title: Cost analysis of options for management of African Animal Trypanosomiasis using interventions targeted at cattle in Tororo District; south-eastern Uganda.
abstract: BACKGROUND
  Tsetse-transmitted African trypanosomes cause both nagana (African animal Trypanosomiasis-AAT) and sleeping sickness (human African Trypanosomiasis - HAT) across Sub-Saharan Africa. Vector control and chemotherapy are the contemporary methods of tsetse and trypanosomiasis control in this region. In most African countries, including Uganda, veterinary services have been decentralised and privatised. As a result, livestock keepers meet the costs of most of these services. To be sustainable, AAT control programs need to tailor tsetse control to the inelastic budgets of resource-poor small scale farmers. To guide the process of tsetse and AAT control toolkit selection, that now, more than ever before, needs to optimise resources, the costs of different tsetse and trypanosomiasis control options need to be determined.
  
  
  METHODS
  A detailed costing of the restricted application protocol (RAP) for African trypanosomiasis control in Tororo District was undertaken between June 2012 and December 2013. A full cost calculation approach was used; including all overheads, delivery costs, depreciation and netting out transfer payments to calculate the economic (societal) cost of the intervention. Calculations were undertaken in Microsoft Excel without incorporating probabilistic elements.
  
  
  RESULTS
  The cost of delivering RAP to the project was US$ 6.89 per animal per year while that of 4 doses of a curative trypanocide per animal per year was US$ 5.69. However, effective tsetse control does not require the application of RAP to all animals. Protecting cattle from trypanosome infections by spraying 25%, 50% or 75% of all cattle in a village costs US$ 1.72, 3.45 and 5.17 per animal per year respectively. Alternatively, a year of a single dose of curative or prophylactic trypanocide treatment plus 50% RAP would cost US$ 4.87 and US$ 5.23 per animal per year. Pyrethroid insecticides and trypanocides cost 22.4 and 39.1% of the cost of RAP and chemotherapy respectively.
  
  
  CONCLUSIONS
  Cost analyses of low cost tsetse control options should include full delivery costs since they constitute 77.6% of all project costs. The relatively low cost of RAP for AAT control and its collateral impact on tick control make it an attractive option for livestock management by smallholder livestock keepers.
authors.affiliation: Department of Biomolecular and Biolaboratory Sciences, School of Biosecurity, Biotechnical and Laboratory Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda. luckydenno@covab.mak.ac.ug.|Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. luckydenno@covab.mak.ac.ug.
authors.forename: Dennis
authors.initials: D
authors.lastname: Muhanguzi
authors.affiliation: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. waltokello@yahoo.com.
authors.forename: Walter O
authors.initials: WO
authors.lastname: Okello
authors.affiliation: Department of Biosecurity, Ecosystems & Veterinary Public Health, School of Biosecurity, Biotechnical and Laboratory Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda. kabasajd@covab.mak.ac.ug.
authors.forename: John D
authors.initials: JD
authors.lastname: Kabasa
authors.affiliation: Department of Pharmacy, Clinical and Comparative Medicine, School of Veterinary Medicine and Animal Resources, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda. cwaiswa@covab.mak.ac.ug.
authors.forename: Charles
authors.initials: C
authors.lastname: Waiswa
authors.affiliation: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. sue.welburn@ed.ac.uk.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Welburn
authors.affiliation: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. alex@apconsultants.co.uk.|Avia-GIS, Risschotlei 33, B-2980, Zoersel, Belgium. alex@apconsultants.co.uk.
authors.forename: Alexandra P M
authors.initials: AP
authors.lastname: Shaw
mesh_terms: D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000188:drug therapy / Q000191:economics* / Q000635:transmission; D003365:Costs and Cost Analysis; D007300:Insect Control / Q000191:economics / Q000379:methods; D007306:Insecticides / Q000494:pharmacology; D014344:Trypanocidal Agents / Q000008:administration & dosage / Q000191:economics; D014353:Trypanosomiasis, African / Q000188:drug therapy / Q000191:economics / Q000635:transmission / Q000662:veterinary*; D014370:Tsetse Flies / Q000187:drug effects / Q000502:physiology; D014454:Uganda
chemical_list: D007306:Insecticides; D014344:Trypanocidal Agents