Knowledge Attitude and Practices (KAPs) on Control of Bovine African Trypanosomosis in Pastoral Communities Surrounding Murchison Falls National Park, Uganda

Background: A survey was done among pastoral communities surrounding Murchison Falls National Park, Uganda to assess knowledge, attitude and practices about the control of bovine traypanosomosis. Methods: This was done using participatory methods and structured questionnaire. Results: The majority of the participants had ever seen tsetse ies and had ever heard about trypanosomosis with no signicant difference (P > 0.05) across the ve sub counties About 116 participants (73.9%) stated that trypanosomosis was a major disease in their area and across the ve sub counties signicant difference (P < 0.05) was observed. Farmers grazing near national parks and animals sharing grazing land and watering points with wild life respectively were considered the main causes of Bovine trypanosomosis. A signicant difference (P < 0.01) in knowledge of farmers about the causes and signs of trypanosomosis in the study sub counties was observed. There was a high signicant difference (P < 0.01) in control practices of trypanosomosis used in the study sub counties with the majority of farmers (58.6%) using insecticide treated cattle and signicantly differed across the sub counties. Conclusion: The majority of participants had ever heard/seen tsetse ies and had ever heard about Nagana. Grazing near national parks and animal sharing grazing land and watering points with wildlife were the main causes of trypanosomosis. Insecticide treated cattle and not grazing in areas infested with tsetse ies were the major control practices of trypanosomosis. Knowledge about the disease, farmers’ attitude and control practices have overtime contributed to the pastoral communities and their cattle developing the needed resilience for survival in this high risk area.


Background
Animal trypanosomosis are a major limitation for livestock production and a constraint to food security and livelihood contributing to huge economic losses to livestock industry by causing mortality of livestock, reduction in milk and weight gain, high control and treatment costs (Cox et al., 2010). Areas with high tsetse ies' presence and animal trypanosomosis prevalence limits the use of land for livestock production with farmers often reliant on only crop production. In addition, the disease affects crop production due to reduced traction power and production of manure as fertilizers (Kristjanson et al., 1999).
In sub Saharan Africa, it is projected that USD 4.75 billion is lost annually due to trypanosomosis (Van den Bossche et al., 2010).
Uganda has been one of the worst hit countries in Sub Saharan Africa with African trypanosomes accounting for over 50% of reported T.b rhodesiense cases between 2000 and 2009 (Holt et al., 2016). According to Coordinating O ce for Control of Trypanosomiasis in Uganda (COCTTU) about 70% of the whole country is estimated to be infested with tsetse ies (Albert et al., 2015). The 'tsetse belt' stretches from the highlands in South-western Uganda across Lake Kyoga through to north eastern Uganda. Areas around Murchison Falls National park occupied by pastoral communities are heavily infested by tsetse ies hence having high prevalence of trypanosomosis among their livestock. However controlling of bovine trypanosomiasis in this area has remained a challenge. It is against this back ground that this study was designed to understand cattle owners' attitudes, perceptions and practices in control of bovine trypanosomosis. This is critical in that locally sustainable adapted control program can be designed for this area. (Mwaseba & Kigoda, 2017a) (WHO, 2008), (Malulu et al., 2017).

Methods
Study area and population-

MAP OF UGANDA SHOWING THE STUDY DISTRICT
The study was conducted in Buliisa district located at (02 11 N 31 24 E) neighbouring Murchison Falls National Park. Buliisa was purposively selected as it is located in the cattle corridor and its proximity to Murchision Falls National Park.
Study design and sampling-A cross sectional survey was conducted from January 2020 to April 2020 using a pre tested questionnaire. Data was collected from 157 participants that were purposively selected. The selection criteria of study participants were being a cattle farmer. Through the regional tsetse control focal person, Bullisa district production o ce (DPO) and veterinary o ce (DVO) were approached and study objectives explained. The DVO contacted the sub county animal husbandry o cers (AHO) who identi ed the study participants. The study objectives were explained to AHO's and trained as research assistants. The questionnaire was pre tested and additional information generated and some questions were modi ed.
The questionnaire was translated from English into Runyoro by Makerere University Center for languages and communication services (CLCS).
Based on the estimated prevalence of 41% trypanosomiasis in Nwoya, (Angwech et al., 2015) a sample size of 157 was computed using the following formula Where n = sample size, Z = Z value at 95% con dence level, e = desired level of precision (8%), p = estimated proportion of an attribute that is present in the population, q = 100-p For precision 12 additional questionnaires were added to 145 calculated sample size adjusted to 157 study participants. Additional qualitative information was collected through two participatory methods; focus group discussion and key informant interviews using a check list of questions. Two focus group Page 4/19 discussion were organized composed of cattle farmers while three in-depth interviews with purposively selected key informants were conducted. The discussions and interviews collected information about factors that contribute to the emergency of trypanosomosis, the livestock species affected, the age and breed of livestock most susceptible, the clinical signs livestock exhibit; drugs used and at what dose, control practices used at the farms and if they were human cases of trypanosomosis. Qualitative Information from both focus group discussion and interviews was interpreted coded and organized into themes and patterns Data Management-Data was collected and collated from the questionnaire and observational check list. Data was then coded and entered into Excel and exported to SPPS software (IBM version 20). Descriptive statistics were generated and Chi-square test was used to identify the most signi cant factors associated with KAPs on controlling bovine trypanosomosis.

Results
Socio-demographic characteristics of participants. Communities' awareness and perception (attitude) about tsetse and bovine trypanosomosis Details of communities' awareness and perception (attitude) about tsetse and bovine trypanosomosis are shown in Table 2  Communities' knowledge about causes of Bovine trypanosomosis were presented in Table 3  Knowledge about transmission of bovine trypanosomosis is presented in Table 4  Communities' knowledge about signs and symptoms of Bovine trypanosomosis were presented in Table  5    Communities' practices on control of tsetse ies (Tables 9 and 10) Bush clearing  During focus group discussion and key informant interviews, factors reported that contributed to the emergency of trypanosomosis were tsetse ies biting their animals, grazing animals near or inside the game reserve and grazing their animals near forested areas. During wet seasons farmers reported an upsurge of tsetse y population compared to the dry season. Farmers reported that bigger ruminants were more susceptible to tsetse bites compared to small ruminants like goats and sheep. According to farmer, the clinical signs of bovine trypanosomosis exhibited included loss of appetite, emaciation, intermittent fevers, eyes producing tears and in calves the disease may cause death if not treated. The most common drugs used in treating suspected infected animals were Samorin (Isometamidium Chloride) and Berenil (Diminazene Aceturate). The most common practices used in herds was spraying animals using insecticide. The use of insecticide impregnated traps and targets in controlling the vector was not commonly used as a control strategy. During the discussion and interviews human cases of trypanosomosis were mentioned as a health challenge in Buliisa district.

Discussion
KAP studies are vital in identifying knowledge gaps, cultural beliefs and behavior patterns that may categorize needs, problems and barriers to help plan and implement interventions in communities. The results from such studies propose intervention strategy that re ect speci c local circumstances, the underlying cultural beliefs that in uence them, plan activities that are suited to the respective population.
From our study it is clearly evident that majority of farmers in Buliisa district (96.8%) had ever seen tsetse ies and about (91.7%) had ever heard about bovine trypanosomosis into their area with no signi cant difference (P = 0.610) among the study sub counties .These revelations indicated the magnitude of bovine trypanosomosis burden was a major constraint within the pastoral communities around MFNP to cattle productivity. The high proportions of study participants who had ever seen tsetse and had ever heard about bovine trypanosomosis were similar to ndings of from a study from Eastern Uganda by (Magona et al., 2004) in Tororo and Busia. The location of Buliisa in the cattle corridor, vegetation type, bordering a national park and water body and hosting a wildlife reserve are plausible reasons for the presence of tsetse ies which enhance trypanosomosis being a major cattle disease in this area. Wild animals especially wild ruminants, elephants and wild suids act as maintenance hosts of Glossina species, the anthropod vector that transmit trypanosomosis (Bengis et al., 2002) which accentuates the population of tsetse ies. Seasonal changes in uence the living conditions of different tsetse y species.
The Palpalis and Fusca tsetse y species survive well in moist conditions surrounded by woody vegetation while the moristan species thrive well in hot, dry conditions and during wet season they migrate into savanna woodland. In the dry season moristan species the live in vegetation near water bodies. Furthermore, seasonal change modi es the relative humidity, vegetation, temperature, light radiance which in uence the development and multiplication of the tsetse ies. (Sow, 2013). Farmers grazing near the national parks (60.5%) and animals sharing grazing land and watering points (19.1%) were reported as the main causes of bovine trypanosomosis in Buliisa district. Contrary to this nding, a study in Kenya (Machila et al., 2003) found that 44.1% of the respondents reported that tsetse ies were the main cause of trypanosomosis and 54% of the respondents did not know the cause of trypanosomosis The major signs of trypanosomosis identi ed by farmers differed signi cantly (P = 0.001) across the study counties. The clinical signs identi ed by the farmers focused mainly on the impaired animals' physiological processes and not on economic losses. Participants however did not link the signs of trypanosomosis to loss in milk production, mortality and other productivity indicators like decreased offtake and reduced calving rate as reported in several studies (Swallow, 2000) (Muhanguzi et al., 2014).
The reason for lack of connection between productivity indices and the clinical signs may be attributed to the multiple functions of cattle in pastoral communities which are beyond production of milk and beef.
The highly signi cant difference among the sub counties in interpreting disease signs could be attributed to the fact that farmers could at least associate one peculiar sign to presence of the disease in their herds.
The ability and precision to identify these visual signs depend on the experience of the farmers. Although respectively. These ndings are in contrast from a study in Tanzania by (Mwaseba & Kigoda, 2017b) which found that dipping was the major control method of trypanosomosis. Avoiding grazing cattle in risky areas can be rather a challenging strategy in pastoral setting especially where the land tenure system is communal. In the dry spell, pastures and watering points are limited thereby forcing herders to graze and water their animals in the same location shared by wildlife. During dry season tsetse ies especially the moristans species live in vegetation close to water points targeting both domestic and wild ruminants for blood meals (Hargrove, 2004).
A small proportion of cattle farmers (6.6%) reported using insecticide impregnated traps and targets and bush clearing (16.5%) as control practices of the tsetse vector. The tsetse population changes in time and space therefore cannot not effectively be monitored and disease management strategy based on tsetse population is di cult to implement.
The over dependence of farmers on using insecticide treated cattle as a major control strategy of bovine trypanosomosis could be attributable to a breakdown of the livestock extension and entomology community intervention programs that control the vector (tsetse) population that transmits the disease.
The most common treatment method of trypanosomosis is using curative trypanocides (68.8%) and followed by use of preventive trypanocides (15.9%) with a signi cant difference (P = 0.023) across the study sub counties Although both curative and prophylactic trypanocides are effective in treating and controlling trypanosomosis respectively, the choice to use curative trypanocides to treat suspected infected cattle can be attributed to the fact that fatality cases from trypanosomosis are not immediate. In addition, using prophylactic trypanocides can be expensive to the farmers since it involves treating the entire average herd of about 34 animals. Treating only suspected sick animals that have shown signs of the disease is a cheaper option in the shorter term for farmers.
The farmers' decision to administer treatment to their cattle was based on observation of clinical signs. A highly signi cant difference (P = 0.001) was observed among the study sub counties on information based on before administering treatment. The difference could be a result of the years of experience in cattle keeping and herd sizes. In smaller herd sizes farmers can easily use clinical signs correctly compared to in larger herd sizes. The longer the experience in cattle keeping the higher the chances to use clinical signs correctly as these are among the many factors that can contribute to control or persistence of animal trypanosomosis in a community as evidenced by (Wangoola et al., 2019) in a recent study covering Lango sub region of Uganda. The practice of using clinical signs before treatment further suggests that many seemingly healthy animals are left untreated. Without proper diagnosis of animals, it may result in treating wrong disease condition since there are other diseases that can present similar signs like bovine trypanosomosis such as East Coast Fever and Helminthiasis. The use of clinical signs may be attributed to lack of animal diagnostic facilities leading to failure in getting results in real time by farmers, the costs and expertise involved in collecting the blood samples from the animals and the long distances from the study area to places where laboratory services can be found. In addition, although rapid diagnostic tool (Very-Diag manufactured by Ceva Sante Animale Libourne France) is available, the tool is still not widely used by livestock farmers probably due to cost or unavailability of the technology in the study area. The practice of administering treatment of cattle against trypanosomosis without proper diagnosis can lead to misuse and abuse of trypanocides and cause resistance of trypanosome against the drug.

Conclusion
The majority of the participants were highly knowledgeable on the disease vector, the clinical signs, predisposing factors, and disease control measures. The attitude of participants about trypanosomosis was very positive with the majority had heard or seen tsetse, heard about Nagana and considered Nagana an