported
• and the absence of  new compaunds for the treatment of trypanosomiasis

• Noting with appreciation the efficacy of new formulations of some existing trypanocides
• Noting with appreciation progress made in diagnostic tests (pen-side and molecular) for detecting drug resistance

The ISCTRC RECOMMENDS

1. to pharmaceutical companies and Research Institutions to encourage further work on the development of new formulation of existing trypanocides.

2. to implement previous recommendations made on the development of new trypanocidal drugs.

c) ON MECHANICAL VECTORS OF TRYPANOSOMOSIS

Noting with appreciationthe long term objective of  PATTEC that seeks to eliminate tsetse flies and trypanosomiasis

Noting with concern the high incidence/prevalence of  T. vivax infections in tsetse-free areas

The ISCTRC RECOMMENDS to Research Institutions and PATTEC

To support and/or conduct research to determine the role of mechanical vectors in the maintenance of  trypanosomiasis in the eventual eradication of tsetse flies.

28TH ISCTRC (ADDIS ABABA) DECLARATION

            Noting with appreciation the progress PATTEC has made since the declaration by African Heads of States and Governments in Lome in the year 2000, Member Countries and PATTEC Coordination Office are URGED to initiate Eradication Campaign Projects against Tsetse and Trypanosomiasis in all the affected 37 African countries by the year 2015 in line with the Global Fund for HIV/AIDS, Malaria and other diseases.

            Nine papers were presented on Vector Control.  Three of the papers were on different aspects of the Sterile Insect Technique, two on the vectorial capacity and on tsetse suppression.  One paper was on modeling and planning of tsetse control operations.

           The models (tsetse plan and tsetse muse) that can be used to predict outcome of tsetse eradication programmes was presented.  The paper cautioned against the use of SIT as it was considered to be too costly.

           This paper generated some controversy and was critized for what was perceived as a bias against SIT.  It was suggested that the tools box be ‘keep open’ and techniques should be used as feasible.  The model was considered to be unrealistic as it assumed even populations of tsetse population and even cattle distributions.

           A paper was presented on community-based programmes to control tsetse flies.  The reasons for the failure of tsetse control programmes were discussed.  Different tsetse control methods used by farmers were discussed.  These included the scarecrow target, sackcloth screen, painted tree trunk and the modified mono-screen trap.  Information was disseminated to villages in Uganda through workshops, video shows, radios, farmer-to-farmer contacts. The different methods used were ranked in the order of effectiveness. The use of scarecrows was considered to be more sustainable as it constitutes a tool that farmers would normally use for the protection of their crops.

           Results of tsetse suppression in the South Tsetse Eradication Project (STEP) in Southern Rift Valley of Ethiopia were presented for discussion. The objectives of the project were outlined and these included capacity building, eradication of tsetse from 25,000 km2 of the Rift Valley and to contribute to the National Poverty Eradication Programme.

           Pre-suppression base-line data collection was done on the distribution and density of tsetse using baited traps, parasitology, socio-economic impact and on environmental effects.  The suppression programme was undertaken using blue-black-blue targets and deployed 30,000 targets using local communities on a voluntary basis.  Cattle (1,4 million) treated with insecticides were also used for tsetse suppression. A 92% reduction in the tsetse density and a 60% reduction in the disease prevalence were achieved.

           Prospects of future work in the project area were good as the project was receiving political support and was supported by the communities.  These were however drawbacks which included inaccessibility to some areas.

           The distribution of tsetse (G.austeni and G. brevipalpis) in the Kwazulu Natal area was achieved.  This study looked at the relationship between tsetse species and the environment and the suppression of those species using targets. The SIT traps were placed 300m apart. G. brevipalpis) had a wider distribution in forest and open grassland than G. austeni which wasconfined to a shaded areas and at the edges of forest.  The increase in the numbers of targets resulted in a 98% reduction in the population of G. austeni.

           The vectorial capacity of tsetse was influenced by the age of the fly and the nutritional status.  Younger flies appeared to be more susceptible to infection by trypanosomes than older flies.  Multiple infections of trypanosomes were more common in younger flies.  After starving tsetse flies for 7 days there were very high infection rates detected. In general starvation increased susceptibility of vectorial and adult flies to infection with trypanosomes. There was a co relation between the fat level and infection rate. Infection rates were higher when the fat levels were  low and vice versa.

           A report was made as a study to determine the effects of seasonal variation on the quality of blood and to establish other factors that influence blood quality from local abartous.  Blood was   from Tanga, Arusha and from Dar-es-Salaam.  The blood was sterilized by drying in an oven at 80oC for plastics and at 120oC for heat resistant equipment.

           The bacteria screening procedure of pouring blood on sterilized petri-dishes with   nutrient to identify parhogenic bacteria to tsetse flies was followed.  The quality values (QF) of the samples tested were above one (1) except the one sample from Arusha.  The Bacillus group was more common followed by the staphylococcus bacteria.  Others were minor mortalities in tsetse depended on the type of bacteria.  The need to collaborate with other institutions such as Universities in establishing infections in blood samples was emphasized.

           The need to sex tsetse flies before sterilization was noted so that females can be kept in a colony.  It is preferred to release only sterile males as sterile females live longer than males and will increase the risk of becoming infected and transmitting disease.  There were advantages in sexing in the pupil stage than at the adult stage.  A method for sexing pupae using infra-red spectroscopus has been developed.  A separate calibration was required for different age pupae.  Whilst most of the work has so far been on G. pallidipes tests have indicated that multiple species can be sorted with a single calibration, simplifying the set up of the system.

           The role of symbionts in the vectorial competence of Glossima was elucidated in a study to determine the presence/absence of Sodalis glossinidines in T.congolense infected and non infected maggots of  G. palpalis Gambiensis and G. m. morsitans, respectively poor and  major vectors of the parasite. S. glossinidieis was detected in all , infected or not, for both Glossina species. It was also detected in all proboscis from the G. P. gambiensis displaying mature and immature infection but never in the proboscis of G. m. morsitans, the major vector of the parasite. There results suggest that S. glossinidines might not be involved in the T. congolense maturation process.  The symbiont covered however participate in the parasite establishment.

           An agreement has been made between the government of Ethiopia and the International Atomic Energy Agency (IAEA) to formulate an SIT project in the Rift Valley. The total area of the project is 25,000km2 and the first suppression block is 10,500 km2 .

           Progress has been made including establishment of the insectory (fly mass rearing and eradication facility) and the collection of blood and processing. Tsetse suppression in the project area as already been commenced.  There is need for good base-line data. Several challenges have been encountered including delays in colony build up, presence of inaccessible pockets of infestation, management efficiency and lack of financial flexibility. Future steps will focus on technical activities, Human Resources Development, enhancement of National and International partnerships and the implementation of land use plans.

RECOMMENDATIONS

1. Following the launching of National and Regional PATTEC Programmes, after a long time of in activity in many countries and noting the need for standardized or harmonized baseline data collection and operational procedures, it is recommended that gaps be filled in the area of data collection, tsetse suppression, sterile insect techniques (SIT) and capacity building including private sector participation.

2. Community participation should be considered for integration during the initial stages of tsetse suppression in PATTEC programmes.  However, due to problems experienced with sustainability, the meeting recommends that specialized and effective strategies be considered for the eradication of low tsetse densities beyond the community’s capability.

3. Considering the variety of tsetse eradication technologies available for use under different field conditions, it is recommended that appropriate techniques including SIT, be integrated in order to achieve the desired results and use predictive models to assess progress and outcomes where and when necessary.

           This section had five oral presentations and 1 poster. All the five oral presentations were given. The papers were of very high quality science relating to environments under which tsetse and trypanosomiasis control is carried out. It was noted that to have a separate session dedicated to environmental matters alone was a big improvement from the previous ISCTRC conference where papers on environment were presented alongside the socio-economics and have never been more than three. The improved number of papers may be a reflection of the growing importance of environment in tsetse intervention issues. This may be due to the recent focus in diversification of objectives of tsetse and trypanosomiasis control to embrace aspects of promoting agriculture and rural development. As a result of this change in focus environmental impacts of tsetse and trypanosomiasis control are more and more addressing the indirect/ secondary effects that may be triggered by changes in land use after the disease constraint to livestock production is removed. This focus is highly welcome as there is a need to enhance agricultural productivity in the project areas and protect the environment.

           The papers presented rage from application of environmental monitoring methodologies, environmental surveys in tsetse infested areas to show how tsetse distribution matches habitat structures, and development of a framework for environmental impacts assessment. An interesting presentation was made that discussed environmental affinities important in the transmission of human trypanosomiasis. The paper on mapping of benefits generated a lot of interest as there were a number of questions as to how to apply the model. 

           There were many questions following each presentation which showed the interest the audience had on issues of environment in T&T interventions. Environmental monitoring and sustainable land management in PATTEC project is critical to achieving the desired goals and objectives of rural development. Despite this session being on the last day of paper presentations, it was encouraging to find that participant of the previous three days were still attentive and participating even though most of them were from as distant disciplines as parasitology and immunology.

RECOMMENDATIONS:

Recommendations drawn from the discussions are that:

1. Environmental considerations in T&T interventions should be promoted in order to ensure sustainability of agricultural practices. 

2. Methodologies used in environmental monitoring impact assessments should be standardized and made available to all countries.

3. The involved countriesshould undertake capacity building in order to develop adequate manpower with appropriate skills to conduct environmental studies in T&T project areas.

4.  PATTEC or PAAT should undertakes a coordination exercise to ensure that a standard terms of reference for baseline data collection among countries is developed to ensure that data collected is of high quality and is similar in all sites.

5. A standard framework or guides for environmental data collection should be  developed to ensure that data from different sites and countries are comparable.

6. That studies including GIS work should be encouraged in human and animal trypanosomiasis for spatial risk and impact assessment

RECOMMENDATIONS

1. Manufactures should be encouraged provide sachets of trypanocidal drugs  in variety sizes for a range of animal weights.

2. For sustainability, animal trypanosomosis control interventions should be targeted towards communities committed to controlling tryponosomosis.

3. Primary school teachers should be included in campaigns to raise awareness of tsetse and trypanosomosis and be provided with appropriate information and materials.

4. Technology delivery should be targeted at the appropriate gender group and policy formulation and implementation should be gender balanced.

5. Continued support for the Orma Boran breeding programme is required to maintain the genetic qualities of this indigenous breed and maximise benefits from previous investments.

VIII.    POSTER PRESENTATION

A total of 31 posters were presented during the 28th ISCTRC meeting in Addis Ababa, Ethiopia. Highlights of each poster is as follows:

a)   Biology, Protozoology, Immunology and Diagnosis

• Detection of trypanosome specific antibodies in saliva for non-intrusive diagnosis of sleeping sickness. Saliva, serum and whole blood were used to measure specific antibodies using direct ELISA, indirect ELISA and CATT. Result indicates that the best test format for saliva testing is the indirect ELISA on sample dilution 1:20.

• Highlights the importance of improved diagnostic benefits by farmers by reducing losses from morbidity and mortality and cost of unnecessary drug. More accurate diagnosis would allow more rational drug use and slow the development and progression of drug resistance.

b)   Human Sleeping Sickness

• Veterinary measures against animal trypanosomosis suppress the incidence of human sleeping sickness in southern Uganda.

• Assess the impact of one dose isometamedium (ISMM) treatment in cattle on the incidence of human sleeping sickness due to T. b. rhodesiense

• Highlights the importance of genetic host parasite interaction for the diagnosis, treatment and control of human sleeping sickness

• Stage determination of human sleeping sickness using LATEX/IgM and LATEX/T. b. gambiense agglutination tests in CSF.

• Evaluation of various diagnostic techniques indicated that CTC and   mAECT are better tests for field application.

• Pathogenesis of T. b. gambiense  in verbet monkey with particular emphasis on clinical and haematological parameters
• DMFO-niturtimox combination treatment against T. b. g. in African Green Monkey and the use of Melarsoprol in relapse cases.

c)   African Animal Trypanosomosis (AAT)

• Describes drug resistance of T. congolense field isolates from cattle in relation to drug use practices in Mozambique

• Variation in virulence of T. congolense field isolates tested in mice in Eastern Zambia

• Spatial distribution of drug resistant animal trypanosomes in Mali and Guinea

• Nkedi zebu cattle are more tolerant to tsetse-transmitted trypanosomiasis compared to Ankole cattle under the same tsetse challenge in Uganda

• Highlights the importance of haemorrhagic T. vivax in Uganda

• Tsetse blood meal analysis and its relation to the transmission of T. b. gambiense to human in southern Cameroon

• Cross sectional and longitudinal studies on bovine trypanosomiasis indicated high risk in the lowlands compared to the plateau in Cameroon. Drug treatment in the buffer zone will reduce the incidence on the plateau.

• Use of insecticide to kill tsetse and ticks reduce the incidence of trypanosomiasis and TBD in cattle in Bugiri and Busia districts of Uganda.

• F1 (Orma Boran x Tseso Zebu) showed low prevalence of trypanosome infection with better PCV in Teso district, western Kenya.

• ILRI/EARO. Sheko breed of cattle showed relatively high tolerance to trypanosomosis compared to Gurage, Horro and Abigar breeds of cattle in Ethiopia

d)   Vector Control

• Highlights the association between G. f. fuscipes. and T. b. gambiense. and the river basins in Uganda.

• G. f. ffuscipes. of lake Victoria islands feed predominantly on Varnidae. Blue-black insect targets are more effective to suppress G. f. fuscipes than pour-ons/sprays

• Toxicological effects of synthetic repellents was tested on rabbits and showed mild irritation on the skin and eyes of the rabbits.

• “Push-Pull” technology gave a 70% reduction in trypanosome infection in 6 months time.

• Describes vector and rodent holding devices during parasite transmission experiment in the laboratory

• New tsetse mass rearing and research facility in Slovakia with present female colony of 33,000 G. pallidipes, 45,000 G. fuscipes and 12,000 G. m. morsitans.

e)   Environment and GIS

Assess the prevalence of trypanosomosis in cattle, pig, sheep and goats using PCR in Busia, Kenya. individual homesteads with T. brucei were mapped

f)   Socio-economics and Rural Development

In western Kenya, community beliefs about the cause of human sleeping sickness attributed the cause to witchcrafts (34.7%), HIV/AIDS (33%) and tsetse flies (21%) and recommend awareness creation and education among others.

Modérateur    :           Modibo T. Traoré
Rapporteur     :           Udo Feldman

UNION EUROPEENNE (UE)

           Depuis plus de vingt cinq ans, l’Union Européenne (UE) appuie les activités de lutte contre la mouche tsétsé et la trypanosomose dans le cadre du développement rural.  Au début des années 1980, la Commission Européenne a initié le Programme régional de lutte contre la mouche tsétsé et la trypanosomose  (RTTCP) au Malawi, au Mozambique et en Zambie.  Le programme RTTCP était axé sur une approche communautaire et portait sur une étendue de plus de 300.000 km².  Ce programme, financé par la Commission Européenne pendant plus de 15 ans (1986 – 2000), a eu des résultats mitigés dus en partie à son ampleur.  Une leçon tirée du RTTPC  est qu’une approche de lutte contre la mouche tsétsé et la trypanosomose devrait mettre l’accent sur le renforcement des capacités aux niveaux régional, national et local, et en particulier, sur la participation des communautés locales au processus de décision.

           En s’inspirant de l’expérience du RTTCP, la Commission a, en 1986, mis en place un programme régional intitulé : « l’Agriculture dans les zones de contrôle des tsétsé » (FITCA) dans cinq pays de l’Afrique de l’est (l’Ethiopie, le Kenya, le Rwanda, l’Ouganda et la République unie de Tanzanie).  Ce programme était initialement prévu pour une durée de quatre ans (jusqu’en 2000), mais compte tenu de la lenteur administrative et d’autres problèmes, il fut jugé nécessaire de le prolonger jusqu’en 2004.  Le programme FITCA  a prévu que la lutte contre la mouche tsétsé et la trypanosomose réussira mieux sur la base de partenariats actifs et de mesures de contrôle permettant la pleine participation des communautés, dans le but de g&eac