WOMEN-LED TSETSE CONTROL: A PILOT STUDY IN NORTHWEST UGANDA

ABSTRACT Women-led tsetse control: a pilot study in North West Uganda Vanja Kovačič INTRODUCTION Human African Trypanosomiasis (HAT) is a disease caused by infection with trypanosomes and transmitted by tsetse flies, which continues to threaten thousands of people in Africa. Tiny targets –small pieces of cloth impregnated with insecticide– are a new, cheap, and effective entomological tool to prevent transmission. The most sustainable and effective way to implement these targets remains uncertain, but their simplicity makes them an excellent candidate for community led schemes. The aim of this research was to design, implement, and evaluate a women-led tsetse control intervention using tiny targets in an area endemic to HAT. METHODS The research was conducted in North West Uganda and organized in three distinct phases: 1) The baseline phase used in-depth interviews, GPS human tracking, seasonal calendars and participatory mapping to explore the factors influencing community participation; 2) The intervention and evaluation phase piloted a women-led tsetse control operation in three villages and evaluated its impact using action research; 3) The stakeholders’ reflections phase explored the community and decision-makers’ perceptions of community involvement in future HAT control interventions, through community role play and in-depth interviews with decision-makers. RESULTS During the baseline phase, the community did not express negative perceptions towards HAT control programmes, although they recalled past experiences with different programmes imposed upon them. Both men and women perceived women to be at greater risk of tsetse bites then men because of their daily activities in close proximity to rivers, and this was an important facilitator for their involvement. However, the GPS human tracking study suggested that the actual risk was similar among men and women. During the six month pilot intervention, women were highly motivated, and their ownership of the programme and sense of empowerment increased. Participants perceived the intervention as feasible. The evaluation demonstrated that more tiny targets were functional at six months post deployment in the pilot villages than in an expert-led programme in an adjacent area, due to community maintenance of the targets. The pilot community-led intervention was also more cost-effective. Through role-play in the stakeholders’ reflection phase, women demonstrated with confidence their ability to define priorities, good negotiation skills, and critical insights into decision-making. During in-depth interviews, decision- makers acknowledged that the community has an important role in HAT elimination, but that they lacked knowledge and skills in community based approaches. Women are not well represented in HAT control policy and planning, and the perception of tsetse control as a male domain was an additional barrier to women-participation approaches. CONCLUSIONS This study demonstrated that a community-based tsetse control programme organized and led by women was feasible and cost-effective. The high-level of engagement and motivation of these women and their effective management of the tiny targets provide evidence that community-based approaches may be a sustainable option for tsetse control. However, this will need widespread engagement of policy and programme staff and recognition that communities are equal partners in HAT elimination

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs

Simultaneous dual-species laser cooling using an optical frequency comb

We demonstrate 1D simultaneous laser cooling of $^{87}$Rb and $^{85}$Rb atoms using an optical frequency comb. By adjusting the pulse repetition frequency and the offset frequency, the frequency comb spectrum is tuned to ensure that two distinct frequency comb modes are simultaneously red-detuned from the cooling transitions, one mode for each species. Starting from a pre-cooled cloud of $^{85,87}$Rb atoms at above-Doppler temperatures, we show simultaneous cooling of both species down to the Doppler temperature using two counter-propagating $\sigma$$^{+}$/$\sigma$$^{-}$-polarized beams from the frequency comb. The results indicate that simultaneous dual-species frequency comb cooling does not affect the cooling characteristics of individual atomic species. The results of this work imply that several atomic species could be cooled simultaneously using a single frequency comb source. This comb-based multi-channel laser cooling could bring significant advances in multi-species atom interferometers for space applications and in the study of multi-species interactions

Nonintegrability of the two-body problem in constant curvature spaces

We consider the reduced two-body problem with the Newton and the oscillator potentials on the sphere ${\bf S}^{2}$ and the hyperbolic plane ${\bf H}^{2}$. For both types of interaction we prove the nonexistence of an additional meromorphic integral for the complexified dynamic systems.Comment: 20 pages, typos correcte

Radiation exposure to the population of Europe following the Chernobyl accident

On the occasion of the 20th anniversary of the Chernobyl accident an attempt has been made to evaluate the impact of the Chernobyl accident on the global burden of human cancer in Europe. This required the estimation of radiation doses in each of the 40 European countries. Dose estimation was based on the analysis and compilation of data either published in the scientific literature or provided by local experts. Considerable variability has been observed in exposure levels among the European populations. The average individual doses to the thyroid from the intake of 131I for children aged 1 y were found to vary from ∼0.01 mGy in Portugal up to 750 mGy in Gomel Oblast (Belarus). Thyroid doses to adults were consistently lower than the doses received by young children. The average individual effective doses from external exposure and ingestion of long-lived radiocaesium accrued in the period 1986-2005 varied from ∼0 in Portugal to ∼10 mSv in Gomel Oblast (Belarus) and Bryansk Oblast (Russia). The uncertainties in the dose estimates were subjectively estimated on the basis of the availability and reliability of the radiation data that were used for dose reconstruction in each countr

Parabolic resonances and instabilities in near-integrable two degrees of freedom Hamiltonian flows

When an integrable two-degrees-of-freedom Hamiltonian system possessing a circle of parabolic fixed points is perturbed, a parabolic resonance occurs. It is proved that its occurrence is generic for one parameter families (co-dimension one phenomenon) of near-integrable, t.d.o. systems. Numerical experiments indicate that the motion near a parabolic resonance exhibits new type of chaotic behavior which includes instabilities in some directions and long trapping times in others. Moreover, in a degenerate case, near a {\it flat parabolic resonance}, large scale instabilities appear. A model arising from an atmospherical study is shown to exhibit flat parabolic resonance. This supplies a simple mechanism for the transport of particles with {\it small} (i.e. atmospherically relevant) initial velocities from the vicinity of the equator to high latitudes. A modification of the model which allows the development of atmospherical jets unfolds the degeneracy, yet traces of the flat instabilities are clearly observed

Non integrability of a self-gravitating Riemann liquid ellipsoid

We prove that the motion of a triaxial Riemann ellipsoid of homogeneous liquid without angular momentum does not possess an additional first integral which is meromorphic in position, impulsions, and the elliptic functions which appear in the potential, and thus is not integrable. We prove moreover that this system is not integrable even on a fixed energy level hypersurface.Comment: 14 pages, 8 reference

Tsetse control and Gambian sleeping sickness ; implications for control strategy

Background Gambian sleeping sickness (human African trypanosomiasis, HAT) outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT. Methods and Findings The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km(2) field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km(2)). In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings. Interpretation The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised

Arene oxidation with malonoyl peroxides

Malonoyl peroxide 7, prepared in a single step from the commercially available diacid, is an effective reagent for the oxidation of aromatics. Reaction of an arene with peroxide 7 at room temperature leads to the corresponding protected phenol which can be unmasked by aminolysis. An ionic mechanism consistent with the experimental findings and supported by isotopic labeling, Hammett analysis, EPR investigations and reactivity profile studies is proposed