Biotechnology Research Institute, KALRO, P.O. Box 362, -00902, Kikuyu, Kenya.
Biotechnology Research Institute, KALRO, P.O. Box 362, -00902, Kikuyu, Kenya.
Vet Parasitol Reg Stud Reports. 2024 Sep;54:101095. doi: 10.1016/j.vprsr.2024.101095. Epub 2024 Aug 4.
The non-cyclic trypanosomiasis (surra), caused by Trypanosoma evansi, and mechanically transmitted by biting flies, hinders camel productivity in Kenya. Trypanocides are the most commonly used drugs to control surra. However, emergence of drug resistance by the parasites is a major limitation to control efforts. There is limited information on the quality of trypanocides, the supply chain and drug-use practices among camel keepers potentially contributing to development of drug resistance in Kenya. We sought to fill this gap by conducting a cross-sectional study among camel keepers in Isiolo and Marsabit counties, Kenya. We mapped the trypanocide drugs supply chain through quantitative and qualitative surveys. We administered a semi-structured questionnaire to camel keepers to generate data on trypanocides-use practices, including the types, sources, person who administers treatment, reconstitution, dosage, route and frequency of administration, among others. Additionally, we tested the quality of trypanocidal drugs retailed in the region. We mapped a total of 55 and 49 agro-veterinary outlets and general (ordinary) shops retailing veterinary drugs in the two counties, respectively. These comprised of 29 and 26 agro-veterinary outlets, as well as 24 and 25 general shops in Isiolo and Marsabit counties, respectively. Overall, the respondents experienced 283 surra cases in the three-month recall period, which were treated with trypanocides. The majority of these cases were diagnosed by camel owners (71.7%) and herders (24.1%). A significant proportion of the cases were treated by camel owners (54.8%), herders (35.3%), the owner's son (3.2%) and veterinary personnel (1.1%) (χ = 24.99, p = 0.000). Most of the households sourced the drugs from agro-veterinary outlets (59.0%), followed by general shops (19.8%), veterinary personnel (2.1%), and open-air markets (0.4%) (χ = 319.24, p = 0.000). Quinapyramine was the most (56.9%) predominantly used trypanocide in treatment of surra, followed by homidium (19.8%), isometamidium (15.9%), diminazene aceturate (6.7%), and ethidium (0.7%) (χ = 340.75, p < 0.000). Only a meager proportion of respondents (15.2%) used the drugs correctly as instructed by the manufacturers. We recorded an association between correct drug usage, with the person who administers the treatment (χ = 17.7, p = 0.003), and the type of trypanocide used (χ = 19.4, p < 0.001). All the drug samples tested had correct concentrations of active ingredient (100.0%), and therefore of good quality. We have demonstrated that whereas the trypanocides retailed in the region by authorized vendors are of good quality, there is widespread incorrect handling and use of the drugs by unqualified individuals, which may contribute to treatment failure and emergence of trypanocide resistance.
无环泰勒虫病（苏拉病）由伊氏锥虫引起，通过吸血蝇机械传播，严重影响肯尼亚骆驼的生产力。驱虫剂是控制苏拉病最常用的药物。然而，寄生虫对药物的耐药性的出现是控制工作的主要限制。关于驱虫剂的质量、供应链以及骆驼饲养者的用药情况的信息有限，这可能导致肯尼亚出现药物耐药性。我们试图通过在肯尼亚伊斯卡洛和马萨比特县的骆驼饲养者中进行横断面研究来填补这一空白。我们通过定量和定性调查绘制了驱虫剂供应。我们向骆驼饲养者发放了一份半结构式问卷，以生成关于驱虫剂使用情况的数据，包括用药类型、来源、用药人、药物复配、剂量、用药途径和频率等。此外，我们还测试了该地区零售驱虫剂的质量。我们共绘制了伊斯卡洛和马萨比特县的 55 家和 49 家兽药销售点和普通（普通）商店地图，分别销售兽医药品。其中包括 29 家和 26 家兽药销售点，以及伊斯卡洛和马萨比特县的 24 家和 25 家普通商店。总的来说，在三个月的回顾期内，受访者报告了 283 例苏拉病病例，这些病例都用驱虫剂治疗。这些病例主要由骆驼主人（71.7%）和牧民（24.1%）诊断。很大一部分病例是由骆驼主人（54.8%）、牧民（35.3%）、主人的儿子（3.2%）和兽医人员（1.1%）治疗的（χ=24.99，p=0.000）。大多数家庭从兽药销售点（59.0%）购买药物，其次是普通商店（19.8%）、兽医人员（2.1%）和露天市场（0.4%）（χ=319.24，p=0.000）。在苏拉病的治疗中，喹嘧胺（56.9%）是最常用的驱虫剂，其次是双羟萘酸噻嘧啶（19.8%）、异咪啶（15.9%）、二硝托胺（6.7%）和乙啶（0.7%）（χ=340.75，p<0.000）。只有很少一部分受访者（15.2%）按照制造商的说明正确使用了药物。我们记录到正确使用药物与用药人（χ=17.7，p=0.003）和使用的驱虫剂类型（χ=19.4，p<0.001）之间存在关联。所有测试的药物样本均具有正确的有效成分浓度（100.0%），因此质量良好。我们已经证明，尽管该地区经授权的供应商销售的驱虫剂质量良好，但未经授权的个人广泛不正确地处理和使用这些药物，这可能导致治疗失败和驱虫剂耐药性的出现。
