| Sumario: | Background: Animal African trypanosomiasis (AAT) poses a significant impediment to livestock production and economic progress in sub-Saharan Africa. To reduce the burden of AAT in Uganda and contribute to the AAT progressive control pathway, there is a need to develop effective AAT and tsetse control measures. In this study, we assessed a combination of chemotherapy and Restricted Insecticide Application Protocol (RAP) as a last mile control option for the progressive control of AAT and acute sleeping sickness in south- eastern Uganda.
Methods: Cattle from fourteen AAT endemic villages in south-eastern Uganda were treated with two doses of diminazene acecurate 40 days apart and sprayed with deltamethrin once monthly for 6 months following chemotherapy. Both cattle and tsetse flies were screened for trypanosomes before and 6 months into the interventions using ITS1-PCR. Tsetse flies trapped per day per trap were counted and the apparent tsetse fly density [Flies/Trap/Day-FTD] determined and mapped. The effect of chemotherapy and RAP on (1) FTD and (2) trypanosome infection in both cattle and tsetse flies was determined using mixed effects regression models.
Results: RAP and chemotherapy were associated with significantly lower odds of trypanosome infections in cattle (OR = 0.43, 95% CI; 0.35–0.54) and tsetse flies (OR = 0.06, 95% CI; 0.03–0.10). RAP and chemotherapy reduced <i>Trypanosoma</i> species prevalence from 23.38% to 12.70% among cattle and 73.33% to 21.76% in tsetse flies. Additionally, treatment was significantly associated (P = 0.04) with a reduction in FTD by 1.02. Unlike <i>T. vivax</i>, both <i>T. congolense</i> and <i>T. brucei</i> infections were reduced by RAP and chemotherapy. There was a single infection with <i>Trypanosoma brucei rhodesiense</i> detected in the cattle and none in tsetse flies.
Conclusion: Combination of RAP and chemotherapy offers promising approach to control AAT in endemic areas and can support last mile acute sleeping sickness elimination efforts when combined with other available tsetse and AAT control methods. A singular infection with <i>T. b. rhodesiense</i> indicates that there is still a risk of acute sleeping sickness resurgence in south-eastern Uganda unless tsetse and trypanosomiasis control and surveillance efforts are maintained.
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