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Revisiting zoonotic human African trypanosomiasis control in Uganda

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Abstract
Objectives: Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of zoonotic parasitic infections. Human African trypanosomiasis (HAT) control is particularly fraught with intricacies. The primarily zoonotic form, T.b. rhodesiense, and the non-zoonotic T.b. gambiense coexist in Northern Uganda, leading to a potential geographic and genetic overlap of the two foci. This region also has the highest HIV prevalence in Uganda plus poor food security. We examine the bottlenecks facing the control program in a changed political and economic context. Method: We searched the literature in July 2015 using three databases: MEDLINE, Google Scholar, and Web of Science. Findings: Decentralized zoonotic HAT control for animal reservoirs and vectors compromise sustainability of the control programs. Human transmission potential may be underestimated in a region with other endemic diseases and where an HIV-HATepidemic, could merge two strains. Conclusion: Our comprehensive literature review concludes that enhanced collaboration is imperative not only between human and animal health specialists, but also with political science. Multi-sectorial collaborations may need to be nurtured within existing operational national HIV prevention frameworks, with an integrated surveillance framework.
Keywords
RHODESIENSE SLEEPING SICKNESS, HUMAN-IMMUNODEFICIENCY-VIRUS, BRUCEI-GAMBIENSE, DRUG-RESISTANCE, VISCERAL LEISHMANIASIS, POPULATION-GENETICS, EASTERN UGANDA, TSETSE-FLIES, HEALTH, EPIDEMIOLOGY, zoonotic human African trypanosomiasis, HIV, decentralization, human, reservoir, integrated surveillance

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MLA
Menon, Sonia, Rodolfo Rossi, Leon Nshimyumukiza, et al. “Revisiting Zoonotic Human African Trypanosomiasis Control in Uganda.” JOURNAL OF PUBLIC HEALTH POLICY 37.1 (2016): 51–67. Print.
APA
Menon, S., Rossi, R., Nshimyumukiza, L., & Zinszer, K. (2016). Revisiting zoonotic human African trypanosomiasis control in Uganda. JOURNAL OF PUBLIC HEALTH POLICY, 37(1), 51–67.
Chicago author-date
Menon, Sonia, Rodolfo Rossi, Leon Nshimyumukiza, and Kate Zinszer. 2016. “Revisiting Zoonotic Human African Trypanosomiasis Control in Uganda.” Journal of Public Health Policy 37 (1): 51–67.
Chicago author-date (all authors)
Menon, Sonia, Rodolfo Rossi, Leon Nshimyumukiza, and Kate Zinszer. 2016. “Revisiting Zoonotic Human African Trypanosomiasis Control in Uganda.” Journal of Public Health Policy 37 (1): 51–67.
Vancouver
1.
Menon S, Rossi R, Nshimyumukiza L, Zinszer K. Revisiting zoonotic human African trypanosomiasis control in Uganda. JOURNAL OF PUBLIC HEALTH POLICY. 2016;37(1):51–67.
IEEE
[1]
S. Menon, R. Rossi, L. Nshimyumukiza, and K. Zinszer, “Revisiting zoonotic human African trypanosomiasis control in Uganda,” JOURNAL OF PUBLIC HEALTH POLICY, vol. 37, no. 1, pp. 51–67, 2016.
@article{8546960,
  abstract     = {Objectives: Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of zoonotic parasitic infections. Human African trypanosomiasis (HAT) control is particularly fraught with intricacies. The primarily zoonotic form, T.b. rhodesiense, and the non-zoonotic T.b. gambiense coexist in Northern Uganda, leading to a potential geographic and genetic overlap of the two foci. This region also has the highest HIV prevalence in Uganda plus poor food security. We examine the bottlenecks facing the control program in a changed political and economic context.
Method: We searched the literature in July 2015 using three databases: MEDLINE, Google Scholar, and Web of Science.
Findings: Decentralized zoonotic HAT control for animal reservoirs and vectors compromise sustainability of the control programs. Human transmission potential may be underestimated in a region with other endemic diseases and where an HIV-HATepidemic, could merge two strains.
Conclusion: Our comprehensive literature review concludes that enhanced collaboration is imperative not only between human and animal health specialists, but also with political science. Multi-sectorial collaborations may need to be nurtured within existing operational national HIV prevention frameworks, with an integrated surveillance framework.},
  author       = {Menon, Sonia and Rossi, Rodolfo and Nshimyumukiza, Leon and Zinszer, Kate},
  issn         = {0197-5897},
  journal      = {JOURNAL OF PUBLIC HEALTH POLICY},
  keywords     = {RHODESIENSE SLEEPING SICKNESS,HUMAN-IMMUNODEFICIENCY-VIRUS,BRUCEI-GAMBIENSE,DRUG-RESISTANCE,VISCERAL LEISHMANIASIS,POPULATION-GENETICS,EASTERN UGANDA,TSETSE-FLIES,HEALTH,EPIDEMIOLOGY,zoonotic human African trypanosomiasis,HIV,decentralization,human,reservoir,integrated surveillance},
  language     = {eng},
  number       = {1},
  pages        = {51--67},
  title        = {Revisiting zoonotic human African trypanosomiasis control in Uganda},
  url          = {http://dx.doi.org/10.1057/jphp.2015.39},
  volume       = {37},
  year         = {2016},
}

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