Considerable value could be added by clustering this output with research outputs from several other RNSSS projects. Within the 'Research Into Use' initiative, these include links with the Animal Health Programme cluster on zoonoses (R7570, R8383, R7357, R7985), which would strengthen existing veterinary-medical capacity, inter-sectoral integration and policy development for effective control of zoonotic disease in East Africa.

Links with the AHP dissemination and delivery cluster would also enhance training of medical and veterinary practitioners, which is essential for effective zoonotic disease surveillance and treatment. 

The output has very wide applicability to other RNRRS outputs listed, below. Policy considerations should be an integral component of any intervention and using research findings to influence policy is of generic applicability; without supportive policies it is unlikely that any intervention will succeed. Some examples include:

  Crop Protection Programme:

• Improving farmers access to and management of disease resistant maize cultivars in the Southern Highlands of Tanzania
• Improved access to appropriate farm inputs for integrated maize crop management by small-scale farmers in Embu and Kirinyaga Districts, Kenya

  Crop Post Harvest Programme:

• Food safety in peri-urban horticultural products
• Cassava as an industrial commodity

  Natural Resources Systems Programme:

• Integrated floodplain management
• Institutional arrangements for coastal zone management

  Plant Science Research Programme:

• Dry season crops for replacing rice fallows in Nepal
• Wheat varieties for Western India.

  Livestock Production Programme:

• Adoption of planted forages for smallholder dairying in Kenya
• Soil and water conservation

  Aquaculture and Fish Genetics Research Programme:

• Promoting healthy peri-urban aquatic food supply
• Promoting networks for market quality

  Fish Management Science Programme:

• Research to inform management and influence policy
• Development of pro-poor capture fisheries strategies

Validation

How the outputs were validated:

The diagnostic tools developed have enabled assessment of the impact of cattle based interventions in Uganda on both trypanosomiasis and sleeping sickness. These were validated in partnership with the Ugandan Ministry of Agriculture, Animal Industries and Fisheries (MAAIF), Makerere University, Livestock Health Research Institute (LIRI), Farming in Tsetse Controlled Areas (FITCA) and the Coordinating Office for Control of Trypanosomiais in Uganda (COCTU). 

In 2002/3 the tools were used to monitor an EU/ FITCA block treatment operation in which 65,4000 cattle in specific sub-counties were treated with trypanocidal drugs in Tororo, Iganga, Kamulu and Soroti districts. Block treatment was shown to be highly effective, offering long term protection particularly against zoonotic T.b. rhodesiense, when high levels (>80%) of sub-county cattle treatment coverage were achieved^1,28. One year after treatment no T.b. rhodesiense infected cattle were observed.

Molecular tools were used to evaluate a field trial involving 1000 cattle in 12 villages in Tororo and Busia district. Cattle were treated with a curative trypanocidal drug and were subsequently treated monthly with deltamethrin insecticide on the legs belly and ears using the restricted application protocol. Point prevalence of total trypanosome was reduced from 15% to only 3% at 6 month into the intervention and not a single animal became re-infected with T. brucei.  Farmers reported additional benefits: healthier animals carrying fewer ticks, which reduced the direct impact of these blood-sucking pests and lowered the risk of tick-borne diseases.

The science base on which the policy interventions are founded have been rigorously tested and have been published as a series of research papers in prestigious peer-reviewed medical journals. Publication of the molecular diagnostic tool for identification of T.b. rhodesiense (Welburn et al Lancet 2001) and publication that infected cattle were introducing disease into Soroti district (Fevre et al., Lancet 2001) resulted in widespread publicity and policy change regarding treatment of cattle at markets in Uganda. 

Further publication of research findings in The British Medical Journal illustrated that the disease had been introduced to 5 new districts as many years (Picozzi et al., BMJ) this again resulted in significant interest, and commentary by the Ugandan press. This edition of the British Medical Journal specially featured zoonotic diseases and was twinned with the Veterinary Record, the house journal of the veterinary profession. 

Field trials and modelling studies indicate that to be successful, more than 86% of the cattle population in an area need to be treated with trypanocidal drugs. This method can be augmented by preventing subsequent re-infection by controlling tsetse. The added benefit of applying insecticide using the restricted application approach was examined at village cattle level in villages in south-eastern Uganda, which were endemic for sleeping sickness.  This work was supported by donations of drug and insecticide from a veterinary pharmaceutical company and directly led to the creation of the Public Private Partnership to Stamp out Sleeping Sickness (SOS) aimed at preventing overlap between T,b. rhodesiense (spread by cattle movements) into the T.b. gambiense affected districts in the North West.  

Where the Outputs were Validated:      

The new approach to controlling sleeping sickness through treatment of cattle has been tested in Uganda in a series of trials undertaken between 2003 to 2006 in districts where sleeping sickness is endemic; Kamuli, Tororo, Busia, Iganga, Soroti and in newly affected districts Kabaramido, Dokolo, Amolitar, Lira and Apac. The affected districts constitute mixed crop-livestock farming systems.

The PPP approach to controlling sleeping sickness is currently (September to November 2006) being validated in a larger-scale sleeping sickness control campaign (Stamp Out Sleeping Sickness: SOS): in which more than 220,000 cattle are being treated with drugs and insecticide in the districts in Uganda newly affected by Rhodesian sleeping sickness. This activity aims to treat over 85% of all district cattle in Kabaramido, Dokolo, Amolitar, Lira, and in affected sub-counties of Apac and Soroti districts.

Current Situation

Who are the Users?.

The change in the law in Uganda, which now requires treatment of cattle before they are moved from endemic sleeping sickness areas, is a fait accompli which will help to ensure that sleeping sickness is not spread to new districts of Uganda, as happened recently before the law was changed. With large-scale cattle restocking programmes underway - the aim is to increase the cattle population in Uganda from 6.2 million to 10 million - the risk of introducing sleeping sickness (and other cattle borne diseases) into previously unaffected districts is very real.

The public-private partnership established as a direct result of the research findings has resulted in a major sleeping sickness control campaign: between September and November 2006 more than 220,000 cattle in the most northerly of the districts newly affected by sleeping sickness are being treated with trypanocidal drugs and sprayed with insecticide. This represents the first phase of the Stamp Out Sleeping Sickness (SOS) campaign, which has been funded by a veterinary pharmaceutical company and a pan-Europe private equity company: a combined in-kind and cash investment of around US$500,000.

Where the outputs have been used:.

The requirement that cattle must be treated with trypanocidal drugs before movement from sleeping sickness endemic areas has been gazetted and is now part of the laws of Uganda.

The public-private partnership implementing the SOS campaign, Phase One, is currently (September to November 2006) underway in Uganda. This involves treating over 85% of cattle in Kabaramido, Dokolo, Amolitar, Lira districts and partial coverage of the cattle population in the affected sub-counties of Apac and Soroti districts - a total of more than 220,000 cattle.

Scale of Current Use:.

The impact of block treatment with trypanocidal drugs was assessed in 2003 in four districts of Uganda using new molecular tools for diagnosis. The initial trial of restricted application of insecticide was conducted in 2004/5 involving treatment of ca. 1000 cattle from 12 villages.  

The large-scale sleeping sickness control campaign, SOS, was begun within one year of the research findings first being published in high impact peer-reviewed journals (Lancet and British Medical Journal). No steps are being taken to encourage the further spread of the output; rather the intention is to assess the impact and lessons learned from this campaign before scale-up to new situations and to proceed to a second phase in Uganda. SOS was initiated in September 2006 and involves combining drug treatment and insecticide application for more than 220,000 cattle in six districts where around two million people live.

In Burkina Faso, a trial of the restricted application of insecticide approach was performed in 2003 and involved the treatment of ca. 80 cattle. As a result, currently around 60 peri-urban dairy producers are regularly treating around 2500 cattle in the vicinity of Bobo-Dioulasso.

The use of the restricted application approach is expected to expand in both countries, since each has major tsetse control operations planned as part of the Pan African Tsetse and Trypanosomosis Eradication Campaign (PATTEC). These operations, supported by loans from the African Development Bank, aim eventually (up to 100 years) to eliminate tsetse from 15,000 km² of Uganda and 40,000 km² of Burkina Faso.

Policy and Institutional Structures, and Key Components for Success:

The principle investigators and other partners in the research on which this output is based have been active and respected members of the international tsetse and trypanosomiasis community for up to 40 years. Access to a broadly-based network of scientists, veterinary and medical practitioners and administrators, policy makers, members of the private sector and journalists has greatly facilitated the establishment of the public-private partnership that is currently implementing SOS Phase One. It was fortunate that the publication of the landmark papers on the sleeping sickness situation in Uganda in 2005/2006, which highlighted the possibility of intervening by treating cattle with trypanocidal drugs, coincided with the desire by a leading veterinary pharmaceutical company - CEVA Santé Animale - to undertake a public good project to enhance their 'triple bottom-line' reporting profile. More fortune still was the fact that this attitude and desire was shared by CEVA's major shareholder, the pan-European private equity company Industri Kapital.

The output is in line with WHO's policy and recommendations with regard to the need for emergency action to prevent the convergence of the two forms of sleeping sickness in Uganda.

Sleeping sickness is widely recognised as a priority problem in Uganda and two unique government bodies, the Ugandan Tsetse and Trypanosomiasis Control Council and the Coordinating Office for the Control of Trypanosomiasis in Uganda, are testament to the seriousness with which the threat of sleeping sickness is taken in Uganda.

Publications in prestigious peer-reviewed journals, such as the Lancet and British Medical Journal, helped to increase awareness of the problem of sleeping sickness in Uganda and enhanced and galvanised veterinary and medical cooperation to tackle this important zoonosis. As a result of these publications, the story was picked up by the international mainstream press and, in turn, by local journalists in Uganda: publication of the story in Ugandan papers brought the issues to the attention of Ugandan ministers and parliamentarians, whose interventions led to changes in policy in Uganda with regard to sleeping sickness control.

Lessons Learned and Uptake Pathways

Promotion of Outputs:.

The change in law and the creation of the public-private partnership have taken place only in Uganda. Once the on-going SOS Campaign Phase One is completed and the monitoring and evaluation results analysed, lessons can be derived which will have wider applicability in other countries which have Rhodesian sleeping sickness. At this point the lessons learned will be disseminated widely to other countries affected with zoonotic sleeping sickness in where domestic livestock constitute a significant reservoir of human infective parasites and/or where tsetse feed predominantly on livestock which can be targeted (Tanzania, Malawi, Zambia, Kenya, S. Sudan, DR Congo). Partnerships between stakeholders from human health service providers and agencies, animal health service providers and agencies, and the private sector are key to success in controlling diseases which cross the animal health and human health divide.

With suitable packaging and presentation, the broader lessons will be disseminated to a wider audience concerned with a range of zoonotic diseases.

Potential Barriers Preventing Adoption of Outputs:

One of the barriers to using research findings to influence policy on control of zoonotic diseases is the existence of good examples where this approach has been successful. The present example, where research findings have influenced policy in relation to control of zoonotic sleeping sickness in Uganda, provides just such an example. Distillation and dissemination of lessons learned in the Uganda case study will be instrumental in enabling similar achievements by other research groups.

How to Overcome Barriers to Adoption of Outputs:.

The Ugandan sleeping sickness case study needs to be analysed and written up in a variety of media and formats, targeted at the range of actors - policy makers, animals and human health practitioners and administrators, donors, the private sector, livestock keepers and journalists. Questions that need answering include: What have been the drivers which have made this approach so successful, how might the lessons learned extend to other country foci? How might this be rolled out to other areas where zoonotic sleeping sickness persists Zambia, Malawi, Tanzania, Kenya, DR Congo, S. Sudan and for other disease where medical and veterinary services interact?

Lessons Learned:

The key to influencing policy was to carry out high-quality research and to publish the results in prestigious, peer-reviewed journals. These findings were picked up by senior policy makers in Uganda, both medics and veterinarians. The British Medical Journal published the work on sleeping sickness in a special edition on Zoonoses - twinned with the Veterinary Record Publication; this meant that professional vets and medics were both exposed to the research by their respective leading professional journals. The BMJ is also an open access journal. These findings were then picked up by mainstream international journalists, which in turn caught the attention of local Ugandan journalists. Articles appearing in the Ugandan press were read by politicians, who acted as 'champions' and raised the issue in parliament. The result was that the law in Uganda was changed: cattle being moved from sleeping sickness endemic areas now need to be treated with drugs.

The creation of the public-private partnership was facilitated by the active involvement of the principle researchers in the international tsetse and trypanosomiasis research and control community over a period of several decades. Access to this network - which involves public and private sector player, international organisations, researchers, animal and human health practitioners, policy makers and donors - enabled the research findings, the worsening situation regarding sleeping sickness in Uganda, and the possibility of intervening using a new approach - treatment of cattle to control the disease in people, to be brought to their attention. The timing was also fortuitous, coinciding with the desire of a major veterinary pharmaceutical company and its main shareholder to invest in a major public good project to enhance their 'triple bottom line' profile. The result was that, in less than a year from publication of the research findings, a major public-private partnership has been established which designed, funded and implemented a large-scale sleeping sickness control campaign - Stamp Out Sleeping Sickness - which targeted the most northerly of the districts of Uganda newly affected by Rhodesian sleeping sickness.

Impacts on Poverty

Poverty Impact Studies:

Phase One of the SOS campaign is underway, scheduled to be completed in mid November, with monitoring and evaluation ongoing to June 2007, so it is too early to demonstrate impacts on poverty. However, if sleeping sickness can be sustainably controlled in five districts of Uganda, this will have a large impact on poverty. Currently it is estimated that for every person diagnosed and treated for sleeping sickness, 12 more die undiagnosed^24,25.

If government policy is effective and animals continue to be treated at point of sale/ movement the risk of disease spread will be minimal. It is too early to determine the effectiveness of enforcement of the treatment at point of sale policy. The disease has moved to three new districts since the policy was reinforced. However, we do not see market foci of disease, suggesting that policy is being enforced at livestock markets on the ground, but more work needs to be undertaken to ensure comprehensive compliance.

There have been no formal studies of the poverty impact of the restricted application method. There however, is a considerable literature on cost-benefit analysis of tsetse control including comparisons between tsetse control methods (including insecticide-treated cattle) and between tsetse control and use of trypanocidal drugs. Methods have been developed for spatial targeting of tsetse control on areas where benefits per km² will be high.

No formal studies have been undertaken to consider the restricted application method, with its promise of radically cheaper control. Many cattle-owners across Africa can be classed as poor, the constant animal health inputs required to maintain animals free of endemic diseases in a decentralized animal health systems pushes farmers below the poverty line.  In some areas farmers have evolved relatively sustainable strategies of prompt trypanocidal treatment of sick animals, particularly higher value ones such as draught oxen and lactating cows in others, a critical lack of disease awareness and perceptions hamper sustainable intervention.

Moreover, it makes both economic and political sense to treat cattle - cost of treating a sleeping sickness patient is US$200; cost of treating one cow with trypanocidal drug 50c and subsequent restricted application of insecticide for 1 year less than us$1. Communities are fearful of sleeping sickness and superstitious communities associate sleeping sickness with bewitchment.

How the Poor have Benefited (including gender and other poverty groups):

In Uganda, 17 districts are now affected by zoonotic sleeping sickness: 8 million people and 1.3 million cattle are at risk. It is too early to document how the poor have benefited from this new approach to control of sleeping sickness. More information is available, however, for one component of the control strategy: the restricted application of insecticide to control animal trypanosomiaisis.  Even in the absence of direct human health benefits, e.g. in Zimbabwean communal cattle keeping areas, it has been extrapolated that the control of tsetse achieved, in part, by insecticide-treated cattle has impacted on poor people's livelihoods.

Effective tsetse control will reduce expenditure on trypanocides. Savings will be contributed towards other elements of household expenditure, thereby contributing indirectly to financial capital and through health, food and educational expenditure to human capital.

Even where cattle mortality can be controlled by constant trypanocidal drug regimes, calving rates are still reduced by ca. 5% and thus herd growth is reduced.  Effective trypanosomiasis control can increase the size and value of herds and the potential availability of milk and animals for offtake.  Healthier herds improve the functioning of livestock as stores of value, and indicators of social status. Together, these contribute to natural, financial and social capital.

Successful trypanosomiasis control interventions have a positive impact on households as a whole, by increasing household income and food supply. There are positive benefits on women, many of which are de facto or de jure household heads. Financial savings on trypanocides and increased sales of livestock products can also contribute to health and educational benefits for children

Environmental Impact

Direct and Indirect Environmental Benefits:

Influencing policy on control of sleeping sickness in Uganda is likely to have beneficial impacts through replacing ineffective and potentially environmentally harmful control methods - such as large-scale aerial and ground spraying with insecticides - with safer, better targeted approaches, such as treatment of cattle with drugs and spraying cattle using the restricted application approach. The latter uses just one-fifth of the insecticide used during conventional whole body spraying.  The interventions involved in the outputs are environmentally neutral and could replace alternative approaches to controlling sleeping sickness, such as large-scale aerial or ground insecticide spraying campaigns, which are potentially more environmentally harmful.

Adverse Environmental Impacts:

Treatment of cattle with trypanocidal drugs to control the animal reservoir of human-infective parasites and thus prevent sleeping sickness cases in people will also have a direct impact on cattle health. Treatment will also control parasites that cause disease (nagana) in cattle, thereby reducing mortality and mobidity. This could potentially lead to an increase in livestock numbers which could have a detrimental impact on the environment, through overgrazing. However, demand for livestock products in developing countries is currently growing and strong and increased demand is forecast to continue for the foreseeable future; any additional production should therefore meet a ready market.

Coping with the Effects of Climate Change, or Risk from Natural Disasters:

One of the affects of climate change is likely to be spread of vector-borne disease to new areas as these become suitable habitat for the vector. In the case of sleeping sickness, new areas and populations are likely to become at risk. An effective, proven control strategy with a supportive policy framework that can rapidly be implemented in such areas will be a valuable asset.

More generally, livestock play an important role in reducing vulnerability to natural and man-made disasters. The use of insecticide-treated cattle is particularly useful in this context since the treatment is applied to mobile cattle whereas other methods of control (e.g. targets, aerial spraying, sterile insect technique) are geographically fixed.  Hence, livestock keepers fleeing a war zone, drought or flood can move with their treated cattle and still achieve some measure of control. By contrast, if the area had been controlled by, say, aerial spraying, the benefits would be lost. 

Better control of zoonotic diseases resulting from development of better, evidence-based policies, will remove a serious threat to the health and wellbeing of the poor and reduce their vulnerability.

Annex

Appendix 1.  References

1. Welburn S.C., Fevre, E.M., Odiit, M., Maudlin, I and M.C. Eisler (2006) Crisis, what crisis? Control of Rhodesian sleeping sickness. Trends in Parasitology.  22 123-8.

2. Welburn, S.C, Picozzi, K., Fevre, E.M., Coleman, P.G., Odiit, M., Carrington, M. and I. Maudlin (2001). Identification of human infective trypanosomes in animal reservoir of sleeping sickness in Uganda by means of serum-resistance-associated (SRA) gene.  Lancet 358: 2017-19.

3. Picozzi, K., Fevre, E.M., Odiit, M., Carrington, M., Eisler, M.C., Maudlin, I and S.C. Welburn (2005). Sleeping sickness in Uganda: a thin line between two fatal diseases. British Medical Journal.   Nov 26;331(7527):1238-41

4. Fevre, E.M. Coleman, P.G., Odiit, M.D., Magona, J., Welburn, S.C., and M.E.J. Woolhouse (2001).  The origins of a new sleeping sickness outbreak (caused by Trypanosoma brucei infection) in eastern Uganda. Lancet 358: 625-628.

5. Fèvre, E.M., Picozzi, K., Fyfe, J., Waiswa, C., Odiit, M., Coleman, P.G. and S.C. Welburn (2005).  A burgeoning epidemic of sleeping sickness in Uganda. Lancet 366: 747-747.

6. Fèvre, E.M., Tilley, A., Picozzi, K., Fyfe, J., Magona, J.W., Shaw., D.J., Eisler, M.C., and S.C. Welburn. (2006) Central point sampling from cattle in livestock markets in areas of human sleeping sickness.  Acta Tropica. 97(2):229-32.

7. Hutchinson, C., Fevre, E., Carrington, M and S.C. Welburn (2003). Farmer went to market: Lessons learnt from the re-emergence of T. brucei rhodesiense sleeping sickness in Uganda. Lancet Infectious Diseases 3(1):42-5.

8. Cox, A., Tilley, A., McOdimba, F., Fyfe, J., Eisler, M.C., Hide, G and S.C. Welburn (2005).  A PCR based assay for detection and differentiation of African trypanosome species in blood. Experimental Parasitology 111: 24-29.

9. Hide G, Tilley, A; Welburn S.C., Maudlin, I. and A. Tait (2000). Trypanosoma brucei: Identification of trypanosomes with genotypic similarity to human infective isolates in tsetse from a region free of human sleeping sickness. Experimental Parasitology 96: 67-74

10.Hide, G., Angus, S., Holmes, P.H., Maudlin, I and S.C. Welburn (1998). Comparison of circulating Trypanosoma brucei strains in an endemic and an epidemic area of a sickness focus. Experimental Parasitology, 89 (1): 21-29.

11.Macloed, A et al., (2000). Minisatellite marker analysis of Trypanosoma brucei: reconciliation of clonal, panmictic and epidemic population genetic structures. Proceedings of the National Academy of Sciences USA 97: 13442-13447.

12. Picozzi, K., Tilley, A., Fèvre, EM., Coleman, PG., Odiit, M., Magona, J, Eisler, M.C  and S.C. Welburn (2003) The diagnosis of trypanosome infections: applications of novel technology for reducing disease risk.  African Journal of Biotechnology. 1 (2): 39-45.

13. Tilley A et al., (2003) Trypanosoma brucei: Trypanosome strain typing using PCR analysis of mobile genetic elements (MGE-PCR). Experimental Parasitology 104(1-2): 26-32.

14. Eisler, MC., Torr, S, Coleman, PG., Morton J. & Machila, N. (2003) Integrated control of vector-borne diseases of livestock--pyrethroids: panacea or poison? Trends Parasitol. 19:341-5.

15. Torr et al., (2006b)  Less is more: the restricted application of insecticide to cattle to improve the cost and efficacy of tsetse control.  Medical & Veterinary Entomology (in press).

16. Torr, S. J. & Mangwiro, T.N.C (2000)  Interactions between cattle and biting flies:  effects on the feeding rate of tsetse.  Medical and Veterinary Entomology 14, 400-409

17. Torr, S. J. et al.(2001). Application of DNA markers to identify the individual-specific hosts of tsetse feeding on cattle. Medical and Veterinary Entomology 15, 78-86.

18. Vale G A. et al. 1999. Insecticide-treated cattle for controlling tsetse (Diptera: Glossinidae): some questions answered, many posed. Bulletin of Entomological Research 89, 567-577.

19. Shaw A et al. (2006) Mapping the benefits: a new decision tool for tsetse and trypanosomiasis interventions. Research Report. Department for International Development, Animal Health Programme, Centre for Tropical Veterinary Medicine, University of Edinburgh, UK and Programme Against African Trypanosomiasis, Food and Agriculture Organization of the United Nations, Rome, Italy.

20. Welburn, S.C. Coleman, P.G., Fevre, E and I. Maudlin (2001)  Sleeping sickness - a tale of two diseases. Trends in Parasitology 17: 19-24.

21. Welburn, S. C. and M. Odiit (2002). Recent developments in human African trypanosomiasis.  Current Opinion in Infectious Disease 15: 477-484

22. Welburn, S.C et al., (2005).  Control Options for Human Sleeping Sickness in Relation to the Animal Reservoir of Disease. In Conservation and Development Interventions at the Wildlife/Livestock Interface: Implications for Wildlife, Livestock and Human Health. Eds. Osofsky et al.,  IUCN, Gland, Switzerland and Cambridge, UK.  220 pp.

23. Kaare, M et al., (2007) Sleeping sickness - a re-emerging disease in the Serengeti? Travel Medicine and Infectious Disease. In press

24. Odiit, M et al., (2005) Quantifying the level of under-reporting of sleeping sickness cases. Tropical Medicine International Health 10(9): 840-9.

25. Odiit, M et al., (2004) Assessing the patterns of health-seeking behaviour and awareness among sleeping-sickness patients in eastern Uganda. Annals of Tropical Medicine and Parasitology 98(4): 339-48.

26. Odiit, M et al., (2004) Spatial and temporal risk factors for the early detection of Trypanosoma brucei rhodesiense sleeping sickness patients in Tororo and Busia districts, Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene  98(10): 569-576.

27. Odiit, M et al  (2006). Using remote sensing and geographic information systems to identify villages at high risk for T. b. rhodesiense sleeping sickness in Uganda. Trans R Soc Trop Med Hyg.

28. Coleman, P.G. and S.C. Welburn (2004) Are fitness costs associated with resistance to human serum in Trypanosoma brucei rhodesiense? Trends in Parasitology  20: 311-315.

Relevant Research Projects, with links to the
Research for Development (R4D) web site
and Technical Reports:

R4D	Project Title	Technical Report
R7173	Cattle management practices in tsetse-affected areas
R7360	Field methods and tools for resource-poor farmers and extension workers to improve targetting and appropriate use of drugs used for control of African bovine trypanosomosis
R7596	Decision support system for the control of trypanosomosis in South-East Uganda; improving public health and livestock productivity through the cost-effective control of trypanosomosis in livestock
R7597	A low-cost haemoglobinometer as a decision support tool for bovine disease diagnosis in sub-Saharan Africa
R7987	Message in a Bottle: Disseminating Tsetse Control Technologies
R8214	Integrated vector management: controlling malaria and trypanosomiasis with insecticide-treated cattle
R8318	Decision support for endemic disease control in sub-Saharan Africa - private sector drivers for technology adoption by resource-poor farmers