Detection of multiple drug-resistant Trypanosoma congolense populations in village cattle of south-east Mali

Longitudinal observational (single cohort) study on the causes of trypanocide failure in cases of African animal trypanosomosis in cattle near wildlife protected areas of Northern Tanzania

African animal trypanosomosis (AAT) in cattle is primarily managed through trypanocide administration and insecticide application. Trypanocides can be used for both treatment and prophylaxis, but failure is often reported; this may occur due to resistance, substandard drugs, or inappropriate administration. This study in Tanzania aims to quantify reasons for trypanocide failure. An observational year-long longitudinal study was conducted in high-risk AAT areas in Serengeti District between June 2021-October 2022. Purposive sampling targeted herds with high utilization of the prophylactic trypanocide isometamidium chloride (ISM). When a farmer administered a trypanocide (ISM, diminazine aceturate, homidium), the project veterinarian assessed administration and treatment outcomes were determined based on PCR results from blood samples. A multivariable mixed model was utilized to evaluate risk factors for prophylaxis failure. Quality analysis was performed on trypanocide samples using High Performance Liquid Chromatography. A total of 630 cattle from 21 farms were monitored for a year-long period. A total of 295 trypanocide administrations were reported, predominantly being ISM (56%) used for prophylaxis (87%). One-third of trypanocide administrations were not given adequately, and many trypanocides were given to animals that tested negative for trypanosome infections by PCR. Failures occurred in 7% (95% CI 3.0-14%) of curative treatments, and 44% (95% CI 35-42%) of prophylactic administrations. The brand of ISM was significantly associated with odds of prophylaxis failure (p = 0.011). On quality analysis, two ISM samples had no detectable ISM isomers, but the remainder of ISM and DA samples (n = 46) fell within the range of acceptable levels. Drug counterfeiting, inadequate use of trypanocides, and resistance are all contributing to trypanocide failure, limiting effective AAT control and with implications for human disease risk. In order to curb trypanocide failure a multi-modal approach to managing the use of trypanocides is required to address all contributing factors.

Prudent use and antimicrobial prescription practices in Ethiopian veterinary clinics located in different agroecological areas

BACKGROUND

Understanding antimicrobial prescribing (AMP) practices and their prudent use in livestock can support the implementation of stewardship programs in veterinary medicine. Empiric therapy using antimicrobials is widely practiced in resource-poor settings, including Ethiopia. This could significantly contribute to the global burden of antimicrobial resistance (AMR) and the potential accumulation of residues in food. This study assessed AMP practices in Ethiopian veterinary clinics located in different agroecological zones (AEZs) as well as adherence to antimicrobial stewardship principles (ASPs).

METHODS

Data were collected from case book records from four district veterinary clinics located in different AEZs in Ethiopia from 2015 to 2019. To identify factors associated with non-prudent AMP practices (i.e., the use of antimicrobials without therapeutic effects or benefits to the animal), data from registered clinical veterinary cases were selected using a systematic random sampling method. This led to the inclusion of approximately one-third of all records, including animal characteristics, disease symptoms and diagnosis, and details about the prescribed drugs. Descriptive statistics were used to report the proportions of drugs prescribed and adherence to the ASPs. The Chi-square test was used to establish an association between the drugs prescribed and the disease diagnoses and the districts. The factors associated with cases receiving antimicrobials and non-prudent AMP practices were also assessed using a multivariable logistic regression analysis.

RESULTS

In total, 12,438 clinical case records were considered. Approximately 97% of these cases received treatment without laboratory confirmation, and 15,243 drugs were prescribed. Among these prescriptions, 75% were for antimicrobials, with oxytetracycline (29%) and a combined formulation of penicillin-dihydrostreptomycin (19%) being the most often prescribed drugs. Overall, 19% of the cases were treated non-prudently with antimicrobials, with high incidences at Holeta (32%) and Sekoru (19%) (p < 0.001). Most cases, including viruses and other non-pathogens (100%), toxicants (97%), unknown causes (94%), fungi (70%), nutritional (64%), risk of bacterial infection (42%), and endo-ectoparasites (24%), were treated non-prudently. Cases receiving antimicrobials and non-prudent AMP were associated with Holeta and Sekoru study clinics, major clinical signs of bloat and loss of body condition, and illness due to viral infections (p < 0.05). Conversely, species of animals and cases diagnosed with multiple etiologic agents and respiratory diseases were negatively associated with prudent AMP practices (p < 0.05).

CONCLUSIONS

Much of the prescription practice observed in this study did not adhere to the ASPs; there were significant discrepancies between the prescribed drugs and disease diagnoses. Prescribing antimicrobials for unrelated diagnoses may contribute to an increase in AMR. The study thus underlines the need for mechanisms to improve accurate disease diagnosis and prescriber adherence to prudent AMP in countries with limited resources.

An evaluation of African animal trypanosomiasis control strategies in remote communities of Eastern Zambia

Communities living in African animal trypanosomiasis (AAT) endemic areas of Zambia use several control strategies to protect their livestock from the devastating effects of trypanosomiasis. Several studies have reported the effectiveness of trypanosomiasis control strategies based on retrospective data. In this study, we assessed incidence rates of AAT in cattle (n = 227) using a prospective cohort study comprising 4 treatment groups, i.e., Diminazene aceturate, Isometamidium chloride, Cyfluthrin pour-on and Cypermethrin treated targets. The study was conducted in Mambwe district in Eastern Zambia between February 2019 and March 2020. The endemic prevalence of AAT for each group was determined using ITS-PCR prior to application of treatments. High endemic trypanosome pre-treatment rates were found in all Groups (Diminazene aceturate (61%), Isometamidium chloride (48%), Cyfluthrin pour-on (87%) and Cypermethrin targets (72%)). The overall apparent prevalence for the Mambwe district was 67% (152/227) and true prevalence at 95%CI was 63–71%. Once treatments were implemented, 12 monthly follow-ups were conducted. The average monthly incidence rates without standardization recorded: Diminazene aceturate (67%) Isometamidium chloride (35%), Cyfluthrin pour-on (55%) and Cypermethrin targets (61%). Incidence rates were standardized considering the endemic level of disease for each Group and the average standardized monthly incidence rate in the Diminazene aceturate Group was 7%; the Isometamidium chloride Group −13%; the Cyfluthrin Group −26%; and the Cypermethrin target Group, −17%. All Groups showed a decrease in incidence of AAT over the period of the study with the Cyfluthrin group showing to be the most effective in reducing AAT incidence in cattle.

Drug resistance in animal trypanosomiases: Epidemiology, mechanisms and control strategies

Animal trypanosomiasis (AT) is a complex of veterinary diseases known under various names such as nagana, surra, dourine and mal de caderas, depending on the country, the infecting trypanosome species and the host. AT is caused by parasites of the genus Trypanosoma, and the main species infecting domesticated animals are T. brucei brucei, T. b. rhodesiense, T. congolense, T. simiae, T. vivax, T. evansi and T. equiperdum. AT transmission, again depending on species, is through tsetse flies or common Stomoxys and tabanid flies or through copulation. Therefore, the geographical spread of all forms of AT together is not restricted to the habitat of a single vector like the tsetse fly and currently includes almost all of Africa, and most of South America and Asia. The disease is a threat to millions of companion and farm animals in these regions, creating a financial burden in the billions of dollars to developing economies as well as serious impacts on livestock rearing and food production. Despite the scale of these impacts, control of AT is neglected and under-resourced, with diagnosis and treatments being woefully inadequate and not improving for decades. As a result, neither the incidence of the disease, nor the effectiveness of treatment is documented in most endemic countries, although it is clear that there are serious issues of resistance to the few old drugs that are available. In this review we particularly look at the drugs, their application to the various forms of AT, and their mechanisms of action and resistance. We also discuss the spread of veterinary trypanocide resistance and its drivers, and highlight current and future strategies to combat it.

Ascofuranone antibiotic is a promising trypanocidal drug for nagana

Trypanosomosis is a disease complex which affects both humans and animals in sub-Saharan Africa, transmitted by the tsetse fly and distributed within the tsetse belt of Africa. But some trypanosome species, for example, Trypanosoma brucei evansi, T. vivax, T. theileri and T. b. equiperdum are endemic outside the tsetse belt of Africa transmitted by biting flies, for example, Tabanus and Stomoxys, or venereal transmission, respectively. Trypanocidal drugs remain the principal method of animal trypanosomosis control in most African countries. However, there is a growing concern that their effectiveness may be severely curtailed by widespread drug resistance. A minimum number of six male cattle calves were recruited for the study. They were randomly grouped into two (T. vivax and T. congolense groups) of three calves each. One calf per group served as a control while two calves were treatment group. They were inoculated with 105 cells/mL parasites in phosphate buffered solution (PBS) in 2 mL. When parasitaemia reached 1 × 107.8 cells/mL trypanosomes per mL in calves, treatment was instituted with 20 mL (25 mg/kg in 100 kg calf) ascofuranone (AF) for treatment calves, while the control ones were administered a placebo (20 mL PBS) intramuscularly. This study revealed that T. vivax was successfully cleared by AF but the T. congolense group was not cleared effectively.Contribution: There is an urgent need to develop new drugs which this study sought to address. It is suggested that the AF compound can be developed further to be a sanative drug for T. vivax in non-tsetse infested areas like South Americas.

Ethnoveterinary survey of trypanocidal medicinal plants of the beninese pharmacopoeia in the management of bovine trypanosomosis in North Benin (West Africa)

Cattle breeding is of great socio-economic importance for Benin's cattle farmers in general and those of North Benin in particular. The objective of this study is to inventory the natural products of medicinal plants of the Beninese pharmacopoeia for the management of trypanosomes in cattle in North Benin. The methodology consisted of individual and semi-structured interviews with cattle farmers on the use of medicinal plants. A total of 360 cattle farmers were selected and interviewed in twelve villages in four municipalities (Tchaourou, N'dali, Bembèrèkè and Gogounou) in northern Benin. Different quantitative ethnobotanical indices were calculated to determine the level of use of plant species. The Relative Frequency of Citation (RFC), the Informant Consensus Factor (ICF = 0.918) and the Generic Coefficient (Rg = 1.04) were evaluated. The knowledge of medicinal plants was influenced by the level of education and the main activity of those who practiced animal husbandry. The results yielded 48 medicinal plants for veterinary use belonging to 46 genera and 28 families. The Leguminosae family (12.50%) was the most represented. The most cited plants with a RFC above 10% were K. senegalensis, P. africana, K. africana, M. inermis, S. latifolius, M. polyandra. The parts used were leaves (46.15%); barks (24.62%) and roots (15.38%). Decoction (53.23%), plundering (32.26%) and maceration (11.26%) were the main methods of preparation. The administration was mainly by oral route. The calculated indices show a high diversity of medicinal plants with trypanocidal properties in the control of cattle trypanosomosis in the Sudanese and Sudano-Guinean zones of northern Benin. Plant species with high citation and RFC values should be selected for comprehensive pharmacological and phytochemical research to validate this ethnomedical knowledge in the management of cattle trypanosomosis.

Trypanosome infections in animals from tsetse infected areas of Cameroon and their sensitivity and resistance molecular profiles for diminazene aceturate and isometamidium chloride

Monitoring and assessment of control strategies for African trypanosomoses' elimination require not only updating data on trypanosome infections, but also to have an overview on the molecular profiles of trypanocides resistance in different epidemiological settings. This study was designed to determine, in animals from six tsetse-infested areas of Cameroon, the prevalence of trypanosome infections as well as the diminazene aceturate (DA) and isometamidium chloride (ISM) sensitivity/resistance molecular profiles of these trypanosomes. From 2016 to 2019, blood was collected in pigs, dogs, sheep, goats and cattle from six tsetse infested areas of Cameroon. DNA was extracted from blood and trypanosome species were identified by PCR. The sensitivity/resistance molecular profiles of trypanosomes to DA and ISM were investigated using PCR-RFLP. From 1343 blood samples collected, Trypanosoma vivax, Trypanosoma congolense forest and savannah, Trypanosoma theileri and trypanosomes of the sub-genus Trypanozoon were identified. The overall prevalence of trypanosome infections was 18.7%. These prevalence vary between trypanosome species, animal taxa, within and between sampling sites. Trypanosoma theileri was the predominant species with an infection rate of 12.1%. Trypanosomes showing resistant molecular profiles for ISM and DA were identified in animals from Tibati (2.7% for ISM and 65.6% for DA) and Kontcha (0.3% for ISM and 6.2% for DA). No trypanosome carrying resistant molecular profile for any of the two trypanocides was detected in animals from Fontem, Campo, Bipindi and Touboro. Mixed molecular profiles of sensitive/resistant trypanosomes were detected in animals from Tibati and Kontcha. Results of this study highlighted the presence of various trypanosome species as well as parasites carrying sensitive/resistant molecular profiles for DA and ISM in animals of tsetse infested areas of Cameroon. They indicate that the control strategies must be adapted according to epidemiological settings. The diversity of trypanosomes indicates that AAT remains a serious threat for animal breeding and animal health in these tsetse infested areas.

African animal trypanocide resistance: A systematic review and meta-analysis

Background

African animal trypanocide resistance (AATr) continues to undermine global efforts to eliminate the transmission of African trypanosomiasis in endemic communities. The continued lack of new trypanocides has precipitated drug misuse and overuse, thus contributing to the development of the AATr phenotype. In this study, we investigated the threat associated with AATr by using the major globally available chemotherapeutical agents.

Methods

A total of seven electronic databases were screened for an article on trypanocide resistance in AATr by using keywords on preclinical and clinical trials with the number of animals with treatment relapse, days taken to relapse, and resistant gene markers using the PRISMA checklist. Data were cleaned using the SR deduplicator and covidence and analyzed using Cochrane RevMan®. Dichotomous outputs were presented using risk ratio (RR), while continuous data were presented using the standardized mean difference (SMD) at a 95% confidence interval.

Results

A total of eight publications in which diminazene aceturate (DA), isometamidium chloride (ISM), and homidium chloride/bromide (HB) were identified as the major trypanocides were used. In all preclinical studies, the development of resistance was in the order of HB > ISM > DA. DA vs. ISM (SMD = 0.15, 95% CI: -0.54, 0.83; I ² = 46%, P = 0.05), DA vs. HB (SMD = 0.96, 95% CI: 0.47, 1.45; I ² = 0%, P = 0.86), and HB vs. ISM (SMD = -0.41, 95% CI: -0.96, 0.14; I ² = 5%, P = 0.38) showed multiple cross-resistance. Clinical studies also showed evidence of multi-drug resistance on DA and ISM (RR = 1.01, 95% CI: 0.71-1.43; I ² = 46%, P = 0.16). To address resistance, most preclinical studies increased the dosage and the treatment time, and this failed to improve the patient's prognosis. Major markers of resistance explored include TbAT1, P1/P2 transporters, folate transporters, such as F-I, F-II, F-III, and polyamine biosynthesis inhibitors. In addition, immunosuppressed hosts favor the development of AATr.

Conclusion

AATr is a threat that requires a shift in the current disease control strategies in most developing nations due to inter-species transmission. Multi-drug cross-resistance against the only accessible trypanocides is a major public health risk, justifying the need to revise the policy in developing countries to promote control of African trypanosomiasis.

Molecular genotyping reveals mixed bovine and human trypanosomiasis in cattle from West Africa

Background and Aim

Animal trypanosomiasis is a major contributor to agricultural and economic losses, especially in sub-Saharan Africa. We have shown that some animal species expressed genes that are significant players in immune response to bovine trypanosomosis, impeding signs and symptoms of the disease. We hypothesize that such animals are contributors to disease transmission dynamics and severe outcomes. Therefore, this study aims to ascertain trypanosome species diversity in cattle and their potential role as reservoirs for the transmission of human disease.

Materials and Methods

We performed a molecular genotyping of trypanosome internal transcribed spacer 1 (ITS-1) and 18S ribosomal RNA genes on genomic DNA extracts from randomly sampled N'Dama cattle from slaughterhouses in Nigeria. We identified trypanosome species circulating among the animals through polymerase chain reaction and genomic sequencing. We performed multiple sequence alignments as well as conducted a phylogenetic relationship between identified species.

Results

In all, 9 of 127 (7.1%) samples were positively amplified (band sizes ranging from 250 bp to 710 bp), including an isolate with two distinct bands (700 and 710 bp), indicating two trypanosome types. Sequence similarity and homology analysis identified four species, namely: Trypanosoma vivax, Trypanosoma congolense forest type, T. congolense savannah type, and Trypanosoma brucei. Interestingly, one of the bands, additionally verified by nucleotide sequencing, was identified as a human trypanosome (Trypanosoma brucei gambiense), confirming our hypothesis that cattle are potential reservoir hosts for human trypanosomes.

Conclusion

Overall, we observed different trypanosome species in our study area, with animals on the same farm infected with multiple species, which could complicate treatment and disease control strategies. Finding human trypanosome species strengthens the argument that disease transmission dynamics are modulated by other vertebrates, further complicating control programs.

African Animal Trypanosomiasis: A Systematic Review on Prevalence, Risk Factors and Drug Resistance in Sub-Saharan Africa

African animal trypanosomiasis (AAT) a parasitic disease of livestock in sub-Saharan Africa causing tremendous loses. Sub-Saharan continental estimation of mean prevalence in both large and small domestic animals, risk factors, tsetse and non-tsetse prevalence and drug resistance is lacking. A review and meta-analysis was done to better comprehend changes in AAT prevalence and drug resistance. Publish/Perish software was used to search and extract peer-reviewed articles in Google scholar, PubMed and CrossRef. In addition, ResearchGate and African Journals Online (AJOL) were used. Screening and selection of articles from 2000-2021 was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles 304 were retrieved; on domestic animals 192, tsetse and non-tsetse vectors 44, risk factors 49 and trypanocidal drug resistance 30. Prevalence varied by, host animals in different countries, diagnostic methods and species of Trypanosoma. Cattle had the highest prevalence with Ethiopia and Nigeria leading, T. congolense (11.80-13.40%) and T. vivax (10.50-18.80%) being detected most. This was followed by camels and pigs. Common diagnostic method used was buffy coat microscopy. However; polymerase chain reaction (PCR), CATT and ELISA had higher detection rates. G. pallidipes caused most infections in Eastern regions while G. palpalis followed by G. mortisans in Western Africa. Eastern Africa reported more non-tsetse biting flies with Stomoxys leading. Common risk factors were, body conditions, breed type, age, sex and seasons. Ethiopia and Nigeria had the highest trypanocidal resistance 30.00-35.00% and highest AAT prevalence. Isometamidium and diminazene showed more resistance with T. congolense being most resistant species 11.00-83.00%.

Post marketing surveillance of selected veterinary medicines in Tanzania mainland

BACKGROUND

Veterinary medicines have been widely used for the prevention and treatment of animal diseases. Globally, the veterinary medicine industry is growing. However, there is a significant increase of concern on the quality of veterinary medicines in various developing countries' legal markets. Poor-quality medicines are associated with treatment failure, development of drug resistance, increased healthcare cost, and death. These reasons warrant a need for monitoring the quality of the medicines circulating in the Tanzania Mainland.

METHODS

This was a survey study and veterinary medicines samples were collected from 9 out of 26 regions of Tanzania mainland between 2014 and 2017. Veterinary medicines were sampled from wholesale pharmacies, retail pharmacies, veterinary clinics and Veterinary Accredited Drug Dispensing Outlets (ADDO-vet). All sampled medicines were subjected to product information review and full quality control testing at the Tanzania Medicines and Medical Devices Authority-World Health Organization prequalified laboratory.

RESULTS

A total of 238 samples of veterinary medicines were collected. Out of these, 97.1% (231/238) were subjected to full quality control testing and product information review. All sampled veterinary medicines conformed to visual appearance, clarity, pH, solubility and sterility tests. Also, of the sampled veterinary medicines 97.8% (226/231) and 89.2% (206/231) passed identification and assay tests, respectively. As well as, the majority of the collected samples 92% (219/238) failed to comply with product information requirements. The most observed deficiencies on product information were inadequate information on the package insert 94.1% (224/238), inappropriate storage conditions 55.5% (132/238) and lack of Tanzania registration number 27% (64/238).

CONCLUSION

Veterinary medicines with poor quality were found circulating in the legal markets of Tanzania. This can potentiate treatment failure and the development of drug resistance in animals and humans. Post marketing surveillance program will continue to be implemented to ensure that only good quality, safe and efficacious medicines are circulating in the Tanzania Mainland market.

Therapeutic Efficacy of Orally Administered Nitrofurantoin against Animal African Trypanosomosis Caused by Trypanosoma congolense Infection

Animal African trypanosomosis (AAT) leads to emaciation and low productivity in infected animals. Only six drugs are commercially available against AAT; they have severe side effects and face parasite resistance. Thus, the development of novel trypanocidal drugs is urgently needed. Nitrofurantoin, an antimicrobial, is used for treating bacterial urinary tract infections. Recently, we reported the trypanocidal effects of nitrofurantoin and its analogs in vitro. Furthermore, a nitrofurantoin analog, nifurtimox, is currently used to treat Chagas disease and chronic human African trypanosomiasis. Thus, this study was aimed at evaluating the in vivo efficacy of nitrofurantoin in treating AAT caused by Trypanosoma congolense. Nitrofurantoin was orally administered for 7 consecutive days from 4 days post-infection in T. congolense-infected mice, and the animals were observed for 28 days. Compared to the control group, the treatment group showed significantly suppressed parasitemia at 6 days post-infection. Furthermore, survival was significantly prolonged in the group treated with at least 10 mg/kg nitrofurantoin. Moreover, 100% survival and cure was achieved with a dose of nitrofurantoin higher than 30 mg/kg. Thus, oral nitrofurantoin administration has potential trypanocidal efficacy against T. congolense-induced AAT. This preliminary data will serve as a benchmark when comparing future nitrofurantoin-related compounds, which can overcome the significant shortcomings of nitrofurantoin that preclude its viable use in livestock.

Development of cationic Isometamidium chloride loaded long-acting lipid nanoformulation: optimization, cellular uptake, pharmacokinetics, biodistribution, and immunohistochemical evaluation

The aim of the present work involved the development and evaluation of long-acting Isometamidium chloride (ISMM)-Docusate sodium (DS) complex loaded lipid nanoparticles (LA ISMM-DS LNP). The development involved screening various anionic complexing agents, including DS, dextran sulphate, and sodium alginate. Anionic DS was selected to synthesize hydrophobic ionic complex (ISMM-DS HIC), which was loaded into lipid nanoparticles (LA ISMM-DS LNP) by in situ complexation followed by the solvent evaporation method. 35-5-folds increase in the drug loading of hydrophilic cationic ISMM within nanoparticles was observed due to ISMM-DS HIC. The LA ISMM-DS LNP were non-hemolytic (0-2.52%), cytocompatible (80.6-47.5% cell viability), and enhanced THP-1 cellular uptake (2.3-folds higher) compared with free ISMM. The LA ISMM-DS LNP engender protracted in vivo plasma drug concentration for seven days with enhanced AUC_0-ꝏ, MRT_0-ꝏ, and t_1/2, along with reduced Cl compared with free ISMM. Interestingly, the amount of ISMM was 2.9-, 4.2- and 2.0-folds higher in target reticuloendothelial (RES) organs like liver (Kupffer cells), spleen (spleenotropic macrophages and 15% T-lymphocytes), and lymph nodes (75% T-lymphocytes), respectively in LA ISMM-DS LNP group compared with free ISMM. Furthermore, LA ISMM-DS LNP caused higher peripheral blood mononuclear cells (PBMC) infiltration with diminished toxicity and inflammation. Therefore, the in vitro and in vivo studies predicted enhanced safety and efficacy of LA ISMM-DS LNP compared with free ISMM. To conclude, successfully developed LA ISMM-DS LNP would elicit a tremendous clinical potential for treatment and prevention against trypanosomiasis.

Drug-resistant trypanosome isolates populations in dogs in Enugu North Senatorial Zone, Southeastern Nigeria

African animal trypanosomosis is an important wasting and endemic protozoan disease causing morbidities and mortalities in animals in the sub-Saharan Africa. Currently, chemotherapy is the widely used method of African animal trypanosomosis control, especially in dogs in the sub-Saharan Africa. However, their efficacy is threatened by the emergence of drug-resistant trypanosomes owing to their extensive use and misuse over several decades amongst other factors. Thus, this study focused on the trypanocidal sensitivity and characterization of Trypanosoma species isolated from dogs in Enugu North Senatorial Zone (ENSZ), Southeastern Nigeria. Trypanosoma brucei (n = 44) and T. congolense (n = 4) isolated from naturally infected dogs in ENSZ, Southeastern Nigeria, between January and August 2016 were subjected to single dose test to assess their sensitivity to diminazene aceturate (DA) and isometamidium chloride (ISM). Subsequently, DA and multidrug-resistant isolates were further subjected to DA multi-dose test and CD₅₀ was determined and was used to characterize the drug-resistant trypanosomes. Clones were derived from a randomly selected multidrug-resistant isolate and their sensitivity also assessed. 100% and 83.3% of T. congolense and T. brucei respectively were resistant to the trypanocides. Amongst the drug-resistant isolates, 50%, 16.7%, and 33.3% were resistant to DA, ISM, and both trypanocides respectively with CD₅₀ ranging between 11 and 32.34 mg/kg. Drug-resistant trypanosomes were characterized into highly resistant (CD₅₀ = 11-24.99 mg/kg) and very highly resistant (CD₅₀ =  > 25 mg/kg) trypanosome isolates. Clones also expressed high levels of resistance to both DA and ISM with CD₅₀ values between 35.58 and 38.85 mg/kg. Trypanocidal resistance was, thus, confirmed and appears to be widespread in dogs in ENSZ, Southeastern Nigeria. The adoption of an integrated trypanosomosis control strategy in ENSZ is most desirous.

Pharma to farmer: field challenges of optimizing trypanocide use in African animal trypanosomiasis

Trypanocides are a key control component of African animal trypanosomiasis (AAT) in tsetse-infested areas of sub-Saharan Africa. While farmers are dependent upon trypanocides, recent research highlights their inappropriate and ineffective use, problems with drug quality, and treatment failure. There are currently gaps in knowledge and investment in inexpensive AAT diagnostics, understanding of drug resistance, and the effective use of trypanocides in the field. Without this important knowledge it is difficult to develop best practice and policy for existing drugs or to inform development and use of new drugs. There needs to be better understanding of the drivers and behavioural practices around trypanocide use so that they can be incorporated into sustainable solutions needed for the development of effective control of AAT.

Epidemiological investigation of bovine trypanosomosis and distribution of vectors in Jimma zone, Ethiopia

Trypanosomosis is highly reliant on the distribution of vectors responsible for transmission. A cross-sectional study was conducted to determine the prevalence and associated risk factors of bovine trypanosomosis as well as the distribution of vectors in the Jimma zone, Ethiopia. Blood samples from a total of 2088 cattle were collected and tested using a buffy coat and Giemsa techniques. An overall 13.36% prevalence of trypanosomosis was recorded in study areas. The highest proportion of the infections was caused by T. vivax (44.80%) followed by T. congolense (36.92%) and mixed infection (18.28%) of both species. The study also revealed that trypanosomosis was associated with anemia as the mean PCV was significantly lower among trypanosome-infected animals (20.34 ± 4.39) than non-infected ones (27.98 ± 3.68). Moreover, anemia was more pronounced with T. congolense infection (19.54 ± 3.22) than T. vivax (21.07 ± 3.96) and mixed infection of both species (20.16 ± 2.71). This study identified age, body condition, and agro-ecology as risk factors for the occurrence of trypanosomosis in cattle. Vector survey was conducted by deploying 377 mono-pyramidal traps in selected districts. Accordingly, Glossina species and other biting flies (Stomoxys and Tabanus) were identified with an apparent density of 5.27 and 1.74 fly/trap/day, respectively. Moreover, a higher 4.49 fly/trap/day of G. tachinoides than G. morsitans submorsitans (0.79 fly/trap/day) was noted in study areas. The present study indicated that trypanosomosis is the major cattle production constraint in the areas. Hence, applicable management techniques of the disease and its vector should be implemented and further investigation involving molecular technique should be conducted in different seasons.

Prevalence and associated risk factors of bovine trypanosomosis in tsetse suppression and non-suppression areas of South Omo Zone, Southwestern Ethiopia

A cross-sectional study aimed to elucidate the prevalence of bovine trypanosomosis and its potential risk factors was conducted in tsetse suppression and non-suppression areas of South Omo Zone, Southern Ethiopia from November 2018- May 2019. A total of 1284 blood samples from local zebu cattle (642 each in dry and wet season) were examined by using buffy coat technique and thin blood smear method. The overall prevalence was 11.05 % with 14.33 % in dry and 7.78 % in wet season. According to multiple logistic regression analysis of tsetse suppression areas, higher prevalence in female than male (OR = 0.48, 95 % CI: 0.27, 0.83), in poor (OR = 3.25, 95 % CI: 1.26, 11.09) and medium (OR = 2.07, 95 % CI: 0.74, 7.37) than good body conditioned animals was recorded. Moreover, tethered animals (OR = 2.07, 95 % CI: 1.06, 3.92) were more likely to be infected than communal grazers and also higher prevalence in dry season than wet season (OR = 0.52, 95 % CI: 0.30, 0.87). Similarly, in tsetse non-suppression areas, higher prevalence in female than male (OR = 0.48, 95 % CI: 0.27, 0.85) and in wet season (OR = 0.41, 95 % CI: 0.23, 0.7) than dry season was recorded. Trypanosoma congolense and Trypanosoma vivax were found in cattle with the former more prevalent in both areas. Overall pooled mean packed cell volume (PCV) of parasitaemic animals (23.57 ± 3.13) was significantly lower than aparasitaemic animals (27.80 ± 4.95). Similarly, parasitaemic animals from tsetse suppression areas and tsetse non-suppression areas had significantly lower mean PCV than their aparasitaemic counterparts. Mean PCV of T. congolense (23.59 ± 3.22) infected animals was not different (P > 0.05) from T. vivax infected animals (23.26 ± 3.31). It was also indicated that the probability of anaemic animals to be parasitaemic was significantly higher (P < 0.05) than non-anaemic animals in both areas. In conclusion, the prevalence of trypanosomosis revealed its endemicity which bottlenecked the livestock production and productivity in the study area despite of tsetse suppression activities. Therefore, integrated parasite and vector control approach should be undertaken to curve the disease.

Global distribution, host range and prevalence of Trypanosoma vivax: a systematic review and meta-analysis

BACKGROUND

Trypanosomosis caused by Trypanosoma vivax is one of the diseases threatening the health and productivity of livestock in Africa and Latin America. Trypanosoma vivax is mainly transmitted by tsetse flies; however, the parasite has also acquired the ability to be transmitted mechanically by hematophagous dipterans. Understanding its distribution, host range and prevalence is a key step in local and global efforts to control the disease.

METHODS

The study was conducted according to the methodological recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A systematic literature search was conducted on three search engines, namely PubMed, Scopus and CAB Direct, to identify all publications reporting natural infection of T. vivax across the world. All the three search engines were screened using the search term Trypanosoma vivax without time and language restrictions. Publications on T. vivax that met our inclusion criteria were considered for systematic review and meta-analysis.

RESULT

The study provides a global database of T. vivax, consisting of 899 records from 245 peer-reviewed articles in 41 countries. A total of 232, 6277 tests were performed on 97 different mammalian hosts, including a wide range of wild animals. Natural infections of T. vivax were recorded in 39 different African and Latin American countries and 47 mammalian host species. All the 245 articles were included into the qualitative analysis, while information from 186 cross-sectional studies was used in the quantitative analysis mainly to estimate the pooled prevalence. Pooled prevalence estimates of T. vivax in domestic buffalo, cattle, dog, dromedary camel, equine, pig, small ruminant and wild animals were 30.6%, 6.4%, 2.6%, 8.4%, 3.7%, 5.5%, 3.8% and 12.9%, respectively. Stratified according to the diagnostic method, the highest pooled prevalences were found with serological techniques in domesticated buffalo (57.6%) followed by equine (50.0%) and wild animals (49.3%).

CONCLUSION

The study provides a comprehensive dataset on the geographical distribution and host range of T. vivax and demonstrates the potential of this parasite to invade other countries out of Africa and Latin America.

Molecular Identification of ABC2 Transporter Gene Encode Protein Ngawi Trypanosoma evansi Isolate that suspected resistance to Isometamidium Chloride

This study aims to determine the profile of the ABC2 encoding transporter on Trypanosoma evansi (T. evansi) Ngawi isolates, Indonesia, exposed with Isometamidium Chloride (ISM). This study used blood samples of mice containing Trypanosoma evansi that had been exposed with ISM 0.05 mg/kg BW, ISM 0.1 mg/kg BW and ISM 0.3 mg/kg BW for 4 weeks, and control group. Blood samples were extracted and amplified using primers. ABC2 F 5 ’GCTTGTCCGACCATCTTGCA 3’ and ABC2 R 5 ’AGGTCCACTCCCATGCTACA 3’ that produced 350 basepairs (bp). The sequencing results were then analyzed using BLAST and MEGA 7.0. There was 1 deference nucleotide (107) derived from multiple alignments, while in amino acids there was no difference in all samples. Trypanosoma evansi which was exposed with ISM does not have many differences in nucleotide or amino acid and only one type of mutation. The ABC2 Transporters of four groups of T.evansi have high similarity to ABC Transporters of T. brucei gambiense, T. brucei brucei, and T. brucei brucei (Tbabc2). Therefore, further research on the ABC2 Transporter gene is needed.

Response of Three Nigerian Breeds of Sheep Experimentally Infected with Trypanosoma vivax to Diminazene Aceturate Therapy

The efficacy of diminazene aceturate in three Nigerian breeds of sheep [West African Dwarf (WAD), Yankassa and Ouda] experimentally infected with Trypanosoma vivax was studied. Five rams of each breed were administered 0.5 ml of goat blood containing 2.5 × 106 T. vivax per millilitre intravenously, while three rams of each breed served as uninfected controls. The treatment with diminazene aceturate was intramuscularly administered to the infected sheep, when their packed cell volume (PCV) fell to 15 %, at a dosage of 7 mg.kg−1 b. w. The parameters measured were parasitaemia, live weight gain and PCV. By 24 hours post treatment (pt.), no trypanosomes were detected by either the Haematocrit Concentration Technique (HCT) or the Polymerase Chain Reaction (PCR) in the blood of any of the treated sheep. However, a relapse of parasitaemia occurred 17 to 32 days pt. in 46.7 % of the treated rams and these were retreated with 14 mg.kg−1 b. w. diminazene aceturate. There were gradual increments in the live weight gain and the PCV of the treated rams until the resurgence of parasitaemia. Ouda had the highest cases of relapse (80 %), the least mean live weight gain and was the only breed in which mortality was recorded despite the treatment. In conclusion, diminazene aceturate administered at 7 mg.kg−1 b. w. cleared the trypanosomes in the blood of all the treated sheep within 24 hours and this was accompanied by the restoration of lost weight and the reversal of anaemia. However, the subsequent resurgence of parasitaemia indicated that a dosage of 7 mg.kg−1 b. w. was no longer reliable for complete elimination of trypanosomes from all the tissues of the host.

Occurrence of Trypanosoma spp. and piroplasm infections of horses at Obollo-Afor southeastern Nigeria and resistance profiles of trypanosomes to isometamidium and diminazene salts

Epidemiological data on trypanosomosis and piroplasmosis of horses are lacking in southeastern Nigeria. The prevalence of trypanosome and piroplasm infections in horses and resistance profile of isolated trypanosomes to diminazene and isometamidium salts were investigated. For the cross-sectional study of horses billed for slaughter, 304 horses were randomly sampled. Approximately 2 ml of blood was collected into anticoagulant-treated bottles for haematocrit (HCT) determination, direct microscopic examinations, and rat inoculation. Gender, body condition scores (BCS), age groups, and body weights of sampled horses were noted. Two isolates of Trypanosoma brucei recovered from the cross-sectional study were profiled for resistance to isometamidium hydrochloride and diminazene diaceturate in 36 BALB/c mice. Standardized protocols were used (Eisler et al., Veterinary Parasitology 97:171-182, 2001). 19.1% of horses (95% confidence interval 14.7-23.5%) were positive for haemoparasite infections including Theileria equi (16.1%) and Babesia caballi (3.9%). Only two (0.66%) Trypanosoma brucei infections were seen, being from active cases. Associations between age or gender, and presence of haemoparasites were only random. Haemoparasite-infected horses had significantly (p < 0.05) lower mean HCT and body weights and poorer BCS. From resistance profiling, for each isolate, all mice in control groups were parasitaemic by day 6 post-inoculation, while mice in test groups remained aparasitaemic over 60-day observation period. The study showed the endemicity and weights of Trypanososma spp. and piroplasm infections and among horses within the area. Furthermore, circulating strains of Trypanosoma brucei in the area are still susceptible to isometamidium and diminazene salts in mice. The pharmacoepidemiological significances of these findings were discussed.

Molecular identification of diminazene aceturate-resistant strains of Trypanosoma congolense in naturally infected domestic animals of Yoko in the centre region of Cameroon

African animal trypanosomiases (AAT) remain the major constraint for livestock production, agriculture and food security in Africa. Although several control measures have been developed to fight AAT, the use of trypanocides remains the main strategy in most affected poor and rural communities. However, several studies have highlighted drug-resistant-trypanosome infections in many African countries, though this phenomenon is still not well described. This study aims to detect trypanosome species and the molecular profiles of drug-resistant-trypanosomes in naturally infected domestic animals of Yoko in the centre region of southern Cameroon. Therefore, in October 2017, 348 animals were blood sampled. The level of packed cell volume (PCV) was evaluated in each animal and trypanosome infections were investigated with the capillary tube centrifugation technique (CTC). Thereafter, DNA was extracted from blood samples and different trypanosome species were identified by PCR. The resistant/sensitive molecular profiles of trypanosomes for diminazene aceturate (DA) and isometamidium chloride (ISM) were investigated by PCR-RFLP. About 18.4% (64/348) of animals analyzed by PCR were found with trypanosome infections including Trypanosoma vivax, Trypanosoma brucei s.l. and Trypanosoma congolense forest and savannah. Trypanosoma congolense savannah was the predominant species with an infection rate of 15.2%. Between villages, significant (p˂0.0001) differences were found in the overall trypanosome infection rates. No molecular profile for ISM resistant-trypanosomes was identified. Conversely, about 88.9% (40/45) of T. congolense positive samples have shown molecular profiles of DA-resistant strains while the remaining 11.1% (5/45) showed mixed molecular profiles of resistant/sensitive strains. Results showed that the molecular profiles of DA-resistant strains of T. congolense in domestic animals of Yoko were widespread. This data needs to be confirmed by testing in vivo the drug susceptibilities of the trypanosome strains herein detected. In conclusion, appropriate future control measures are required. In addition to the intensification of vector control, ISM is advised for the treatment of animals infected by trypanosomes.

A national atlas of tsetse and African animal trypanosomosis in Mali

Background

Tsetse-transmitted trypanosomosis is a deadly, neglected tropical disease and a major challenge for mixed crop-livestock agriculture in sub-Saharan Africa. It is caused by several species of the genus Trypanosoma. Information on the occurrence of tsetse flies and African animal trypanosomosis (AAT) is available for different areas of Mali. However, these data have never been harmonized and centralized, which prevents the development of comprehensive epidemiological maps and constrains an evidence-based planning of control actions. To address this challenge, we created a dynamic geo-spatial database of tsetse and AAT distribution in Mali.

Methods

A digital repository containing epidemiological data collected between 2000 and 2018 was assembled. In addition to scientific publications, the repository includes field datasheets, technical reports and other grey literature. The data were verified, harmonized, georeferenced and integrated into a single spatially-explicit database.

Results

For the tsetse component, approximately 19,000 trapping records, corresponding to 6000 distinct trapping locations and 38,000 flies were included in the database. Glossina palpalis gambiensis was the most widespread and abundant species, and it was found in the southern, southern-central and western parts of the country. Glossina tachinoides was only found in the South. Only a few specimens of Glossina morsitans submorsitans were detected. For the AAT component, approximately 1000 survey records were included, corresponding to 450 distinct survey sites and 37,000 tested bovines. AAT was found in all surveyed regions, although data for the tsetse-free North and North-East are lacking. Trypanosoma vivax and Trypanosoma congolense were the dominant species, while Trypanosoma brucei infections were much less numerous.

Conclusions

The atlas of tsetse and AAT in Mali provides a synoptic view of the vector and disease situation at the national level. Still, major geographical gaps affect the North, the North-East and the West, and there is also a severe lack of data over the past five years. Trypanosomosis remains a major animal health problem in Mali. However, despite its prevalence and distribution, monitoring and control activities are presently very limited. Efforts should be made to strengthen the progressive control of AAT in Mali, and the atlas provides a new tool to identify priority areas for intervention.

The individual components of commercial isometamidium do not possess stronger trypanocidal activity than the mixture, nor bypass isometamidium resistance

The four components present in the trypanocidal treatment Samorin, the commercially available formulation of isometamidium, were separated and purified by column chromatography. These compounds as well as the Samorin mixture and the other phenanthridine trypanocide, homidium, were tested on Trypanosoma congolense and wild type, diamidine- and isometamidium-resistant Trypanosoma brucei brucei strains using an Alamar blue drug sensitivity assay. EC₅₀ values obtained suggest that M&B4180A (2) was the most active of the components, followed by M&B38897 (1) in all the strains tested, whereas M&B4596 (4) was inactive. Samorin was found to be significantly more active than any of the individual components alone, against T. congolense and all three T. b, brucei strains. Samorin and all its active constituents displayed reduced activity against the previously characterised isometamidium-resistant strain ISMR1.

A meta-analysis of the prevalence of bovine trypanosomiasis in some African countries from 2000 to 2018

Bovine trypanosomiasis is a disease of cattle. In sub-Saharan Africa, the disease mean prevalence estimates are unknown in most endemic countries. We therefore performed a meta-analysis with the aim of estimating national mean prevalence of bovine trypanosomiasis in endemic countries across sub-Saharan Africa. Relevant articles reporting bovine trypanosomiasis prevalence were retrieved through systematic literature search and scanning of articles reference-lists. Eligibility criteria included that articles reported sample size, prevalence, and diagnostic technique adopted. Overall, data from 180 eligible articles from 19 countries satisfied the inclusion criteria. Meta-analysis of prevalence data based on the random-effects model resulted in an overall mean prevalence of 15.10% (95% CI: 13.22-17.08). National prevalence estimates were generally high except those of Benin and Senegal where estimates ranked below 10.00%. Significant heterogeneity (I² = 98.75%. p = <0.0001) was noted between studies, and univariate meta-regression analysis identified choice of diagnostic method being major contributor to observed heterogeneity (R² = 36.37%); while country of study (R² = 9.57%) and sample size (R² = 3.47%) had marginal effect on heterogeneity. In spite of past and ongoing control activities, bovine trypanosomiasis remains highly prevalent in most endemic sub-Saharan African countries. Nevertheless, dearth of epidemiological data in some countries and the use of less sensitive diagnostic tools limit reliable estimation of the disease prevalence. Therefore, there is the need to intensify efforts in aspects of surveillance and increased application of molecular diagnostic tool(s) across endemic locations as this would raise the chances of achieving a near-accurate estimate of the disease prevalence which is the first step to attempting eradication.

Development of a Nanobody-based lateral flow assay to detect active Trypanosoma congolense infections

Animal African trypanosomosis (AAT), a disease affecting livestock, is caused by parasites of the Trypanosoma genus (mainly T. vivax and T. congolense). AAT is widespread in Sub-Saharan Africa, where it continues to impose a heavy socio-economic burden as it renders development of sustainable livestock rearing very strenuous. Active case-finding and the identification of infected animals prior to initiation of drug treatment requires the availability of sensitive and specific diagnostic tests. In this paper, we describe the development of two heterologous sandwich assay formats (ELISA and LFA) for T. congolense detection through the use of Nanobodies (Nbs). The immunisation of an alpaca with a secretome mix from two T. congolense strains resulted in the identification of a Nb pair (Nb44/Nb42) that specifically targets the glycolytic enzyme pyruvate kinase. We demonstrate that the Nb44/Nb42 ELISA and LFA can be employed to detect parasitaemia in plasma samples from experimentally infected mice and cattle and, additionally, that they can serve as ‘test-of-cure’ tools. Altogether, the findings in this paper present the development and evaluation of the first Nb-based antigen detection LFA to identify active T. congolense infections.

Aberrant use and poor quality of trypanocides: a risk for drug resistance in south western Ethiopia

BACKGROUND

Trypanocidal drugs have been used to control African animal trypanosomosis for several decades. In Ethiopia, these drugs are available from both authorized (legal) and unauthorized (illegal) sources but documentation on utilization practices and quality of circulating products is scanty. This study looked at the practices of trypanocidal drug utilization by farmers and the integrity of active ingredient in trypanocides sold in Gurage zone, south western Ethiopia. The surveys were based on a structured questionnaire and drug quality determination of commonly used brands originating from European and Asian companies and sold at both authorized and unauthorized markets. One hundred farmers were interviewed and 50 drug samples were collected in 2013 (Diminazene aceturate = 33 and Isometamidium chloride = 17; 25 from authorized and 25 from unauthorized sources). Samples were tested at the OIE-certified Veterinary Drug Control Laboratory (LACOMEV) in Dakar, Senegal, by using galenic standards and high performance liquid chromatography.

RESULTS

Trypanosomosis was found to be a major threat according to all interviewed livestock keepers in the study area. Diminazene aceturate and isometamidium chloride were preferred by 79% and 21% of the respondents respectively, and 85% of them indicated that an animal receives more than six treatments per year. About 60% of these treatments were reported to be administered by untrained farmers. Trypanocidal drug sources included both unauthorized outlets (56%) and authorized government and private sources (44%). A wide availability and usage of substandard quality drugs was revealed. Twenty eight percent of trypanocidal drugs tested failed to comply with quality requirements. There was no significant difference in the frequency of non-compliance between diminazene-based and isometamidium chloride products (P = 0.87) irrespective of the marketing channel (official and unofficial). However, higher rates of non-compliant trypanocides were detected for drugs originating from Asia than from Europe (P = 0.029).

CONCLUSION

The findings revealed the presence of risk factors for the development of drug resistance, i.e. wide distribution of poor quality drugs as well as substandard administration practices. Therefore, it is strongly recommended to enforce regulatory measures for quality control of veterinary drugs, to expand and strengthen veterinary services and to undertake trypanocidal drug efficacy studies of wider coverage.

Resistance to trypanocidal drugs in cattle populations of Zambezia Province, Mozambique

African animal trypanosomosis is a debilitating tsetse-transmitted parasitic disease of sub-Saharan Africa. Therapeutic and prophylactic drugs were introduced more than 50 years ago, and drug resistance is increasingly reported. In a cross-sectional study, 467 cattle were microscopically screened for trypanosomes. Samples were collected in May-July 2014 from five villages (Botao, Mungama, Zalala-Electrosul, Zalala-Madal, and Namitangurine) in Nicoadala district, Zambezia province. To evaluate treatment efficacy, trypanosome-positive animals in each village were randomly assigned to two groups, one treated with 0.5 mg/kg b.w. isometamidium (Inomidium®), the second with 3.5 mg/kg b.w. diminazene (Inomazene®). Cattle were microscopically monitored at days 0, 14, and 28 post-treatment. At day 28, trypanocides were swapped to investigate single or multiple resistance. Microscopically negative samples from the monitoring days were tested using 18S-PCR-RFLP. 22.9% (107/467) was found positive on day 0. On day 14, nine animals in Botao and seven in Mungama were positive. On day 28, in Botao, four animals from the diminazene group and four from the isometamidium group were positive. In Mungama, four animals from the diminazene group were positive on day 28. On day 42, six animals (9%) in Botao and two (9.5%) in Mungama remained positive after drug swap. No relapses occurred in Namitangurine. The 18S-PCR-RFLP consistently detected more positive than microscopy: indeed, positives reached 12, 13, and 8 in Botao and 9, 7, and 4 in Mungama, at days 14, 28, and 42, respectively. Single- and multi-drug resistance in Nicoadala district, Zambezia province, is thus here confirmed. This should be considered when choosing control options.

Genomic analysis of Isometamidium Chloride resistance in Trypanosoma congolense

Isometamidium Chloride (ISM) is one of the principal drugs used to counteract Trypanosoma congolense infection in livestock, both as a prophylactic as well as a curative treatment. However, numerous cases of ISM resistance have been reported in different African regions, representing a significant constraint in the battle against Animal African Trypanosomiasis. In order to identify genetic signatures associated with ISM resistance in T. congolense, the sensitive strain MSOROM7 was selected for induction of ISM resistance in a murine host. Administered ISM concentrations in immune-suppressed mice were gradually increased from 0.001 mg/kg to 1 mg/kg, the maximal dose used in livestock. As a result, three independent MSOROM7 lines acquired full resistance to this concentration after five months of induction, and retained this full resistant phenotype following a six months period without drug pressure. In contrast, parasites did not acquire ISM resistance in immune-competent animals, even after more than two years under ISM pressure, suggesting that the development of full ISM resistance is strongly enhanced when the host immune response is compromised. Genomic analyses comparing the ISM resistant lines with the parental sensitive line identified shifts in read depth at heterozygous loci in genes coding for different transporters and transmembrane products, and several of these shifts were also found within natural ISM resistant isolates. These findings suggested that the transport and accumulation of ISM inside the resistant parasites may be modified, which was confirmed by flow cytometry and ex vivo ISM uptake assays that showed a decrease in the accumulation of ISM in the resistant parasites.

In Vitro, Ex Vivo, and In Vivo Activities of Diamidines against Trypanosoma congolense and Trypanosoma vivax

African animal trypanosomosis (AAT) is caused by the tsetse fly-transmitted protozoans Trypanosoma congolense and T. vivax and leads to huge agricultural losses throughout sub-Saharan Africa. Three drugs are available to treat nagana in cattle (diminazene diaceturate, homidium chloride, and isometamidium chloride). With increasing reports of drug-resistant populations, new molecules should be investigated as potential candidates to combat nagana. Dicationic compounds have been demonstrated to have excellent efficacy against different kinetoplastid parasites. This study therefore evaluated the activities of 37 diamidines, using in vitro and ex vivo drug sensitivity assays. The 50% inhibitory concentrations obtained ranged from 0.007 to 0.562 μg/ml for T. congolense and from 0.019 to 0.607 μg/ml for T. vivax On the basis of these promising results, 33 of these diamidines were further examined using in vivo mouse models of infection. Minimal curative doses of 1.25 mg/kg of body weight for both T. congolense- and T. vivax-infected mice were seen when the diamidines were administered intraperitoneally (i.p.) over 4 consecutive days. From these observations, 15 of these 33 diamidines were then further tested in vivo, using a single bolus dose for administration. The total cure of mice infected with T. congolense and T. vivax was seen with single i.p. doses of 5 and 2.5 mg/kg, respectively. This study identified a selection of diamidines which could be considered lead compounds for the treatment of nagana.

Trypanosomiasis challenge estimation using the diminazene aceturate (Berenil) index in Zebu in Gabon

A longitudinal study was conducted within a cattle ranch in Gabon to determine the diminazene aceturate (Berenil) index (DAI) in a group of Zebu, raised under low tsetse density; this measure providing an assessment of trypanosomiasis risk. The objective was to evaluate the trypanosomiasis pressure thus informing trypanosomiasis control methods and cattle management. Twenty female adult Zebu were monitored for 24 weeks during the dry season. Blood samples were collected on a weekly basis and subjected to parasitological and haematological analysis (n = 480), using the buffy-coat method and the packed cell volume value (PCV), respectively, infected animals were treated with a single intramuscular injection of diminazene aceturate (8 mg/kg). Twenty-nine single infectious events were recorded and a DAI of 1.45 was calculated. Two trypanosome species were identified: Trypanosoma congolense (96.2%) and Trypanosoma vivax (3.8%). The mean PCV value of the infected animals was lower (26.6) compared to non-infected animals (32.0). This study shows that DAI may be a useful tool to assess trypanosomiasis. However, this is a time-consuming method that may be improved by using randomly selected sentinel animals to adapt the chemoprophylactic schemes, hence decreasing the costs and the drug resistance risk.

Cattle breeding, trypanosomosis prevalence and drug resistance in Northern Togo

African Animal Trypanosomosis (AAT) is a major disease of cattle in Togo and its control is essentially based on chemotherapy. However, because of excessive use of trypanocides during the past decades, chemo-resistance in the parasites has developed. In order to assess the current situation of AAT and resistance to trypanocidal drugs in Northern Togo, a study was conducted on cattle from December 2012 to August 2013 in the regions of Kara and Savanes. An initial cross-sectional survey was carried out in 40 villages using the Haematocrit Centrifugation Technique (HCT). Out of these, 5 villages with a trypanosome prevalence of >10% were selected for a block treatment study (BT) with diminazene diaceturate (DA: 3.5mg/kg for a 14-day follow-up) and isometamidium chloride (ISM: 0.5mg/kg for a 28-day follow-up). Positive blood samples collected during the parasitological surveys and an equivalent number of negatives were further analyzed by PCR-RFLP for trypanosome species confirmation and molecular diagnosis of resistance to DA in Trypanosoma congolense. The results from 1883 bovine blood samples confirmed a high overall trypanosome prevalence of 10.8% in Northern Togo. PCR-RFLP revealed that T. congolense is the dominant pathogenic trypanosome species (50.5%) followed by T. vivax (27.3%), and T. brucei (16.2%). The BT showed varying levels of treatment failures ranging from 0 to 30% and from 0 to 50% for DA and for ISM respectively, suggesting the existence of resistant trypanosome populations in the study area. Our results show that AAT still represents a major obstacle to the development of cattle husbandry in Northern Togo. In areas of high AAT risk, a community-based integrated strategy combining vector control, rational use of trypanocidal drugs and improving the general condition of the animals is recommended to decision makers.

In vitro activity and mode of action of distamycin analogues against African trypanosomes

Distamycin, a natural polyamide containing three heterocycle rings with a polar end, has inspired several groups to prepare synthetic analogues, which proved to have anti-trypanosomal and anti-tumoral activity. We describe the synthesis of bi and tri thiazoles amides that harbor different substitutions at their ends and the evaluation of their anti-Trypanosoma brucei activity. The most active compound 10b showed better biological activity (EC₅₀ 310 nM and selectivity index 16) than the control drug nifurtimox (EC₅₀ 15 μM and selectivity index 10). Studies on the mode of action show that the parasiticidal activity of 10b originates from disruption of lysosomal homeostasis, which is followed by release of redox active iron, an increase in oxidizing species and collapse of cell membrane integrity. In this respect, our study suggests that non-charged lipophylic distamycins destabilize cell membranes.

The animal trypanosomiases and their chemotherapy: a review

Pathogenic animal trypanosomes affecting livestock have represented a major constraint to agricultural development in Africa for centuries, and their negative economic impact is increasing in South America and Asia. Chemotherapy and chemoprophylaxis represent the main means of control. However, research into new trypanocides has remained inadequate for decades, leading to a situation where the few compounds available are losing efficacy due to the emergence of drug-resistant parasites. In this review, we provide a comprehensive overview of the current options available for the treatment and prophylaxis of the animal trypanosomiases, with a special focus on the problem of resistance. The key issues surrounding the main economically important animal trypanosome species and the diseases they cause are also presented. As new investment becomes available to develop improved tools to control the animal trypanosomiases, we stress that efforts should be directed towards a better understanding of the biology of the relevant parasite species and strains, to identify new drug targets and interrogate resistance mechanisms.

Reduced Mitochondrial Membrane Potential Is a Late Adaptation of Trypanosoma brucei brucei to Isometamidium Preceded by Mutations in the γ Subunit of the F1Fo-ATPase

Background

Isometamidium is the main prophylactic drug used to prevent the infection of livestock with trypanosomes that cause Animal African Trypanosomiasis. As well as the animal infective trypanosome species, livestock can also harbor the closely related human infective subspecies T. b. gambiense and T. b. rhodesiense. Resistance to isometamidium is a growing concern, as is cross-resistance to the diamidine drugs diminazene and pentamidine.

Methodology/Principal Findings

Two isometamidium resistant Trypanosoma brucei clones were generated (ISMR1 and ISMR15), being 7270- and 16,000-fold resistant to isometamidium, respectively, which retained their ability to grow in vitro and establish an infection in mice. Considerable cross-resistance was shown to ethidium bromide and diminazene, with minor cross-resistance to pentamidine. The mitochondrial membrane potentials of both resistant cell lines were significantly reduced compared to the wild type. The net uptake rate of isometamidium was reduced 2-3-fold but isometamidium efflux was similar in wild-type and resistant lines. Fluorescence microscopy and PCR analysis revealed that ISMR1 and ISMR15 had completely lost their kinetoplast DNA (kDNA) and both lines carried a mutation in the nuclearly encoded γ subunit gene of F₁ ATPase, truncating the protein by 22 amino acids. The mutation compensated for the loss of the kinetoplast in bloodstream forms, allowing near-normal growth, and conferred considerable resistance to isometamidium and ethidium as well as significant resistance to diminazene and pentamidine, when expressed in wild type trypanosomes. Subsequent exposure to either isometamidium or ethidium led to rapid loss of kDNA and a further increase in isometamidium resistance.

Conclusions/Significance

Sub-lethal exposure to isometamidium gives rise to viable but highly resistant trypanosomes that, depending on sub-species, are infective to humans and cross-resistant to at least some diamidine drugs. The crucial mutation is in the F₁ ATPase γ subunit, which allows loss of kDNA and results in a reduction of the mitochondrial membrane potential.

Isometamidium is the only prophylactic treatment of Animal African Trypanosomiasis, a wasting disease of livestock and domestic animals in sub-Saharan Africa. Unfortunately resistance threatens the continued utility of this drug after decades of use. Not only does this disease have severe impacts on agriculture, but some subspecies of Trypanosoma brucei are human-infective as well (causing sleeping sickness) and there is concern that cross-resistance with trypanocides of the diamidine class could further undermine treatment of both veterinary and human infections. It is therefore essential to understand the mechanism of isometamidium resistance and the likelihood for cross-resistance with other first-line trypanocides. Here, we report that isometamidium resistance can be caused by a mutation in an important mitochondrial protein, the γ subunit of the F₁ ATPase, and that this mutation alone is sufficient for high levels of resistance, cross-resistance to various drugs, and a strongly reduced mitochondrial membrane potential. This report will for the first time enable a structural assessment of isometamidium resistance genes in T. brucei spp.

Animal African Trypanosomiasis: Time to Increase Focus on Clinically Relevant Parasite and Host Species

Animal African trypanosomiasis (AAT), caused by Trypanosoma congolense and Trypanosoma vivax, remains one of the most important livestock diseases in sub-Saharan Africa, particularly affecting cattle. Despite this, our detailed knowledge largely stems from the human pathogen Trypanosoma brucei and mouse experimental models. In the postgenomic era, the genotypic and phenotypic differences between the AAT-relevant species of parasite or host and their model organism counterparts are increasingly apparent. Here, we outline the timeliness and advantages of increasing the research focus on both the clinically relevant parasite and host species, given that improved tools and resources for both have been developed in recent years. We propose that this shift of emphasis will improve our ability to efficiently develop tools to combat AAT.

Drug quality analysis through high performance liquid chromatography of isometamidium chloride hydrochloride and diminazene diaceturate purchased from official and unofficial sources in Northern Togo

Trypanocidal drugs remain the most accessible and thus commonly used means of controlling tsetse transmitted animal African trypanosomosis. In Togo, trypanocides are sold on official as well as unofficial markets, but the quality of these trypanocides is undocumented so a drug quality assessment study was conducted from May 2013 to June 2014. Trypanocides supplied by European, Indian and Chinese pharmaceutical companies and sold on official and unofficial markets in Togo were purchased. In total fifty-two trypanocides were obtained, 24 of these samples from official markets and 28 from unofficial markets made up of a total of 36 diminazene diaceturate and 16 isometamidium chloride hydrochloride samples. The samples were analysed in the reference laboratory of the OIE (World Organisation for Animal Health), Laboratory for the Control of Veterinary Medicines (LACOMEV) in Dakar which uses galenic testing and high performance liquid chromatography (HPLC) testing as standard reference analysis methods. The results revealed a high proportion of trypanocides of sub-standard quality on the Togolese market: 40% were non-compliant to these quality reference standards. All of the HPLC non-compliant samples contained lower amounts of active ingredient compared to the concentration specified on the packaging. Non-compliance was higher in samples from the unofficial (53.57%) than from the official markets (25%; p=0.04).The main drug manufacturers, mostly of French origin in the study area, supply quality drugs through the official legal distribution circuit. Products of other origins mostly found on illegal markets present a significantly lower quality.

Subverting lysosomal function in Trypanosoma brucei

In this issue of Microbial Cell, Koh and colleagues present data highlighting the utility of the lysosomotropic compound L-leucyl-L-leucyl methyl ester (LeuLeu-OMe) as an anti-Trypanosoma brucei agent, adding to the range of compounds that either directly target lysosomal enzymes or that can be used to subvert the function of the lysosome for parasite destruction.

In vivo experimental drug resistance study in Trypanosoma vivax isolates from tsetse infested and non-tsetse infested areas of Northwest Ethiopia

Ethiopia, particularly in the Northwest region, is affected by both tsetse fly and non-tsetse fly transmitted trypanosomosis with a significant impact on livestock productivity. The control of trypanosomosis in Ethiopia relies on either curative or prophylactic treatment of animals with diminazene aceturate (DA) or isometamidium chloride (ISM), respectively. However, since these two trypanocides have been on the market for more than 40 years, this may have resulted in drug-resistance. Therefore, in vivo drug resistance tests on two Ethiopian isolates of Trypanosoma vivax were completed, one from an area where tsetse flies are present and one from an area where tsetse flies are not present. Twenty four cattle (Bos indicus) aged between 6 and 12 months, purchased from a trypanosome-free area (Debre Brehan: Northcentral Ethiopia) and confirmed to be trypanosome-negative, were randomly assigned into four groups of six animals, which were infected with T. vivax isolated from a tsetse-infested or non-tsetse infested area, and in each case treated with curative doses of DA or ISM. Each animal were inoculated intravenously 3×10(6) trypanosomes from donor animals. Parasitaemia became patent earlier in infections with non-tsetse T. vivax (∼7 days post-infection) than tsetse (∼14 days post-infection). Both groups were treated at the highest peak parasitaemia with DA or ISM and nine cattle, four with non-tsetse T. vivax (two ISM- and two DA-treated) and five with tsetse T. vivax (three ISM- and two DA-treated) showed relapses of parasitaemia. Moreover, treatment did not improve diagnostic host markers of trypanosome infections in these animals. In conclusion, in vivo drug tests indicated the presence of resistant parasites (>20% of treated animals in each group relapsed) against recommended doses of both available trypanocidal drugs.

9- and 11-Substituted 4-azapaullones are potent and selective inhibitors of African trypanosoma

Trypanosomes from the "brucei" complex are pathogenic parasites endemic in sub-Saharan Africa and causative agents of severe diseases in humans and livestock. In order to identify new antitrypanosomal chemotypes against African trypanosomes, 4-azapaullones carrying α,β-unsaturated carbonyl chains in 9- or 11-position were synthesized employing a procedure with a Heck reaction as key step. Among the so prepared compounds, 5a and 5e proved to be potent antiparasitic agents with antitrypanosomal activity in the submicromolar range.

Development and evaluation of an ITS1 "Touchdown" PCR for assessment of drug efficacy against animal African trypanosomosis

Animal African trypanosomoses (AAT) are caused by flagellated protozoa of the Trypanosoma genus and contribute to considerable losses in animal production in Africa, Latin America and South East Asia. Trypanosoma congolense is considered the economically most important species. Drug resistant T. congolense strains present a threat to the control of AAT and have triggered research into discovery of novel trypanocides. In vivo assessment of trypanocidal efficacy relies on monitoring of treated animals with microscopic parasite detection methods. Since these methods have poor sensitivity, follow-up for up to 100 days after treatment is recommended to increase the chance of detecting recurrent parasitaemia waves. Molecular techniques are more amendable to high throughput processing and are generally more sensitive than microscopic detection, thus bearing the potential of shortening the 100-day follow up period. The study presents a "Touchdown" PCR targeting the internal transcribed spacer 1 of the ribosomal DNA (ITS1 TD PCR) that enables detection and discrimination of different Trypanosoma taxa in a single run due to variations in PCR product sizes. The assay achieves analytical sensitivity of 10 parasites per ml of blood for detection of T. congolense savannah type and T. brucei, and 100 parasites per ml of blood for detection of T. vivax in infected mouse blood. The ITS1 TD PCR was evaluated on cattle experimentally infected with T. congolense during an investigational new veterinary trypanocide drug efficacy study. ITS1 TD PCR demonstrated comparable performance to microscopy in verifying trypanocide treatment success, in which parasite DNA became undetectable in cured animals within two days post-treatment. ITS1 TD PCR detected parasite recrudescence three days earlier than microscopy and had a higher positivity rate than microscopy (84.85% versus 57.58%) in 66 specimens of relapsing animals collected after treatments. Therefore, ITS1 TD PCR provides a useful tool in assessment of drug efficacy against T. congolense infection in cattle. As the assay bears the potential for detection of mixed infections, it may be applicable for drug efficacy studies and diagnostic discrimination of T. vivax and T. congolense against other pathogenic trypanosomes, including T. brucei, T. evansi and T. equiperdum.

Best-bet integrated strategies for containing drug-resistant trypanosomes in cattle

BACKGROUND

African animal trypanosomosis is a major constraint to the rearing of productive livestock in the sub-humid Sudan-Sahel zone of West Africa where cotton is grown. Trypanosomosis is mainly controlled using trypanocidal drugs, but the effective use of drugs is threatened by the development of widespread resistance. This study tested integrated best-bet strategies for containment and/ or reversal of trypanocide resistance in villages in south-east Mali where resistance has been reported.

METHODS

Four sentinel villages each from an intervention area (along the road from Mali to Burkina Faso) and a control area (along the road from Mali to Côte d'Ivoire) were selected for the study. Tsetse control was based on deltamethrin-treated stationary attractive devices and targeted cattle spraying between March 2008 and November 2009. Trypanosome-positive cattle were selectively treated with 3.5 mg/kg diminazene aceturate. Strategic helminth control using 10 mg/kg albendazole was also undertaken. During the intervention, tsetse densities along drainage lines, trypanosome infections and faecal egg counts in risk cattle (3 to 12 months of age) were monitored.

RESULTS

Catch reductions of 66.5 % in Glossina palpalis gambiensis and 90 % in G. tachinoides were observed in the intervention area. Trypanosome prevalence was significantly (p < 0.05) lower in the intervention area (2.3 %; 1.3-3.6 %) compared to the control area (17.3 %; 14.8-20.1 %). Albendazole treatment resulted in a faecal egg count reduction of 55.6 % and reduced trypanosome infection risk (2.9 times lower than in the placebo group) although not significantly (p > 0.05). Further studies are required before confirming the existence of albendazole resistant strongyles in the study area.

CONCLUSION

Integration of best-bet strategies in areas of multiple drug-resistance is expected to reduce trypanosome infection risk thus contributing to containment of trypanocidal drug resistance. Integrated best-bet strategies could therefore be considered a viable trypanosomosis control option especially in areas where multiple drug-resistance has been reported.