Equine trypanosomosis in the Central River Division of The Gambia: a study of veterinary gate-clinic consultation records.

The objective of this study was to provide epidemiological information of equine trypanosomosis in the Central River Division (CRD) of The Gambia. Therefore, 2285 consultations records of equines, admitted in a gate-clinic at Sololo in CRD, were studied retrospectively. The data were recorded in the period between September 1995 and July 2002 and comprised consultations of 2113 horses and 172 donkeys. 'Trypanosome infection' was the most frequently diagnosed condition and accounted for 61% of the cases. Horses were more frequently diagnosed with trypanosome infections than donkeys (p<0.001), with an occurrence of 63% compared to 43% in donkeys. In both horses and donkeys, trypanosome infections were mainly due to Trypanosoma congolense (64%) and T. vivax (32%). There was no difference observed in the occurrence of trypanosome infections in male or female donkeys (p=0.585), but there were more female (67.8%) horses observed with trypanosome infections than male horses (60.7%; p=0.003). There was no difference observed in the occurrence of trypanosome infections in donkeys older or younger than 1 year (p=0.130), but more older horses (63.2% >1 year) were observed with trypanosome infections than young horses (54.5% <1 year; p=0.033). The number of donkeys and horses with trypanosome infections decreased during the rainy season (June-September). The majority of equines that were admitted with trypanosome infections were severely anaemic. The average packed cell volume (PCV) declined with increasing parasitaemia (p=0.006). Seventy-four percent of the farmers' predictions of trypanosome infections in their equines were confirmed by darkground-microscopy. That proved that farmers had a fairly accurate knowledge of the diseases affecting their equines. The treatments executed at the gate-clinic were generally effective. The few (0.4%) relapses of the T. vivax infections that were previously treated with diminazene aceturate in this study were not sufficient to prove drug resistance. The study showed that the analysis of consultation records at a gate-clinic can provide complementary information to conventional epidemiological studies in the same research area.

Susceptibility of West African Dwarf goats and WAD x Saanen crosses to experimental infection with Trypanosoma congolense.

West African Dwarf goats (WADs) and their Saanen crosses were experimentally infected with Trypanosoma congolense. No significant differences were found between trypanosome parasitaemia and antibody response of the crossbred and WAD goats. Neither the WAD goats nor the Saanen crosses were able to control the drop in PCV following trypanosome infection. The level of anaemia caused by the trypanosome infection was similar in the two breeds during the trial. Based on these findings, no difference in tolerance or susceptibility to T. congolense could be demonstrated between the WAD goats and their Saanen crosses. Although the weight of all goats increased during the trial, the crosses gained significantly more weight than the WAD goats. The trypanosome infection reduced the growth rate of both breeds, but this reduction was not statistically significant. Crossbreeding trypanotolerant WADs with trypanosusceptible Saanen goats might, therefore, be an effective means of increasing productivity.

The incidence of new and the prevalence and persistence of recurrent trypanosome infections in cattle in southwest Ethiopia exposed to a high challenge with drug-resistant parasites.

A method is described for calculating new infection incidence from monthly field data collected between April 1994 and February 1998 from an average of 770 Ethiopian Highland Zebu cattle maintained under traditional management in the Ghibe valley, southwest Ethiopia and exposed to a high challenge with drug-resistant parasites. Each month cattle with a packed cell volume (PCV)<26% and detected as parasitaemic, or cattle showing clinical signs of trypanosomosis, were treated with diminazene aceturate at 3.5 mg/kg body weight. An infection was defined as a new infection if it was preceded by 2 previous months in which both samples had a PCV>/=26% and were not detected with trypanosomes. Using this definition the average monthly incidence of infections of Trypanosoma congolense in cattle over 36 months of age was 13.3%, and the prevalence of recurrent infections 13.0%. Assuming that an animal had recovered from infection when PCV again returned to 26% without parasites being detected, mean persistence of infection was 3.8 months (median between 2 and 3 months). In contrast, T. vivax infections were susceptible to diminazene. The incidence of T. vivax infections in adults was lower than for T. congolense (2.8%), and they were less pathogenic (mean reduction of 3.1% units of PCV due to T. vivax infection compared with 4.6% units for T. congolense). Also, fewer cases were treated. Calves were first detected parasitaemic at an average age of 8.8 months and their infections persisted longer than those in adults. The effect of age on incidence of infection was not significant beyond 15 months of age. Adult male cattle appeared to be more susceptible to T. congolense infection than adult female cattle.

Use of deltamethrin 'pour-on' insecticide for the control of cattle trypanosomosis in the presence of high tsetse invasion.

A deltamethrin 'pour-on' insecticide was applied monthly to over 2000 cattle exposed to a high challenge of drug-resistant trypanosomes and high tsetse re-invasion pressure in the Ghibe valley, south-west Ethiopia. Blood samples were taken monthly from an average of 760 cattle for determination of PCV and presence of trypanosomes. The area of the valley is approximately 350 km2 and the cattle grazed in roughly four locations covering about a quarter to half of the area. Two years before the trial commenced, Glossina morsitans submorsitans Newstead (Diptera: Glossinidae) began to invade the valley. Despite the use of the pour-on the mean apparent density of G. m. submorsitans continued to rise, and, during the 4 years of tsetse control, was more than three-fold higher than that recorded during the previous 18 months. Over the same period there was little change in the apparent density of Glossina pallidipes Austen (Diptera: Glossinidae). By contrast, the mean monthly prevalence of trypanosome infections in cattle over 36 months of age decreased from 38.3 to 29.0%, the incidence of new infections decreased from 26.6 to 16.0% (a reduction of 40%), and packed cell volume in cattle increased from 21.7 to 24.1%. Evidence of a change in apparent parasite transmission rate was demonstrated by regression of infection incidence in cattle on the logarithm of apparent density of G. m. submorsitans. Before the trial started the regression coefficient was 45.8 +/- 6.3 and this reduced to 9.2 +/- 2.5% incidence per log(e) (flies/trap/day) during the period of tsetse control. It was concluded that this indicated reductions in tsetse numbers in the immediate vicinities of cattle in a way that was not reflected in overall tsetse catches. Nevertheless, the comparatively high levels of trypanosome prevalence that persisted in the cattle demonstrates that, where invasion prevalence is high, treatment of small pockets of cattle will not eradicate tsetse. To achieve more significant reduction in trypanosome prevalence in cattle, integrated methods of control utilizing target barriers in the major routes of invasion will be needed.

Estimating the effects of tsetse control on livestock productivity--a case study in southwest Ethiopia.

A tsetse control campaign was started in January 1991 using a synthetic pyrethroid cypermethrin 'pour-on' applied monthly to cattle exposed to high levels of drug-resistant trypanosomes in the Ghibe valley of southwest Ethiopia. In December 1992, a cost-recovery scheme was introduced, and thereafter farmers paid for treatment. An average of 100 village Ethiopian Highland Zebu cattle were monitored monthly from March 1986 to February 1997. Individual animals in this herd were treated with diminazene aceturate (Berenil, Hoechst, Germany) at 3.5 mg/kg when trypanosomes were detected and their packed cell volume was less than 26%. Superimposed on this systematic trypanocidal chemotherapy, control of tsetse resulted in average reductions from 1992 to 1996 of 95% and 75% in the mean relative densities of tsetse and biting flies, respectively, and of 63% in the prevalence of trypanosomal infections in cattle. Despite these reductions, there was no significant increase in the body weight of the cows, calving rate or the mean body weight of calves at 12 months of age. There was, however, an average decrease of 57% in calf mortality (including still births) by 12 months of age, an increase of 49% in the ratio of live calves under 12 months of age to cows over 36 months of age, and an increase of 8% in the body weight of adult males.

Effect of alpha-phenyl-tert-butylnitrone on endotoxin toxemia in horses.

Lipopolysaccharide (LPS), or endotoxin, is a component of the cell wall of gram-negative bacteria and is toxic to humans and animals. The GI tract of horses contains large numbers of endotoxins which may cause disease if gut wall integrity is compromised. The objective of this study was to develop a unique therapeutic approach to the treatment of endotoxemia with a sulfonyl analog of the alpha-phenyl-N-tert-butyl-nitrone (PBN) spin-trap molecule which may prevent the LPS-induced cytokine cascade. Following challenge with 55 mg/kg LPS, the survivability of ICR Swiss mice was significantly improved after treatment with 100 and 175 mg/kg PBN, although survivability of mice treated with 175 mg/kg PBN was significantly less than those treated with 100 mg/kg PBN. Challenged mice treated with 300 and 1000 mg/kg PBN survived for a significantly shorter period of time (vs control). Horses treated with a sublethal dose (1 microgram/kg) of endotoxin experienced 2 periods of distress at 1 and 6 h after challenge. Disulfonyl-PBN significantly reduced the increase in heart and respiratory rates 6 h after challenge. Analogs of PBN appeared to be more beneficial following near-lethal challenge with LPS. Dramatic benefits to horses may only be observed in life-threatening situations.

Use of insecticide-impregnated targets for the control of tsetse flies (Glossina spp.) and trypanosomiasis occurring in cattle in an area of south-west Ethiopia with a high prevalence of drug-resistant trypanosomes.

In the Ghibe valley, south-west Ethiopia, a tsetse control trial using deltamethrin-impregnated targets was started in May 1990. The mean relative density of the main vector, Glossina pallidipes, fell from 2.1 flies per trap per day in the 12 months prior to introduction of tsetse control to 0.41 flies per trap per day in the 12 months after tsetse control was initiated. The annual mean prevalence of Trypanosoma congolense infections in cattle fell from 32% in the 2 years before tsetse control to 13% in the 2 years following deployment of targets. The largest reduction occurred in the first quarter of 1991 when the mean monthly trypanosome prevalence was 5%. There was also a decrease of approximately 75% in the estimated rate of relapse of trypanosome infections in cattle after treatment with diminazene aceturate. However, in June 1991, socio-political disturbances occurred in Ethiopia and were associated with substantial thefts of targets. Following these thefts, the mean relative density of G. pallidipes rose from 0.41 flies per trap per day in the period May 1990-April 1991, to 1.29 flies per trap per day in the period April 1992-March 1993. Associated with this rise, the mean trypanosome prevalence in cattle increased from 13% in the period May 1991-April 1992 to 28% in the period May 1992-April 1993. This was similar to the mean trypanosome prevalence in cattle during the pre-control period. Thus, while effective tsetse control methods can be used to reduce the transmission of trypanosomes their long-term impact is dependent on their sustainability.

Effect of tsetse control on trypanosome prevalence in livestock: problems of experimental design and statistical interpretation--a case study in northern Côte d'Ivoire.

As part of a study on livestock productivity under trypanosomosis risk in the region of Boundiali, northern Côte d'Ivoire, 21 herds of cattle (N'Dama, Baoulé and Zebu crosses) and 20 flocks of Djallonké and Djallonké x Sahel sheep were monitored monthly for body weight, packed red cell volume and trypanosomal parasitaemia over various periods between January 1984 and December 1992. A tsetse control campaign using biconical traps impregnated with alpha-cypermethrin started in December 1987. Tsetse control reduced the relative tsetse density by over 95% between 1988 and 1992, and this was associated with reductions in the prevalence of Trypanosoma congolense over the same period of over 90% both in sheep and cattle. Average reductions in the prevalence of T. vivax were lower, on average 68% in adults and 85% in young animals. Attempts were made in the design of the study to allow comparisons between controlled and uncontrolled areas; however, there were too many confounding and uncontrollable factors to allow such comparisons to be made. It was necessary, therefore, to compare data collected from all herds and flocks before and after the intervention, with the consequential difficulties in accounting for uncontrollable year-to-year variations in factors affecting trypanosome prevalence in livestock.

Epidemiology of bovine trypanosomiasis in the Ghibe valley, southwest Ethiopia. 1. Tsetse challenge and its relationship to trypanosome prevalence in cattle.

In this, the first of a series of papers on the epidemiology of bovine trypanosomiasis in the Ghibe valley, southwest Ethiopia, the tsetse populations and their relationships to the prevalence of trypanosome infections in cattle are described. The tsetse challenge to cattle at two sites sites in the area was estimated as the product of tsetse relative density and the trypanosome infection rate in flies. The proportion of feeds taken by tsetse from cattle was also considered. Three tsetse species were detected in the area, Glossina pallidipes, G. fuscipes and G. morsitans submorsitans. A significant correlation (r = 0.60, P < 0.001) was observed between the mean monthly estimates of tsetse challenge due to G. pallidipes and the prevalence of trypanosome infections in cattle the following month at one site, whilst at the other, no significant relationship was observed (P = 0.08). The tsetse density at both sites showed seasonal changes which were related to the monthly rainfall. Finally, variations in tsetse density appeared to be the main factor responsible for variation in tsetse challenge and thus trypanosome prevalence in cattle.

Epidemiology of bovine trypanosomiasis in the Ghibe valley, southwest Ethiopia. 2. Factors associated with variations in trypanosome prevalence, incidence of new infections and prevalence of recurrent infections.

An average of 840 East African Zebu cattle from nine herds in the Ghibe valley, southwest Ethiopia were monitored from January 1986 to April 1990. Each month blood samples were collected for analysis of packed red cell volume (PCV) and detection of trypanosomes. Animals found to be parasitaemic and with a PCV less than 26% were treated with diminazene aceturate at a dose of 3.5 mg/kg body weight. The majority of infections were associated with Trypanosoma congolense (84% of infections in adult cattle and 71% in cattle less than 24 months of age), and the mean percentage of adult animals detected parasitaemic 1 month after treatment of an infection with T. congolense was 27%. In order to assess possible existence of drug resistance, a model was applied which allowed monthly incidences of new infections to be distinguished from recurrent infections. This model showed that the monthly incidence of new infections of T. congolense in adult cattle increased significantly from 11% in 1986 to 24% in 1989 following a concomitant increase in the tsetse challenge. The corresponding increase in overall prevalence of T. congolense was from 17% to 38% and the mean prevalence of recurrent infections increased significantly from 6% to 14%. These findings ruled out the possibility that the high prevalence of trypanosome infections in cattle was due only to a high tsetse challenge and pointed to the existence of T. congolense populations which expressed resistance to diminazene. There were variations associated with season, herd, age and sex in the incidence of new infections, prevalence of recurrent infections and relapse to treatment.

Epidemiology of bovine trypanosomiasis in the Ghibe valley, southwest Ethiopia. 3. Occurrence of populations of Trypanosoma congolense resistant to diminazene, isometamidium and homidium.

In July 1989, blood samples were collected from parasitaemic cattle in the Ghibe valley, Ethiopia, frozen in liquid nitrogen and transported to Nairobi, Kenya. Twelve of the stabilates were inoculated into individual Boran (Bos indicus) calves and characterised for their sensitivity, in turn, to diminazene aceturate (Berenil), isometamidium chloride (Samorin) and homidium chloride (Novidium). All 12 stabilates produced infections which were shown to be Trypanosoma congolense and resistant to treatment with diminazene aceturate at a dose of 7.0 mg kg-1 body weight (b.w.). Eleven of the infections were also resistant to isometamidium chloride at a dose of 0.5 mg kg-1 b.w. and homidium chloride at a dose of 1.0 mg kg-1 b.w. The drug-sensitivity phenotypes of three of the same isolates were also determined in goats which were each treated with only one of the three trypanocides: all expressed the same phenotypes as the populations expressed in the aforementioned Boran calves. Five clones were derived from one of the isolates which expressed a high level of resistance to all three trypanocides; each clone expressed high levels of resistance to all three trypanocides when characterised in mice. Thus, the multi-resistance phenotype of the parental isolate was associated with expression of mutli-resistance by individual trypanosomes. Finally, molecular karyotypes and electrophoretic variants of six enzymes were determined for seven and eight of the isolates, respectively. Six different karyotypes were observed and all eight of the latter isolates belonged to different zymodemes, indicating that the multi-resistance phenotype at Ghibe was associated with many genetically distinct populations.

Waiting for placement: an exploratory analysis of determinants of delayed discharges of elderly hospital patients.

This article examines the causes of delayed hospital discharge for 3,111 patients waiting for alternative placement in 80 North Carolina acute care general hospitals during May 1989. Almost all of the patients were elderly: their average age was 77. Delay is defined as the period between the day a patient was judged medically ready for discharge by a discharge planner and the day the patient was discharged (or May 31 if unplaced). The average delay was 16.7 days. The policy-relevant patient characteristics associated with delay are requirement for heavy care, race, source of reimbursement, and whether or not there was a financial problem in arranging discharge. The patient's age and whether or not a problem with behavior or family cooperativeness was noted also were predictors. Along with patient characteristics, hospital features such as bed size, occupancy rate, and total revenues were correlated with delay. Local nursing and rest home (domiciliary) bed supply were insignificant predictors, possibly because of their limited variance: the number of nursing home beds in all North Carolina counties is below the national mean; the number of rest home beds exceeds it. The conclusion reached is that the delay problem warrants more intensive analysis, particularly regarding financial problems encountered at discharge, and race. Guidelines for such an endeavor are provided. Further, there is a need to recognize the increasing preponderance of a new type of heavy care patient via more appropriate reimbursement levels and "transitional care" services.

Glossina fusca group tsetse as vectors of cattle trypanosomiasis in Gabon and Zaire.

1. The significance of Glossina fusca group tsetse flies as vectors of cattle trypanosomiasis was examined using biconical traps to survey tsetse populations at one site in Gabon and two sites in Zaire. 2. Mean trypanosome infection rates in G.tabaniformis Westwood over the study period ranged from a minimum of 8.9% at one site to a maximum of 17.7% at another. The mean infection rate in G.nashi Potts was 6.0%. 3. Up to 49% of bloodmeals of G.tabaniformis were from cattle. Trypanosome prevalence in cattle where G.tabaniformis appeared to be the main vector was 9.5% and 5.4% at the Mushie and OGAPROV ranches, respectively. 4. A highly significant positive correlation was found between tsetse challenge and trypanosome prevalence in N'Dama cattle across sites. Tsetse challenge was defined as the product of tsetse relative densities, trypanosome infection rates in the flies and the proportion of feeds taken by them from cattle. Thus, G.tabaniformis can be an important vector of pathogenic Trypanosoma species in cattle.

Epidemiology of animal trypanosomiasis on a cattle ranch in Kilifi, Kenya.

A study of the epidemiology of animal trypanosomiasis was carried out on a 2500 ha cattle ranch, with a history of trypanosomiasis, in the Coast Province of Kenya in 1982. The tsetse survey on the ranch revealed one breeding focus of Glossina austeni in a thicket of approximately 50 ha. Trypanosomes were detected in 20% of the 46 dissected tsetse. During the study period of 9 months, 0.8% of the 3315 samples collected from 2300 Ayrshire X Sahiwal crossbred cattle were found infected with trypanosomes; 32% of 5909 samples collected from the same cattle had a packed cell volume (PCV) of 30% or less. Animals with a PCV of 30% or less were treated with a trypanocide (Berenil, Ethidium or Novidium). Antibody to trypanosomes was detected in 22.1% of the 343 sera collected from the cattle. A sentinel herd of 20 cattle was exposed for 182 days inside the tsetse infested thicket. All animals became infected with Trypanosoma congolense, on average after 53 days; they were subsequently treated with Berenil (6 mg/kg). A second, third and fourth T. congolense infection was diagnosed in 17, 11 and 1 animals, respectively. The cattle were treated similarly with Berenil after each of these infections. T. vivax and T. brucei were not diagnosed in the sentinel cattle. The results suggest that acquired immunity to T. congolense infection did not play a significant role in the sentinel cattle.

Occurrence of Glossina nashi Potts 1955 Diptera-Glossinidae in the Republic of Gabon.

Glossina nashi, a little known species of tsetse fly, inhabits the forests of central Africa. It has recently been detected in the Province of Haut Ogooué in the south-east of the Republic of Gabon.