Following a joint call by TDR and WHO for research proposals in July 2022, four proposals were selected to address One Health implementation research priorities for vector-borne diseases (VBDs) in the context of climate change in Africa. Below we share details on one of the selected projects being conducted in Uganda and Kenya.
Makerere University, the University of Nairobi, Africa One Health University Network (AFROHUN) Uganda and the Kenya Medical Research Institute (KEMRI) are conducting research on “Strengthening Surveillance of Leishmaniasis in Uganda and Kenya through a Collaborative Multisectoral One Health Capacity Building Approach in Endemic foci.”
Leishmaniasis remains a neglected disease, and Uganda and Kenya still account for 15 percent of the cases. Visceral leishmaniasis (VL), which is the most serious form, is almost always fatal without treatment. Despite the number of interventions in the two countries, VL has remained endemic in rural communities. While cross-border migrations result in disease transmission in both Uganda and Kenya, there is limited collaboration across the two countries.
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Communities in Moroto (left) and Amudat (right) in Uganda presenting their dogs for active screening of Leishmania species parasite. Credit: Makerere University
According to the WHO bi-regional consultation for leishmaniasis control and surveillance in East Africa, key challenges leishmaniasis control programmes faced in Kenya-Uganda included: weak surveillance and reporting systems, limited skills among frontline workers, less or absent active screening and low community awareness among others. The problem is further worsened by limited vector control efforts, with almost no data available from animal sectors.
The study will identify leishmaniasis hotspots and decipher the risk and climate factors associated with the disease. This information will be utilized by country leishmaniasis control programmes to enhance surveillance and target interventions towards high-risk areas.
Multi-stakeholder consultative workshop and visit to VL treatment facilities
The project implementation phase was initiated on 31 May with a one-day multistakeholder consultative meeting organized by the project team to engage with key district stakeholders with a direct link to the control and management of leishmaniasis in Moroto and Amudat districts in Uganda. The purpose of this engagement was to present the project to the stakeholders and acquire feedback. This meeting emphasized the importance of leveraging political will to influence local people and help in sensitization and mobilization among the community members. It was also noted that cross-border meetings on VL had not taken place before.
Curriculum for a One Health course on leishmaniasis
To build capacity among frontline workers, a short One Health course on leishmaniasis has been developed. This course focuses on developing their knowledge, attitudes and skills to enhance effectiveness in the diagnosis, disease management, vector control and community engagement towards disease control and elimination.
Modules in this course include introduction to One Health and leishmaniasis; leishmaniasis surveillance; climate change and risk factors; stakeholder engagement and effective communication on disease control; and gender, risk analysis and control of leishmaniasis in the One Health context.
Sampling dogs for Leishmania parasites and sandfly trapping
The first round of field work for the project took place 5-13 August 2023, in Amudat and Moroto, Uganda. This included active screening of dog populations for the presence of Leishmania species. Along with trapping and studying the vector sandflies, dogs sampled were also de-wormed and vaccinated against rabies.
Picking blood from a dog during active screening for Leishmania species parasites in Moroto communities. Credit: Makerere University
All field work was carried out in collaboration with district officials, including the district veterinary and entomology team. The project team also trained the district entomology team on setting fly traps and vector collection for subsequent identification and storage.
This is the first time that animal data is being obtained for this particular region. Addressing such research gaps and the inter-exchange of knowledge and best practices will enable future research and establish communication channels to deliver long-term impact.
For more information, please contact Dr Corinne Merle.