Factors In Emergence of New Sleeping Sickness Foci In Uganda

描述(申请人提供)：乌干达是非洲唯一存在两种形式的人类非洲锥虫病(HAT)的国家；西北部存在慢性冈比亚病，东南部存在急性罗得森病。最近有报道称，HAT最近从东南部的传统疫区扩大到乌干达中部以前没有疾病的新领土。乌干达中部两个疾病带的可能合并将造成重大公共卫生危机，因为这两种疾病在诊断和治疗方面存在差异。该中心将调查导致乌干达中部最近疫源地扩大的因素，以便能够采取有效的控制方法。拟议的研究以GRANT(NIAID R01Al068932)的研究结果为基础，GRANT分别在乌干达的罗德塞斯和冈比亚疫源地研究了Glossina F.fuscipes(GFF)的分子生态学和进化遗传学方面的问题。亲本资助结果表明，西北部冈比亚疫源地的采采子种群与东南部罗得西亚疫源地的采采树种群在遗传上高度分化。在这里，我们将调查GFF苍蝇是否从历史上存在HAT疫区的东南部地区扩散，传播目前在乌干达中部出现的罗德希恩斯病。此外，我们将调查第二种媒介物种的存在是否通过增强HAT的动物储存库来促进罗得志病流行的维持。这项调查的结果将立即与乌干达正在进行的病媒控制计划有关。这项提议还将在乌干达托罗罗的国家牲畜资源研究所进行大量的HAT流行病学理论和实验方法方面的能力建设，大部分工作将在那里进行。 公共卫生意义：采采病传播的人类昏睡病是撒哈拉以南地区的一种致命疾病；自1980年代末以来，这种疾病在乌干达东南部重新出现。在乌干达中部以前没有疾病的地区，疾病扩展到新的疫源地令人震惊。这里提出的研究将调查HAT的出现，特别是将重点放在苍蝇的活动和采采蝇物种分布作为了解乌干达疾病流行病学的潜在因素。

DESCRIPTION (provided by applicant): Uganda is the only country in Africa where both forms of the Human African Trypanosomiasis (HAT) disease exist; chronic gambiense disease in the northwest and acute rhodesiense disease in the southeast. Recent expansions of HAT from the traditional foci in the southeast to new territories in central Uganda, which previously were disease-free, have recently been reported. Possible merger of the two disease belts in central Uganda would create a major public health crisis given the differences in diagnostics and treatment associated with the two forms of disease. This FIRCA will investigate the factors contributing to the recent expansion of disease foci in central Uganda so that effective control methods can be implemented. The proposed studies build on the findings of the Parent Grant (NIAID R01Al068932), which addresses the molecular ecology and evolutionary genetics aspect of Glossina f. fuscipes (Gff) in the rhodesiense and gambiense foci in Uganda, respectively. Parent grant results have shown that tsetse populations in the gambiense foci in the northwest are genetically highly differentiated from the rhodesiense foci in the SE. Here we will investigate whether Gff flies expanding from southeast areas, where historical HAT foci exist, transmit rhodesiense disease now emerging in central Uganda. In addition, we will investigate whether the presence of a second vector species, Glossina pallidipes, may be fueling the maintenance of rhodesiense epidemics by enhancing the animal reservoirs of HAT. Results from this investigation will immediately be relevant for the ongoing vector control program in Uganda. This proposal will also result in significant capacity building both in theory and experimental methods on HAT epidemiology at National Livestock Resources Institute in Tororo Uganda, where the majority of the work will be performed. PUBLIC HEALTH RELEVANCE: Human sleeping sickness transmitted by tsetse is a fatal disease in sub-Sahara; HAT has reemerged in south-eastern Uganda since late 1980s. Expansion of disease into new foci in previously disease free areas of central Uganda is alarming. Studies proposed here will investigate HAT emergence and specifically will focus on fly movements and tsetse species distribution as potential factors to understand disease epidemiology in Uganda.