An integrated approach to tackling drug resistance in livestock trypanosomes.

Lead Research Organisation: University of Glasgow
Department Name: College of Medical, Veterinary, Life Sci

Abstract

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Planned Impact

This project will fill important knowledge gaps that are currently limiting the development of sustainable control strategies for animal African trypanosomiasis (AAT). Elucidating the mechanisms of T. congolense resistance to Isometamidium chloride (ISM), identifying a marker for diagnosis, and crucially better understanding the emergence and spread of resistance, as proposed in this study, are essential steps towards effective and sustainable control, including optimal use of novel drugs. We anticipate this project will enable and contribute to wider discussions on sustainable use of drugs in AAT control and help to drive this as a priority. Hence, the economic and societal impacts from this work include:

Impact on disease control policies for sustainable use of trypanocides, leading to impacts on livestock farming in developing countries through reducing detrimental effects of resistance emergence:
Ultimate beneficiaries of the project are subsistence farmers in sub-Saharan Africa, who are finding that current AAT treatments are no longer working, threatening their livelihoods and food security. Approximately 50 million cattle, plus millions of other livestock, are at risk of AAT in tsetse-infected across an area of ~10M km2. AAT impacts include reduced milk yields, meat production, fertility, and draught power as well as mortality, and are estimated to cost billions (US$) to the region annually - estimated at $2.5 billion to Eastern Africa alone. The disease severely impacts sub-Saharan regions where livestock rearing is the main livelihood of small communities, including many countries on the DAC list of least developed countries. Tanzania has the third largest livestock population in Africa, and a high proportion of poor livestock keepers, with >4 million cattle threatened by trypanosomiasis.
Livestock keepers currently use 35-70 million doses of trypanocides annually. Two primary options exist for treatment of AAT: Isometamidium chloride and Diminazene aceturate . Both drugs are >50 years old and reported resistance to them is widespread. Outputs from this project will provide local (veterinary services), national (Ministry of Agriculture, Livestock and Fisheries), global (AU-PATTEC, FAO) and donor (GALVmed, DFID, BMGF) organisations with evidence to back up decision-making on sustainable use of drugs in AAT control. This project was co-constructed with local veterinary services and livestock keepers in Serengeti District, and national decision-makers in Tanzania, who have identified effective and sustainable trypanocide use as a particular concern. The same trypanocide drugs used for AAT are also used to reduce T. brucei circulation in cattle, which can be reservoirs for human African trypanosomiasis. Sustainable use of these drugs therefore has added benefits in prevention of human disease.

Impact upon academic and industry AAT drug discovery and development programmes:
We know very little about how resistance emerges and spreads in livestock trypanosomes. This project will significantly advance this knowledge, both in terms of characterising mechanisms and rate of resistance emergence to ISM, and furthering our very scanty knowledge of the epidemiology of resistance in the field. The development of a mathematical model, that is developed and based on reliable data, will both inform on the dynamics of resistance and spread of ISM, and importantly be applicable to predicting resistance emergence and spread for novel trypanocides (such as the candidate compound currently under development by project partners GALVmed) - this output is a critical gap in knowledge and capability at present, which would be able to inform strategies to minimise resistance emergence and spread, and maximise the lifetime of both ISM and novel trypanocides. The applicants have links with relevant academic, industrial and policy stakeholders to enable dissemination and uptake of results in order to translate impact to farmers.

Publications

10 25 50
 
Description Trypanocidal drugs are widely used in cattle in sub-Saharan Africa to treat and prevent trypanosomiasis. However, livestock keepers do not usually have access to diagnostics to confirm if trypanosomiasis is the cause of illness, and limited animal health systems mean that they often purchase and administer the drugs themselves. We monitored livestock keepers when they gave trypanocides to quantify the potential reasons for treatment failure, and followed up treated cattle to see how often treatment failed. Only 35% of samples taken at the time of treatment tested positive for trypanosomiasis. When the dose, route of administration, competence of administration and storage conditions were assessed, 52% of treatments were given appropriately. Both treatment failure and failure of prophylaxis were identified in animals that had been treated inadequately. Some failures were also identified in animals treated adequately, which could reflect issues of drug quality, or resistance, both factors we are still assessing. The approach used establishes a new technique for assessing treatment failures in farmer-led treatments. We held an international symposium "Symposium on African Livestock Trypanosomiasis" in Tanzania with participants from 18 different countries, bringing together all stakeholders involved in trypanocide usage and trypanocide resistance to develop plans for more sustainable and effective trypanosomiasis control.
Exploitation Route Outcomes from the project will help to inform national decision-making about Animal African Trypanosomiasis (AAT) control, as well as having implications for human disease risk. For example the outputs have already helped to inform the Tanzania National Strategy for Control of Human African Trypanosomiasis and Animal African Trypanosomiasis. The results will also help to inform international strategies for trypanosomiasis control. Specifically, they are helping to provide evidence for the FAO international guidelines on trypanocide use and trypanocide resistance, facilitated by the symposium and workshop organised by the project team. The scientific approaches developed here will be relevant to other research teams for assessing failures of trypanocidal drugs or other similar pharmaceuticals.
Sectors Agriculture, Food and Drink,Healthcare

 
Description Outcomes from the project are being used to inform national decision-making about Animal African Trypanosomiasis (AAT) control, as well as having implications for human disease risk. For example the outputs have already helped to inform the Tanzania National Strategy for Control of Human African Trypanosomiasis and Animal African Trypanosomiasis. The results will also help to inform international strategies for trypanosomiasis control. Specifically, they are helping to provide evidence for the FAO international guidelines on trypanocide use and trypanocide resistance, facilitated by the symposium and workshop organised by the project team. The Symposium on African Livestock Trypanosomiasis, organised by the project team with FAO, has provided a turning point in the development of strategies for more effective and sustainable use of trypanocides. Engagement activities that we have conducted with farmers, including provision of an information sheet that clarifies common errors farmers make when administering trypanocides, has already helped farmers to change their behaviour for more effective trypanocide usage.
First Year Of Impact 2022
Sector Agriculture, Food and Drink,Healthcare
Impact Types Societal,Economic,Policy & public services

 
Description Contributing to the Tanzania National Strategy on Control of Human African Trypanosomiasis and Animal African Trypanosomiasis
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
 
Description Contribution to development of FAO international guidelines on trypanocide use and trypanocide resistance
Geographic Reach Africa 
Policy Influence Type Contribution to new or improved professional practice
 
Description Participated in FAO Expert Consultation on Parasite Resistance
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a guidance/advisory committee
 
Description GCRF Small Grant Scheme - Solar Solutions to Build Resiliency in Laboratory Capacity for Vector-borne Zoonoses in Tanzania
Amount £49,091 (GBP)
Organisation University of Glasgow 
Sector Academic/University
Country United Kingdom
Start 07/2022 
End 11/2022
 
Description GKE Flexible Fund - Supporting policy development to improve animal trypanosomiasis control
Amount £26,680 (GBP)
Organisation University of Glasgow 
Sector Academic/University
Country United Kingdom
Start 08/2022 
End 03/2023
 
Description Symposium on African Livestock Trypanosomes - Tanzania
Amount $23,943 (USD)
Funding ID INV-051075 
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 11/2022 
End 03/2023
 
Title Longitudinal study design for quantifying trypanocide treatment failure in cattle 
Description This project established a new methodological approach for assessing the success or failure of farmer-led trypanocidal treatments in a longitudinal study. This included monitoring treatment outcomes by microscopy and PCR, and creating algorithms to assign each treatment to failure or success, based on the results of follow up samples at different time points. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2023 
Provided To Others? Yes  
Impact This approach was used in this project to generate data on the relative contributions of different factors (e.g. inappropriate dosing, incorrect diagnosis) on treatment failure. This data is novel and urgently needed to help inform better strategies for AAT control. A publication describing this approach is being prepared for submission. The approach has been presented at two meetings and the received positive feedback. 
 
Title Data on the response to trypanocide treatments in cattle 
Description Samples, sample testing results and related metadata originate from a longitudinal study conducted in Tanzania to quantify reasons for treatment failure when farmers administer trypanocides. Blood samples, preserved in Paxgene tubes to stabilise genetic material, were collected at the time of treatment, 1 week and 4 weeks later (for treatments with Diminazene and Homidium) and 8 weeks and 12 weeks later (when Isometamidium was given, to measure the extent of prophylaxis). DNA extracts are available from these samples, as well as PCR results. 
Type Of Material Database/Collection of data 
Year Produced 2022 
Provided To Others? No  
Impact In this study, this sample set has been used to quantify treatment failures in farmer-led trypanocide use, and quantify the reasons for treatment failure. This study will be published shortly and data will be made available. 
 
Description Symposium on African Livestock Trypanosomes leadership team 
Organisation Food and Agricultural Organisation (FAO)
Country Italy 
Sector Charity/Non Profit 
PI Contribution Our project team worked with Dr Giuliano Cecchi from FAO to organise the Symposium on African Livestock Trypanosomiasis (see Engagement section). Our contribution was to seek and find funding, plan logistics, organise speakers, and generally coordinate the meeting.
Collaborator Contribution The role of FAO was to provide input on identifying speakers and participants, plan and organise a workshop during the meeting, to chair relevant sessions and to channel information to feed into the development of the FAO international guidelines on trypanocide use and resistance.
Impact Symposium on African Livestock Trypanosomiasis - see Engagement section Contributing to development of FAO international guidelines on trypanocide use and resistance - see Policy section
Start Year 2022
 
Description Symposium on African Livestock Trypanosomes leadership team 
Organisation Tanzania Veterinary Laboratory Agency
Department Vector and Vector-borne Disease Institute
Country Tanzania, United Republic of 
Sector Public 
PI Contribution Our project team worked with Dr Giuliano Cecchi from FAO to organise the Symposium on African Livestock Trypanosomiasis (see Engagement section). Our contribution was to seek and find funding, plan logistics, organise speakers, and generally coordinate the meeting.
Collaborator Contribution The role of FAO was to provide input on identifying speakers and participants, plan and organise a workshop during the meeting, to chair relevant sessions and to channel information to feed into the development of the FAO international guidelines on trypanocide use and resistance.
Impact Symposium on African Livestock Trypanosomiasis - see Engagement section Contributing to development of FAO international guidelines on trypanocide use and resistance - see Policy section
Start Year 2022
 
Description Symposium on African Livestock Trypanosomes leadership team 
Organisation University of Edinburgh
Department The Roslin Institute
Country United Kingdom 
Sector Academic/University 
PI Contribution Our project team worked with Dr Giuliano Cecchi from FAO to organise the Symposium on African Livestock Trypanosomiasis (see Engagement section). Our contribution was to seek and find funding, plan logistics, organise speakers, and generally coordinate the meeting.
Collaborator Contribution The role of FAO was to provide input on identifying speakers and participants, plan and organise a workshop during the meeting, to chair relevant sessions and to channel information to feed into the development of the FAO international guidelines on trypanocide use and resistance.
Impact Symposium on African Livestock Trypanosomiasis - see Engagement section Contributing to development of FAO international guidelines on trypanocide use and resistance - see Policy section
Start Year 2022
 
Description Trypanocide resistance collaborative team 
Organisation GALVmed
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Trypanocide resistance collaborative team 
Organisation Liverpool School of Tropical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Trypanocide resistance collaborative team 
Organisation National Institute for Medical Research, Tanzania
Country Tanzania, United Republic of 
Sector Public 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Trypanocide resistance collaborative team 
Organisation Tanzania Veterinary Laboratory Agency
Department Vector and Vector-borne Disease Institute
Country Tanzania, United Republic of 
Sector Public 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Trypanocide resistance collaborative team 
Organisation University of Edinburgh
Department The Roslin Institute
Country United Kingdom 
Sector Academic/University 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Trypanocide resistance collaborative team 
Organisation University of Glasgow
Department Institute of Infection, Immunity and Inflammation
Country United Kingdom 
Sector Academic/University 
PI Contribution Veterinary epidemiology; field project management; field team coordination and training; liaison with policy makers.
Collaborator Contribution University of Edinburgh: investigation of resistance mechanisms and markers University of Glasgow: investigation of resistance mechanisms and markers LSTM: provision of tsetse for assessment of fitness costs of resistance Galvmed: provision of information on current trypanocide quality, new drug development NIMR, Tanzania: testing of phenotypic resistance TVLA, Tanzania: field surveys for resistance in cattle and tsetse
Impact No outputs yet. Multi-disciplinary: veterinary epidemiology, molecular biology, parasitology, vector biology, antimicrobial resistance, mathematical modelling.
Start Year 2019
 
Description Animal trypanosomiasis research highlights video 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A video was created by the project team highlighting the challenges of African animal trypanosomiasis control. It is available on Youtube and has been promoted via University of Glasgow websites and as part of the World One Health Congress University of Glasgow hub site. It has been viewed over 3000 times.
Year(s) Of Engagement Activity 2020,2021
URL https://www.youtube.com/watch?v=ylejrW5eza4
 
Description Farmer engagement and trypanosomiasis control information sheet 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Study participants or study members
Results and Impact Using findings from the first part of our study on the reasons that trypanocidal treatments fail, we produced an information sheet for livestock keepers on trypanosomiasis control, with clear simple information to help them avoid the most common issues with trypanocide use. The information sheet was shared with all the farmers that participated in our study and distributed to livestock field officers in Serengeti District, where the research took place. In addition, the information sheet was presented and distributed at two workshops held in other parts of Tanzania, Pangani District and Simanjiro District, where it was shared with farmers and livestock field officers. The information sheet and associated presentation was very well received, and all three districts requested more copies of the sheet to distribute further. Multiple farmers said they would change their behaviour regarding trypanocide use now they better understood how to use trypanocides effectively.
Year(s) Of Engagement Activity 2022,2023
 
Description One Health journal club 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact One health journal club organised regularly with members of the project team in Tanzania as well as other Tanzanian One Health professionals and other international participants
Year(s) Of Engagement Activity 2021,2022,2023
 
Description One health teaching with school teachers in Kenya and Tanzania 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Workshops in Kenya and Tanzania with schools and school teachers, training teachers to be able to provide education to primary school children on zoonoses and One Health (not funded by the grant but conducted by the PDRA and provided opportunities to discuss relevant One Health examples). As a result, teaching on One Health included in curriculum.
Year(s) Of Engagement Activity 2021
 
Description Policy feedback meeting Tanzania 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact A national meeting was held in Tanzania to feedback project outcomes to those responsible for implementing control of Animal African Trypanosomiasis, such as representatives of the Ministry of Livestock and Fisheries, District Veterinary Officers, Commission for Science and Technology and Tanzania Livestock Research Institute. Feedback was well received and has helped to inform the finalisation of the Tanzania National Strategy for Human African Trypanosomiasis and Animal African Trypanosomiasis control.
Year(s) Of Engagement Activity 2023
 
Description Presentation to Tanzania Commission for Science and Technology 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Project progress was presented to the Tanzania Commission for Science and Technology, which is the organisation responsible for overseeing research in Tanzania and awarding permissions for international researchers. The presentation was positively received. Several aspects were highlighted as likely to be particularly valuable to other organisations and we were requested to provide further information to those organisations.
Year(s) Of Engagement Activity 2022
 
Description Press coverage associated with Symposium on African Livestock Trypanosomiasis 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact During the Symposium on African Livestock Trypanosomiasis held in Arusha, Tanzania in February 2023, several newspaper articles, radio interviews and TV interviews were broadcast about the symposium, involving members of the project team, in Tanzania national press and East African press. This provided an opportunity to talk about the challenge of trypanosomiasis and its control with the general public.
Year(s) Of Engagement Activity 2023
 
Description Symposium on African Livestock Trypanosomiasis 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The project team organised an international symposium focused on improving sustainable control of Animal African Trypanosomiasis. The symposium was held in Arusha, Tanzania over three days in February 2023. Around 115 participants from 18 countries attended, with the majority of participants from AAT-affected countries. Participants represented all aspects of trypanocide usage, including researchers (including lab, field and modelling), policy makers, those responsible for regulating trypanocide use, those involved in implementing disease control, funders, pharmaceutical companies and distributors. It was generally agreed that this meeting represented a turning point in improving AAT control. Many participants requested ongoing engagement and further meetings. Specific actions have been identified on a number of aspects covered in the meeting.
Year(s) Of Engagement Activity 2023