Livestock Network Analysis for Rhodesiense Human African Trypanosomiasis Control in Uganda

The elimination of human African trypanosomiasis: Monitoring progress towards the 2021-2030 WHO road map targets

BACKGROUND

Human African trypanosomiasis (HAT) is a neglected tropical disease that usually occurs in rural areas in sub-Saharan Africa. It caused devastating epidemics during the 20th century. Sustained, coordinated efforts by different stakeholders working with national sleeping sickness control programmes (NSSCPs) succeeded in controlling the disease and reducing the number of cases to historically low levels. In 2012, WHO targeted the elimination of the disease as a public health problem by 2020. This goal has been reached and a new ambitious target was stated in the WHO road map for NTDs 2021-2030 and endorsed by the 73rd World Health Assembly: the elimination of gambiense HAT transmission (i.e. reducing the number of reported cases to zero). The interruption of transmission was not considered as an achievable goal for rhodesiense HAT, as it would require vast veterinary interventions rather than actions at the public health level.

METHODOLOGY/PRINCIPAL FINDINGS

Data reported to WHO by NSSCPs were harmonized, verified, georeferenced and included in the atlas of HAT. A total of 802 cases were reported in 2021 and 837 in 2022. This is below the target for elimination as a public health problem at the global level (< 2000 HAT cases/year); 94% of the cases were caused by infection with T. b. gambiense. The areas reporting ≥ 1 HAT case/10 000 inhabitants/year in 2018-2022 cover a surface of 73 134 km2, with only 3013 km2 at very high or high risk. This represents a reduction of 90% from the baseline figure for 2000-2004, the target set for the elimination of HAT as a public health problem. For the surveillance of the disease, 4.5 million people were screened for gambiense HAT with serological tests in 2021-2022, 3.6 million through active screening and 0.9 million by passive screening. In 2021 and 2022 the elimination of HAT as a public health problem was validated in Benin, Uganda, Equatorial Guinea and Ghana for gambiense HAT and in Rwanda for rhodesiense HAT. To reach the next goal of elimination of transmission of gambiense HAT, countries have to report zero cases of human infection with T. b. gambiense for a period of at least 5 consecutive years. The criteria and procedures to verify elimination of transmission have been recently published by WHO.

CONCLUSIONS/SIGNIFICANCE

HAT elimination as a public health problem has been reached at global level, with seven countries already validated as having reached this goal. This achievement was made possible by the work of NSSCPs, supported by different public and private partners, and coordinated by WHO. The new challenging goal now is to reach zero cases by 2030. To reach this goal is crucial to maintain the engagement and support of donors and stakeholders and to keep the involvement and coordination of all partners. Along with the focus on elimination of transmission of gambiense HAT, it is important not to neglect rhodesiense HAT, which is targeted for elimination as a public health problem in the WHO road map for NTDs 2021-2030.

Identifying target areas for risk-based surveillance and control of transboundary animal diseases: a seasonal analysis of slaughter and live-trade cattle movements in Uganda

Animal movements are a major driver for the spread of Transboundary Animal Diseases (TADs). These movements link populations that would otherwise be isolated and hence create opportunities for susceptible and infected individuals to meet. We used social network analysis to describe the seasonal network structure of cattle movements in Uganda and unravel critical network features that identify districts or sub-regions for targeted risk-based surveillance and intervention. We constructed weighted, directed networks based on 2019 between-district cattle movements using official livestock mobility data; the purpose of the movement ('slaughter' vs. 'live trade') was used to subset the network and capture the risks more reliably. Our results show that cattle trade can result in local and long-distance disease spread in Uganda. Seasonal variability appears to impact the structure of the network, with high heterogeneity of node and edge activity identified throughout the seasons. These observations mean that the structure of the live trade network can be exploited to target influential district hubs within the cattle corridor and peripheral areas in the south and west, which would result in rapid network fragmentation, reducing the contact structure-related trade risks. Similar exploitable features were observed for the slaughter network, where cattle traffic serves mainly slaughter hubs close to urban centres along the cattle corridor. Critically, analyses that target the complex livestock supply value chain offer a unique framework for understanding and quantifying risks for TADs such as Foot-and-Mouth disease in a land-locked country like Uganda. These findings can be used to inform the development of risk-based surveillance strategies and decision making on resource allocation. For instance, vaccine deployment, biosecurity enforcement and capacity building for stakeholders at the local community and across animal health services with the potential to limit the socio-economic impact of outbreaks, or indeed reduce their frequency.

Analysis of patterns of livestock movements in the Cattle Corridor of Uganda for risk-based surveillance of infectious diseases

Introduction

The knowledge of animal movements is key to formulating strategic animal disease control policies and carrying out targeted surveillance. This study describes the characteristics of district-level cattle, small ruminant, and pig trade networks in the Cattle Corridor of Uganda between 2019 and 2021.

Methodology

The data for the study was extracted from 7,043 animal movement permits (AMPs) obtained from the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) of Uganda. Most of the data was on cattle (87.2%), followed by small ruminants (11.2%) and pigs (1.6%). Two types of networks representing animal shipments between districts were created for each species based on monthly (n = 30) and seasonal (n = 10) temporal windows. Measures of centrality and cohesiveness were computed for all the temporal windows and our analysis identified the most central districts in the networks.

Results

The median in-degree for monthly networks ranged from 0-3 for cattle, 0-1 for small ruminants and 0-1 for pigs. The highest median out-degrees for cattle, small ruminant and pig monthly networks were observed in Lira, Oyam and Butambala districts, respectively. Unlike the pig networks, the cattle and small ruminant networks were found to be of small-world and free-scale topologies.

Discussion

The cattle and small ruminant trade movement networks were also found to be highly connected, which could facilitate quick spread of infectious animal diseases across these networks. The findings from this study highlighted the significance of characterizing animal movement networks to inform surveillance, early detection, and subsequent control of infectious animal disease outbreaks.