Waiswa C, Azuba R, Makeba J, Waiswa I C, Wangoola R M
Coordinating Office for the Control of Trypanosomiasis in Uganda (COCTU), P.O Box 16345, Wandegeya, Kampala, Uganda.
School of Veterinary Medicine, Makerere University, P.O Box 7062, Kampala, Uganda.
Parasite Epidemiol Control. 2020 Sep 21;11:e00185. doi: 10.1016/j.parepi.2020.e00185. eCollection 2020 Nov.
Elimination of sleeping sickness from endemic countries like Uganda is key if the affected communities are to exploit the potential of the available human and livestock resources (production and productivity). , the parasite that causes acute sleeping sickness in humans, is transmitted by tsetse flies and co-exists in non-human animal reservoirs. Uganda by Act of Parliament in 1992 decided to handle the complex approach to control of sleeping sickness and animal trypanosomiasis by establishing the Uganda Trypanosomiasis Control Council (UTCC) and its secretariat the Coordinating Office for the Control of Trypanosomiasis in Uganda (COCTU). The Institutional arrangement aimed to promote engagement with key stakeholders across nine key ministries and the community, all vital for control of zoonotic sleeping sickness, creating a One Health platform, long before such practice was common. From 2006, approaches by the Public Private Partnership, Stamp Out Sleeping Sickness (SOS) have required involvement of stakeholders in the promotion of insecticide treated cattle as live tsetse baits, targeting elimination of zoonotic sleeping sickness. Experiences in promoting sustainability of these interventions have been captured in this study as part of the Tackling Infections to Benefit Africa (TIBA) partnership. Meeting transcripts, focus group discussions and questionnaires were used to collect data from the different stakeholders involved in a rapid impact live bait study over 12 months from Dec 2017. The study provides unprecedented insights into the stakeholders involved in the application of a One health approach for control of zoonotic sleeping sickness across the most important active human African trypanosomiasis focus in East Africa. This unique study is fundamental in guiding multi-stakeholder engagement if the goal to eliminate zoonotic sleeping sickness is to be realised. A major challenge is timely feedback to the community as regards human and animal disease status; rapid diagnostic services that can be delivered from facilities established in close proximity to the affected communities and well equipped in-country reference laboratories are key to delivering effective control and best One Health Approach.
如果受影响社区要挖掘现有人力和牲畜资源（产量和生产率）的潜力，那么在乌干达等流行国家消除昏睡病至关重要。布氏锥虫是导致人类急性昏睡病的寄生虫，通过采采蝇传播，并在非人类动物宿主中共存。1992年，乌干达议会通过法案，决定通过设立乌干达锥虫病控制委员会（UTCC）及其秘书处——乌干达锥虫病控制协调办公室（COCTU），来应对控制昏睡病和动物锥虫病的复杂方法。这种机构安排旨在促进与九个关键部委和社区的主要利益相关者的参与，所有这些对于控制人畜共患昏睡病都至关重要，早在这种做法普遍之前就创建了一个“同一健康”平台。从2006年起，公私合作伙伴关系“根除昏睡病”（SOS）的方法要求利益相关者参与推广用杀虫剂处理过的牛作为活采采蝇诱饵，目标是消除人畜共患昏睡病。作为“应对感染造福非洲”（TIBA）伙伴关系的一部分，本研究记录了促进这些干预措施可持续性的经验。2017年12月起的12个月里，通过会议记录、焦点小组讨论和问卷调查，从参与快速影响活诱饵研究的不同利益相关者那里收集数据。该研究为参与在东非最重要的活跃人类非洲锥虫病重点地区应用同一健康方法控制人畜共患昏睡病的利益相关者提供了前所未有的见解。如果要实现消除人畜共患昏睡病的目标，这项独特的研究对于指导多利益相关者参与至关重要。一个主要挑战是就人类和动物疾病状况及时向社区反馈；能够从在受影响社区附近设立且装备完善的国内参考实验室提供的快速诊断服务，是实现有效控制和最佳同一健康方法的关键。
