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Skip to 0 minutes and 13 seconds ALBERT MUGENYI: I am Albert Mugenyi. I’m a graduate of University of Edinburgh. I did my PHD in the field of spatial epidemiology. I have been working on tsetse and trypanosomiasis issues for the last 15 years. And my major role as a spatial epidemiologist is to do data collection, data analysis, and modelling. We have challenges when it comes to control programmes. I’m more happy to mention that I have been involved in different control programmes. And at the different levels we get challenges. And some of those challenges are financial. Some of the challenges– because of lack of government initiatives to support the process by failing to provide the necessary manpower for continuity of the programme.

Skip to 1 minute and 18 seconds So if a programme is failing, it could be because the people who are working with the programme have been demotivated. Many times we fail to give them support in terms of all allowances, in terms of facilitation. Maybe motorcycles are broken down. Maybe the vehicle– the transport– has broken down. So if you fail to provide the necessary motivation, then that is going to have an impact on the programme. So what we do, normally, is to ensure that we provide the necessary support. And also, do regular field checkups and interactions with the field teams. Without interacting with a field teams, they will feel isolated. And many times, they may do the opposite.

Skip to 2 minutes and 14 seconds So if a programme– the control programme is failing– it is a just right that you catch up with it before implementing it as a government to ensure that you look at what is failing and support them to improve. We have cases– like I said, I’ve been involved in several– a couple of projects– and in many cases, we have one of the projects that has had a challenge. The project had been assembled to play– or to take off for about five years, but along the way, because of– I wouldn’t say mismanagement– but it’s an issue of change of priorities. So we had priorities that changed along the way. And that caused the donor, actually, to withdraw the funding.

Skip to 3 minutes and 19 seconds And because of withdrawal of the funding, then the project had to stall, and eventually had to end. Now, if I could expand on the gist of the matter around that failure– is that we had different options that had been put in the project design. And some of those designs were requiring a series of things to be done. Like for instance, aerial spraying for tsetse control. And also, Sterile Insect Technology, which was supposed to be done. Those were complicated and it required a lot of time. At the time of designing the project– once you do not underscore the time requirements and imagine that everything will happen as obvious as you think– then at a time of implementation, you lose out.

Skip to 4 minutes and 13 seconds So we could not do several things that were required for the aerial spraying. There were a lot of paperwork, a lot of clearances, that were not able to fit in the projects timelines. In that way, the donor had to cut half of the funding so that we were not able to implement the project as desired. That’s why, many times, we have now, time and again, thought that we should’ve consider community based interventions that can easily be adopted– that can easily be adopted with the minimal support. The greatest challenge that I look at in this field of vector control is partly the lack of adequate well-trained manpower to carry out the right research and the right applications that are required.

Skip to 5 minutes and 17 seconds The other challenge would be the– especially if you are talking about tsetse control– is the inaccessibility– the places which are tsetse infested which cannot be accessed. And they can only be accessed using the complicated methods like– complicated and costly– like aerial spraying. Now, if you’re using the traditional methods that we normally use, the control is faced with a challenge because there are places that will remain infested because we can’t access them. And in that way, the control efforts are really affected greatly. A typical example is our national parks. Our national parks are heavily infested with the tsetse flies. But these are areas which you cannot handle using the conventional methods like setting up traps, using live bait, and so on.

Skip to 6 minutes and 17 seconds So those remain as potential centres for re-invasion. So we have always wished to have an integrated vector control programme. And here, we mean, it could be in two ways. You could be chasing one enemy– like, for instance, you would be chasing one vector like the tsetse fly, and you use integrated methods. So you may choose to use the tsetse control traps like pyramidal traps, or biconical. Or you could choose to use the tiny targets. Or you could choose to use a live bait where you end up spraying the cattle with the acaricides which are acaricides will assist in destruction of the vector– in the case, you are talking of tsetse fly.

Skip to 7 minutes and 18 seconds Part B is another form of integration is the– in terms of combining efforts– to chase different vectors that are causing different diseases. So you could choose to conduct an operation that is going to handle mosquitoes, that is going to handle ticks, that’s going to handle tsetse. And in that integration you will have reduced the costs because it’s a joint effort. Resources will be shared. And you will be using one stone to kill several birds. So it is highly recommended that once you do an integration, in terms of what you are doing, you may end up, actually, solving more problems rather than focusing on a single problem.

Skip to 8 minutes and 12 seconds The field of spatial epidemiology helps us to look at the issue of all data in totality, in terms of how we use the data to shape our activities. Data is important for surveillance. Data is important for identifying what we need to do in order to improve our applications. So when you undertake spatial epidemiology, you will end up doing activities– or measuring activities– analysing data– that is going to assist you to look at different things. For instance, you could have a chunk of data that could be shared out, in terms of the reference points, in terms of malaria, in terms of sleeping sickness, in terms of nagana, and so on.

Skip to 9 minutes and 10 seconds So when you do data sharing, or when you do data collection, and you are able to share across board, then the methods of analysing that data can actually touch other diseases indirectly. And we emphasise that data should not be collected and only be left to one entity– that this is the tsetse data, and is for solving tsetse problems. Once you have that package of data, and you attach spatial epidemiological analysis, then we think the same data can be used to access this data can be used to addressing other problems rather than the focus of disease in mind. When you have multi agents of collaboration, or multinational, or multi– call it multi-effort collaboration, then you are likely to synergize.

Skip to 10 minutes and 11 seconds And synergy is important for reducing on the costs for implementing our activities. Synergy is important for learning approaches. Synergy is important for avoidance of duplication of efforts. So we have done this before and that’s why when we’re implementing activities in a– for instance, in one of our project areas– in West Nile– we are deploying traps– or call them targets– and at the same time, we end up taking activities for blood sampling, monitoring the health situation of the people, monitoring the health situation of the animals, as corroborated move toward the framework of vector control. So we have enjoyed this, and the we seem to be seeing a lot of good things happening, because of that multi-effort collaboration.

Experiences of vector control

We are now approaching the end of Week 2 of the Global Challenge of Vector Borne Diseases and How to Control Them. We have covered the fundamental principles of the WHO GVCR document. But how do these principles work in practice? In the first of two videos, we are joined by Dr Albert Mugenyi. Albert is the Research & Development Manager of the Coordinating Office for Control of Trypanosomiasis in Uganda (COCTU). In this interview, we will learn about his first-hand experiences of life and vector control in a disease endemic area.

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The Global Challenge of Vector Borne Diseases and How to Control Them

London School of Hygiene & Tropical Medicine