title: Revisiting zoonotic human African trypanosomiasis control in Uganda.
abstract: OBJECTIVE
  Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of zoonotic parasitic infections. Human African trypanosomiasis (HAT) control is particularly fraught with intricacies. The primarily zoonotic form, T.b. rhodesiense, and the non-zoonotic T.b. gambiense co-exist in Northern Uganda, leading to a potential geographic and genetic overlap of the two foci. This region also has the highest HIV prevalence in Uganda plus poor food security. We examine the bottlenecks facing the control program in a changed political and economic context.
  
  
  METHODS
  We searched the literature in July 2015 using three databases: MEDLINE, Google Scholar, and Web of Science.
  
  
  RESULTS
  Decentralized zoonotic HAT control for animal reservoirs and vectors compromise sustainability of the control programs. Human transmission potential may be underestimated in a region with other endemic diseases and where an HIV-HAT epidemic, could merge two strains.
  
  
  CONCLUSIONS
  Our comprehensive literature review concludes that enhanced collaboration is imperative not only between human and animal health specialists, but also with political science. Multi-sectorial collaborations may need to be nurtured within existing operational national HIV prevention frameworks, with an integrated surveillance framework.
authors.affiliation: International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium.|Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada H3A 1A2.
authors.forename: Sonia
authors.initials: S
authors.lastname: Menon
authors.affiliation: Rodolfo Rossi, LSHTM Alumnus, Beirut, Lebanon E-mail: rossirodolfo@yahoo.co.uk.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Rossi
authors.affiliation: Department of Social and Preventive Medicine Laval University-Faculty of Medicine, Quebec, Canada E-mail: Leon.Nshimyumukiza@fmed.ulaval.ca.
authors.forename: Leon
authors.initials: L
authors.lastname: Nshimyumukiza
authors.affiliation: Boston Children's Hospital, Harvard Medical School, Boston, USA E-mail: kate.zinszer@mail.mcgill.ca.
authors.forename: Kate
authors.initials: K
authors.lastname: Zinszer
mesh_terms: D000818:Animals; D015658:HIV Infections / Q000453:epidemiology; D063426:Human Migration; D006801:Humans; D014353:Trypanosomiasis, African / Q000453:epidemiology / Q000517:prevention & control*; D014454:Uganda / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology / Q000517:prevention & control*