{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:39:03Z","timestamp":1791740343183,"version":"4.3.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["1017770"],"award-info":[{"award-number":["1017770"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1104516"],"award-info":[{"award-number":["OPP1104516"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1154033"],"award-info":[{"award-number":["OPP1154033"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-001785"],"award-info":[{"award-number":["INV-001785"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Parasites Vectors"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Riverine species of tsetse (\n                      <jats:italic>Glossina<\/jats:italic>\n                      ) transmit\n                      <jats:italic>Trypanosoma brucei gambiense<\/jats:italic>\n                      , which causes Gambian human African trypanosomiasis (gHAT), a neglected tropical disease. Uganda aims to eliminate gHAT as a public health problem through detection and treatment of human cases and vector control. The latter is being achieved through the deployment of \u2018Tiny Targets\u2019, insecticide-impregnated panels of material which attract and kill tsetse. We analysed the spatial and temporal distribution of cases of gHAT in Uganda during the period 2010\u20132019 to assess whether Tiny Targets have had an impact on disease incidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To quantify the deployment of Tiny Targets, we mapped the rivers and their associated watersheds in the intervention area. We then categorised each of these on a scale of 0\u20133 according to whether Tiny Targets were absent (0), present only in neighbouring watersheds (1), present in the watersheds but not all neighbours (2), or present in the watershed and all neighbours (3). We overlaid all cases that were diagnosed between 2000 and 2020 and assessed whether the probability of finding cases in a watershed changed following the deployment of targets. We also estimated the number of cases averted through tsetse control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that following the deployment of Tiny Targets in a watershed, there were fewer cases of HAT, with a sampled error probability of 0.007. We estimate that during the intervention period 2012\u20132019 we should have expected 48 cases (95% confidence intervals\u2009=\u200940\u201357) compared to the 36 cases observed. The results are robust to a range of sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tiny Targets have reduced the incidence of gHAT by 25% in north-western Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13071-021-04889-x","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T05:02:59Z","timestamp":1629262979000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Estimating the impact of Tiny Targets in reducing the incidence of Gambian sleeping sickness in the North-west Uganda focus"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7901-969X","authenticated-orcid":false,"given":"Paul R.","family":"Bessell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Esterhuizen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Lehane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Longbottom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Mugenyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Selby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inaki","family":"Tirados","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve J.","family":"Torr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Waiswa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Wamboga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"4889_CR1","doi-asserted-by":"publisher","first-page":"e0008261","DOI":"10.1371\/journal.pntd.0008261","volume":"14","author":"JR Franco","year":"2020","unstructured":"Franco JR, Cecchi G, Priotto G, Paone M, Diarra A, Grout L, et al. Monitoring the elimination of human African trypanosomiasis at continental and country level: update to 2018. PLoS Negl Trop Dis. 2020;14:e0008261.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR2","first-page":"223","volume":"6","author":"L Berrang-Ford","year":"2006","unstructured":"Berrang-Ford L, Odiit M, Maiso F, Waltner-Toews D, McDermott J. Sleeping sickness in Uganda: revisiting current and historical distributions. Afr Health Sci. 2006;6:223\u201331.","journal-title":"Afr Health Sci"},{"key":"4889_CR3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1756-3305-1-3","volume":"1","author":"D Steverding","year":"2008","unstructured":"Steverding D. The history of African trypanosomiasis. Parasit Vectors. 2008;1:3.","journal-title":"Parasit Vectors"},{"key":"4889_CR4","doi-asserted-by":"publisher","first-page":"e0005585","DOI":"10.1371\/journal.pntd.0005585","volume":"11","author":"JR Franco","year":"2017","unstructured":"Franco JR, Cecchi G, Priotto G, Paone M, Diarra A, Grout L, et al. Monitoring the elimination of human African trypanosomiasis: update to 2014. PLoS Negl Trop Dis. 2017;11:e0005585.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR5","volume-title":"Report of a WHO meeting on elimination of African trypanosomiasis (Trypanosoma brucei gambiense)","author":"WHO","year":"2010","unstructured":"WHO. Report of a WHO meeting on elimination of African trypanosomiasis (Trypanosoma brucei gambiense). Geneva: WHO; 2010."},{"key":"4889_CR6","doi-asserted-by":"publisher","first-page":"e0204335","DOI":"10.1371\/journal.pone.0204335","volume":"13","author":"PR Bessell","year":"2018","unstructured":"Bessell PR, Lumbala C, Lutumba P, Baloji S, Bi\u00e9ler S, Ndung\u2019u JM. Cost-effectiveness of using a rapid diagnostic test to screen for human African trypanosomiasis in the Democratic Republic of the Congo. PLoS ONE. 2018;13:e0204335.","journal-title":"PLoS ONE"},{"key":"4889_CR7","doi-asserted-by":"publisher","first-page":"e0186429","DOI":"10.1371\/journal.pone.0186429","volume":"12","author":"C Wamboga","year":"2017","unstructured":"Wamboga C, Matovu E, Bessell PR, Picado A, Bi\u00e9ler S, Ndung\u2019u JM. Enhanced passive screening and diagnosis for gambiense human African trypanosomiasis in north-western Uganda\u2014moving towards elimination. PLoS ONE. 2017;12:e0186429.","journal-title":"PLoS ONE"},{"key":"4889_CR8","doi-asserted-by":"publisher","first-page":"e0004437","DOI":"10.1371\/journal.pntd.0004437","volume":"10","author":"M Lehane","year":"2016","unstructured":"Lehane M, Alfaroukh I, Bucheton B, Camara M, Harris A, Kaba D, et al. Tsetse control and the elimination of Gambian sleeping sickness. PLoS Negl Trop Dis. 2016;10:e0004437.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR9","doi-asserted-by":"publisher","first-page":"e0003822","DOI":"10.1371\/journal.pntd.0003822","volume":"9","author":"I Tirados","year":"2015","unstructured":"Tirados I, Esterhuizen J, Kovacic V, Mangwiro TNC, Vale GA, Hastings I, et al. Tsetse control and Gambian sleeping sickness; implications for control strategy. PLoS Negl Trop Dis. 2015;9:e0003822.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR10","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3389\/fcimb.2013.00033","volume":"3","author":"P Solano","year":"2013","unstructured":"Solano P, Torr SJ, Lehane MJ. Is vector control needed to eliminate gambiense human African trypanosomiasis? Front Cell Infect Microbiol. 2013;3:33.","journal-title":"Front Cell Infect Microbiol"},{"key":"4889_CR11","doi-asserted-by":"publisher","first-page":"e0003624","DOI":"10.1371\/journal.pntd.0003624","volume":"9","author":"APM Shaw","year":"2015","unstructured":"Shaw APM, Tirados I, Mangwiro CTN, Esterhuizen J, Lehane MJ, Torr SJ, et al. Costs of using \u201ctiny targets\u201d; to control Glossina fuscipes fuscipes, a vector of gambiense sleeping sickness in Arua district of Uganda. PLoS Negl Trop Dis. 2015;9:e0003624.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR12","doi-asserted-by":"publisher","first-page":"e0005792","DOI":"10.1371\/journal.pntd.0005792","volume":"11","author":"MH Mahamat","year":"2017","unstructured":"Mahamat MH, Peka M, Rayaisse JB, Rock KS, Toko MA, Darnas J, et al. Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad). PLoS Negl Trop Dis. 2017;11:e0005792.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR13","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1186\/s13071-020-04286-w","volume":"13","author":"JB Rayaisse","year":"2020","unstructured":"Rayaisse JB, Courtin F, Mahamat MH, Ch\u00e9rif M, Yoni W, Gadjibet NMO, et al. Delivering \u201ctiny targets\u201d in a remote region of southern Chad: a cost analysis of tsetse control in the Mandoul sleeping sickness focus. Parasit Vectors. 2020;13:419.","journal-title":"Parasit Vectors"},{"key":"4889_CR14","doi-asserted-by":"publisher","first-page":"103963","DOI":"10.1016\/j.meegid.2019.103963","volume":"75","author":"D Bert\u00e9","year":"2019","unstructured":"Bert\u00e9 D, De Mee\u00fbs T, Kaba D, S\u00e9r\u00e9 M, Djohan V, Courtin F, et al. Population genetics of Glossina palpalis palpalis in sleeping sickness foci of C\u00f4te d\u2019Ivoire before and after vector control. Infect Genet Evol. 2019;75:103963.","journal-title":"Infect Genet Evol"},{"key":"4889_CR15","doi-asserted-by":"publisher","first-page":"e0008270","DOI":"10.1371\/journal.pntd.0008270","volume":"14","author":"I Tirados","year":"2020","unstructured":"Tirados I, Hope A, Selby R, Mpembele F, Miaka EM, Boelaert M, et al. Impact of tiny targets on Glossina fuscipes quanzensis, the primary vector of human African trypanosomiasis in the Democratic Republic of the Congo. PLoS Negl Trop Dis. 2020;14:e0008270.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR16","doi-asserted-by":"publisher","first-page":"e0003727","DOI":"10.1371\/journal.pntd.0003727","volume":"9","author":"F Courtin","year":"2015","unstructured":"Courtin F, Camara M, Rayaisse J-B, Kagbadouno M, Dama E, Camara O, et al. Reducing human-tsetse contact significantly enhances the efficacy of sleeping sickness active screening campaigns: a promising result in the context of elimination. PLoS Negl Trop Dis. 2015;9:e0003727.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR17","doi-asserted-by":"publisher","unstructured":"Kagabadouno M, Camara O, Camara M, Ilboudo H, Camara M, Rayaisse J-B, et al. Ebola outbreak brings to light an unforeseen impact of tsetse control on sleeping sickness transmission in Guinea. bioRxiv. 2018;202762.https:\/\/doi.org\/10.1101\/202762.","DOI":"10.1101\/202762"},{"key":"4889_CR18","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1186\/s13071-015-1131-8","volume":"8","author":"KS Rock","year":"2015","unstructured":"Rock KS, Torr SJ, Lumbala C, Keeling MJ. Quantitative evaluation of the strategy to eliminate human African trypanosomiasis in the Democratic Republic of Congo. Parasit Vectors. 2015;8:532.","journal-title":"Parasit Vectors"},{"key":"4889_CR19","doi-asserted-by":"publisher","first-page":"e0008738","DOI":"10.1371\/journal.pntd.0008738","volume":"14","author":"JM Ndungu","year":"2020","unstructured":"Ndungu JM, Boulang\u00e9 A, Picado A, Mugenyi A, Mortensen A, Hope A, et al. Trypa-NO! contributes to the elimination of gambiense human African trypanosomiasis by combining tsetse control with \u201cscreen, diagnose and treat\u201d using innovative tools and strategies. PLoS Negl Trop Dis. 2020;14:e0008738.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR20","doi-asserted-by":"publisher","DOI":"10.1029\/2005RG000183","author":"TG Farr","year":"2007","unstructured":"Farr TG, Rosen PA, Caro E, Crippen R, Duren R, Hensley S, et al. The shuttle radar topography mission. Rev Geophys. 2007. https:\/\/doi.org\/10.1029\/2005RG000183.","journal-title":"Rev Geophys"},{"key":"4889_CR21","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1029\/2008EO100001","volume":"89","author":"B Lehner","year":"2008","unstructured":"Lehner B, Verdin K, Jarvis A. New global hydrography derived from spaceborne elevation data. Eos Trans Am Geophys Union. 2008;89:93\u20134.","journal-title":"Eos Trans Am Geophys Union"},{"key":"4889_CR22","first-page":"1064","volume-title":"Geomorphology","author":"AE Scheidegger","year":"1997","unstructured":"Scheidegger AE. Stream orders. In: Geomorphology. Springer: Berlin; 1997. p. 1064\u20136."},{"key":"4889_CR23","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/1476-072X-9-57","volume":"9","author":"PP Simarro","year":"2010","unstructured":"Simarro PP, Cecchi G, Paone M, Franco JR, Diarra A, Ruiz JA, et al. The atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases. Int J Health Geogr. 2010;9:57.","journal-title":"Int J Health Geogr"},{"key":"4889_CR24","doi-asserted-by":"publisher","first-page":"e0003785","DOI":"10.1371\/journal.pntd.0003785","volume":"9","author":"PP Simarro","year":"2015","unstructured":"Simarro PP, Cecchi G, Franco JR, Paone M, Diarra A, Priotto G, et al. Monitoring the progress towards the elimination of gambiense human African trypanosomiasis. PLoS Negl Trop Dis. 2015;9:e0003785.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR25","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1471-2334-8-16","volume":"8","author":"F Checchi","year":"2008","unstructured":"Checchi F, Filipe JAN, Haydon DT, Chandramohan D, Chappuis F. Estimates of the duration of the early and late stage of gambiense sleeping sickness. BMC Infect Dis. 2008;8:16.","journal-title":"BMC Infect Dis"},{"key":"4889_CR26","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2019","unstructured":"R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2019."},{"key":"4889_CR27","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/1756-3305-5-157","volume":"5","author":"F Checchi","year":"2012","unstructured":"Checchi F, Cox AP, Chappuis F, Priotto G, Chandramohan D, Haydon DT. Prevalence and under-detection of gambiense human African trypanosomiasis during mass screening sessions in Uganda and Sudan. Parasit Vectors. 2012;5:157.","journal-title":"Parasit Vectors"},{"key":"4889_CR28","doi-asserted-by":"publisher","first-page":"e0008779","DOI":"10.1371\/journal.pntd.0008779","volume":"14","author":"C Lumbala","year":"2020","unstructured":"Lumbala C, Kayembe S, Makabuza J, Lutumba P, Van Geertruyden J-P, Bessell PR, et al. Development and implementation of a strategy for intensified screening for gambiense human African trypanosomiasis in Kongo Central province. DRC PLoS Negl Trop Dis. 2020;14:e0008779.","journal-title":"DRC. PLoS Negl Trop Dis"},{"key":"4889_CR29","doi-asserted-by":"publisher","first-page":"e0007550","DOI":"10.1371\/journal.pntd.0007550","volume":"13","author":"R Selby","year":"2019","unstructured":"Selby R, Wamboga C, Erphas O, Mugenyi A, Jamonneau V, Waiswa C, et al. Gambian human African trypanosomiasis in north west Uganda. Are we on course for the 2020 target? PLoS Negl Trop Dis. 2019;13:e0007550.","journal-title":"PLoS Negl Trop Dis"},{"key":"4889_CR30","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.pt.2017.11.008","volume":"34","author":"P B\u00fcscher","year":"2018","unstructured":"B\u00fcscher P, Bart J-M, Boelaert M, Bucheton B, Cecchi G, Chitnis N, et al. Do cryptic reservoirs threaten gambiense-sleeping sickness elimination? Trends Parasitol. 2018;34:197\u2013207.","journal-title":"Trends Parasitol"},{"key":"4889_CR31","doi-asserted-by":"publisher","unstructured":"Antillon M, Huang C-I, Rock KS, Tediosi F. Economic evaluation of disease elimination: an extension to the net-benefit framework and application to human African trypanosomiasis. medRxiv. 2021. https:\/\/doi.org\/10.1101\/2021.02.10.20181974.","DOI":"10.1101\/2021.02.10.20181974"},{"key":"4889_CR32","doi-asserted-by":"publisher","unstructured":"Antillon M, Huang C-I, Crump RE, Brown PE, Sn\u0133ders R, Miaka EM, et al. Cost-effectiveness of sleeping sickness elimination campaigns in five settings of the Democratic Republic of Congo. medRxiv. 2021. https:\/\/doi.org\/10.1101\/2020.08.25.20181982.","DOI":"10.1101\/2020.08.25.20181982"}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04889-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13071-021-04889-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04889-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T05:08:46Z","timestamp":1629263326000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/s13071-021-04889-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,18]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4889"],"URL":"https:\/\/doi.org\/10.1186\/s13071-021-04889-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-362729\/v1","asserted-by":"object"}]},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,18]]},"assertion":[{"value":"29 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"410"}}