ArticlePLoS neglected tropical diseases2022
The effect of livestock density on Trypanosoma brucei gambiense and T. b. rhodesiense: A causal inference-based approach.
Article in PLoS neglected tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Interventions for Neglected Diseases Caused by Kinetoplastid Parasites: A One Health Approach to Drug Discovery, Development, and Deployment.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Development of a new wealth index for South Sudan: association between household wealth and malaria prevention practices in the context of seasonal malaria chemoprevention in Northern Bahr el Ghazal, South Sudan.Infectious diseases of poverty · 2025Article
- Targeting Cysteine Proteases and their Inhibitors to Combat Trypanosomiasis.Current medicinal chemistry · 2024Review
- Livestock, pathogens, vectors, and their environment: A causal inference-based approach to estimating the pathway-specific effect of livestock on human African trypanosomiasis risk.PLOS global public health · 2023Article
- Molecular Identification of Trypanosome Diversity in Domestic Animals Reveals the Presence ofPathogens (Basel, Switzerland) · 2022Article
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Authors and funding
10 authors at 4 institutions in 4 countries.
Funding
Abstract
Domestic and wild animals are important reservoirs of the rhodesiense form of human African trypanosomiasis (rHAT), however quantification of this effect offers utility for deploying non-medical control activities, and anticipating their success when wildlife are excluded. Further, the uncertain role of animal reservoirs-particularly pigs-threatens elimination of transmission (EOT) targets set for the gambiense form (gHAT). Using a new time series of high-resolution cattle and pig density maps, HAT surveillance data collated by the WHO Atlas of HAT, and methods drawn from causal inference and spatial epidemiology, we conducted a retrospective ecological cohort study in Uganda, Malawi, Democratic Republic of the Congo (DRC) and South Sudan to estimate the effect of cattle and pig density on HAT risk. For rHAT, we found a positive effect for cattle (RR 1.61, 95% CI 0.90, 2.99) and pigs (RR 2.07, 95% CI 1.15, 2.75) in Uganda, and a negative effect for cattle (RR 0.88, 95% CI 0.71, 1.10) and pigs (RR 0.42, 95% CI 0.23, 0.67) in Malawi. For gHAT we found a negative effect for cattle in Uganda (RR 0.88, 95% CI 0.50, 1.77) and South Sudan (RR 0.63, 95% CI 0.54, 0.77) but a positive effect in DRC (1.17, 95% CI 1.04, 1.32). For pigs, we found a positive gHAT effect in both Uganda (RR 2.02, 95% CI 0.87, 3.94) and DRC (RR 1.23, 95% CI 1.10, 1.37), and a negative association in South Sudan (RR 0.66, 95% CI 0.50, 0.98). These effects did not reach significance for the cattle-rHAT effect in Uganda or Malawi, or the cattle-gHAT and pig-gHAT effects in Uganda. While ecological bias may drive the findings in South Sudan, estimated E-values and simulation studies suggest unmeasured confounding and underreporting are unlikely to explain our findings in Malawi, Uganda, and DRC. Our results suggest cattle and pigs may be important reservoirs of rHAT in Uganda but not Malawi, and that pigs-and possibly cattle-may be gHAT reservoirs.
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