Experiences in participatory surveillance and community-based reporting systems for H5N1 highly pathogenic avian influenza: a case study approach

Preventive, safety and control measures against Avian Influenza A(H5N1) in occupationally exposed groups: A scoping review

Introduction

During the outbreak of avian influenza, A (H5N1) (IA) in wild and domestic birds recorded in January 2023, the epidemiological alert has been extended due to its potential contagion to humans, particularly in those exposed occupational groups.

Objective

to identify the primary occupational risk groups, as well as the preventive, safety, and control measures against IA intended or implemented in these positions.

Material and methods

A systematic search was conducted in Pubmed, Scopus, Web of science, Scielo and literature databases. Scientific articles, normative documents, and technical reports identifying vulnerable occupational groups and preventive measures against IA were included. Two authors conducted a full-text review, extracting information independently, and findings were summarized narratively.

Results

A total of 5518 documents were identified, and 30 reports were included. 20% of the reports were published in 2023, 13/30 were affiliated to a university institution. Occupationally exposed groups were identified both directly and indirectly. 63.3% of reports identified breeders, poultry farmers and sellers as the most concerning occupational group, while 60% identified biosecurity practices (use of PPE, handwashing) as the primary measure against IA, followed by strategies such as education (training and capacity-building).

Conclusion

Occupational groups of interest were identified, primarily those involved in sales, commerce, and the handling of bird waste with potential exposure to IA. Furthermore, the maintenance of biosecurity measures, cleaning-disinfection practices, and educational strategies in workplace settings are recommended.

An experimental game to assess hunter's participation in zoonotic diseases surveillance

BACKGROUND

Strengthening the surveillance of zoonotic diseases emergence in the wild meat value chains is a critical component of the prevention of future health crises. Community hunters could act as first-line observers in zoonotic pathogens surveillance systems in wildlife, by reporting early signs of the possible presence of a disease in the game animals they observe and manipulate on a regular basis.

METHODS

An experimental game was developed and implemented in a forested area of Gabon, in central Africa. Our objective was to improve our understanding of community hunters' decision-making when finding signs of zoonotic diseases in game animals: would they report or dissimulate these findings to a health agency? 88 hunters, divided into 9 groups of 5 to 13 participants, participated in the game, which was run over 21 rounds. In each round the players participated in a simulated hunting trip during which they had a chance of capturing a wild animal displaying clinical signs of a zoonotic disease. When signs were visible, players had to decide whether to sell/consume the animal or to report it. The last option implied a lowered revenue from the hunt but an increased probability of early detection of zoonotic diseases with benefits for the entire group of hunters.

RESULTS

The results showed that false alerts-i.e. a suspect case not caused by a zoonotic disease-led to a decrease in the number of reports in the next round (Odds Ratio [OR]: 0.46, 95% Confidence Interval [CI]: 0.36-0.8, p < 0.01). Hunters who had an agricultural activity in addition to hunting reported suspect cases more often than others (OR: 2.05, 95% CI: 1.09-3.88, p < 0.03). The number of suspect case reports increased with the rank of the game round (Incremental OR: 1.11, CI: 1.06-1.17, p < 0.01) suggesting an increase in participants' inclination to report throughout the game.

CONCLUSION

Using experimental games presents an added value for improving the understanding of people's decisions to participate in health surveillance systems.

The influence of trust and social identity in farmers' intentions to report suspected emergency disease outbreaks

This study examines the influence of trust on farmers' intentions to report suspected disease on their farm. Disease reporting is essential to detect and respond to disease early, thereby minimising its impacts on agriculture businesses, the economy, and the environment. Trust has been identified as an important factor influencing farmers' disease reporting intentions but has not been quantitatively investigated. We use an established model of trust-the Integrative Model of Organisational Trust (IMOT)-to conceptualise how trust influences disease reporting intentions. We also examine how social identity is related to trust and disease reporting. Australian plant, livestock, and aquaculture farmers (N = 41) completed an online questionnaire developed from existing validated measures and we also developed two new measures for disease reporting intentions. Trust in government positively and significantly predicted farmer intentions to report suspected disease outbreaks, explaining 26% of the variance. For every one-unit increase in trust, disease reporting intentions increased by over four times. Results also support the role of shared values and group membership as aspects of social identity that influence trust and disease reporting. These results highlight the importance of government decision-makers developing and maintaining trust with farmers to support early detection and response to emergency disease outbreaks.

Research and Innovation Opportunities to Improve Epidemiological Knowledge and Control of Environmentally Driven Zoonoses

While zoonotic diseases are defined by transmission processes between animals and humans, for many of these diseases the presence of a contaminated environmental source is the cause of transmission. Most zoonoses depend on complex environmentally driven interactions between humans and animals, which occur along an occupational and recreational environmental continuum, including farming and animal marketing systems, environmental management systems, and community leisure environments. Environmentally driven zoonoses (EDZs) are particularly challenging to diagnose and control as their reservoirs are in the natural environment and thus often escape conventional surveillance systems that rely on host monitoring. Changes in the environment as a result of climate change [1], human population density [2], and intensification of agriculture [3] have been linked to increasing transmission events for this group of infections. As such, there is a recognised need to be able to detect the presence of EDZs in the environment as a means to better anticipate transmission events and improve source attribution investigations. Finally, the recognition that a One Health approach is needed to combat these infections is signalling to governments the need to develop policy that optimises trade-offs across human, animal, and environmental health sectors. In this review, we discuss and critically appraise the main challenges relating to the epidemiology, diagnosis, and control of environmental zoonotic disease. Using a set of exemplar diseases, including avian influenza and antimicrobial resistant pathogens, we explore the epidemiological contexts (risk factors) within which these infections not only impact human health but also contribute to animal health and environmental impacts. We then critically appraise the surveillance challenges of monitoring these infections in the environment and examine the policy trade-offs for a more integrated approach to mitigating their impacts.

Risk Factors for Positivity to Shiga Toxin-Producing Escherichia coli and Salmonella enterica in Backyard Production Systems Animals from Metropolitana Region, Chile: A Threat to Public Health?

In the Metropolitana region of Chile there are 3836 backyard production systems (BPS), characterized as small-scale systems. They act as a source of zoonotic pathogens, such as Salmonella enterica and Shiga toxin-producing Escherichia coli (STEC), whose prevalence in BPS has not been fully described. The objective of this study was to determine the positivity for both agents in BPS and to establish the risk factors related to their presence. In each BPS, an epidemiological survey was undertaken, and stool samples were collected to detect these pathogens via bacteriological culture and conventional PCR techniques. Subsequently, multivariable logistic regression models were applied to establish the risk factors associated with their presence. BPS positivity rates of 11.76% for STEC and 4.7% for S. enterica were observed. The systems showed poor welfare standards and a lack of biosecurity measures. The risk factor analysis concluded that the Gini-Simpson index (p = 0.030; OR = 1.717) and the presence of neighboring intensive poultry or swine production systems (p = 0.019; OR = 20.645) act as factors that increased the risk of positivity with respect to STEC. In the case of S. enterica, exchanging embryonated eggs (p = 0.021; OR = 39) and the presence of debeaked chickens (p = 0.001; OR = 156) were determined as factors that increased the risk of positivity for this agent. For positivity with respect to both pathogens, the Gini-Simpson index (p = 0.030; OR = 1.544) and being INDAP/PRODESAL users (p = 0.023; OR = 15.026) were determined as factors that increased the risk, whereas the type of confinement (p = 0.002; OR = 0.019) decreased it. Epidemiological surveillance of these neglected populations is lacking, highlighting the fact that STEC and S. enterica maintenance on BPS represents a potential threat to public health.

Factors influencing the performance of voluntary farmer disease reporting in passive surveillance systems: A scoping review

The impacts of exotic disease incursions on livestock industries can be mitigated by having robust surveillance systems in place that decrease the time between disease introduction and detection. An important component of this is having farmers routinely observe their animals for indications of clinical disease, recognise the existence of problems, and then decide to notify their veterinarian or animal health authorities. However, as highlighted by this literature review, farmers are believed to be underreporting clinical events due to factors such as (1) uncertainty around the clinical signs and situations that warrant reporting, (2) fear over the social and economic consequences from both positive and false positive reports, (3) negative beliefs regarding the efficacy and outcomes of response measures, (4) mistrust and dissatisfaction with animal health authorities, (5) absence of sufficiently attractive financial and non-financial incentives for submitting reports, and (6) poor awareness of the procedures involved with the submission, processing, and response to reports. There have been few formal studies evaluating the efficacy of different approaches to increasing farmer engagement with disease reporting. However, there is a recognised need for any proposed solutions to account for farmer knowledge and experience with assessing their own farm situation as well as the different identities, motivations, and beliefs that farmers have about their role in animal health surveillance systems. Empowering farmers to take a more active role in developing these solutions is likely to become even more important as animal health authorities increasingly look to establish public-private partnerships for biosecurity governance.

Live and Wet Markets: Food Access versus the Risk of Disease Emergence

Emerging zoonotic diseases exert a significant burden on human health and have considerable socioeconomic impact worldwide. In Asia, live animals as well as animal products are commonly sold in informal markets. The interaction of humans, live domestic animals for sale, food products, and wild and scavenging animals, creates a risk for emerging infectious diseases. Such markets have been in the spotlight as sources of zoonotic viruses, for example, avian influenza viruses and coronaviruses, Here, we bring data together on the global impact of live and wet markets on the emergence of zoonotic diseases. We discuss how benefits can be maximized and risks minimized and conclude that current regulations should be implemented or revised, to mitigate the risk of new diseases emerging in the future.

A Comparison of Perceptions of Estonian and Latvian Hunters With Regard to the Control of African Swine Fever

Since the first detected African swine fever (ASF) cases in Lithuanian wild boar in 2014, the virus has occurred in many other member states of the European Union (EU), most recently in Belgium in 2018 and in Germany in 2020. Passive surveillance and various control measures are implemented as part of the strategy to stop disease spread in the wild boar population. Within this framework, hunters perform important activities, such as the removal of carcasses, fencing or hunting. Therefore, the successful implementation of these measures largely depends on their acceptability by hunters. Methods of participatory epidemiology can be used to determine the acceptance of control measures. The use of participatory methods allows the involvement of key stakeholders in the design, the implementation and the analysis of control and surveillance activities. In the present study, two studies that had been conducted using participatory epidemiology with hunters in Estonia and Latvia were compared on the topics recruitment, participants, facilitators, focus group discussion (FGDs) and their contents. The aim was to evaluate similarities and differences in the two studies and to identify a broader spectrum of possibilities to increase the willingness of hunters supporting the fight against ASF. Evaluating all conducted FGDs in both countries showed primarily similarities in the perceptions and opinions of the hunters in Estonia and Latvia. One notable difference was that passive surveillance in Latvia was perceived mostly as topic of duty and ethics rather than an issue driven by incentives. Participatory methods have proven to be an effective tool in the evaluation of the acceptance of established ASF control systems. The results of this study point out further chances for improving the cooperation with hunters in the future. Nevertheless, the importance of gathering and analyzing the opinions of hunters in all ASF affected countries individually is highlighted.

Hunters' view on the control of African swine fever in wild boar. A participatory study in Latvia

African swine fever (ASF) has massively spread in recent years and threatens the global pig industry. ASF has been present in Latvia since 2014. Hunters play a major role in the implementation of measures to control ASF and in passive disease surveillance. The probability to detect an ASF-positive wild boar is much higher in animals found dead than in hunted animals. Thus, the willingness and the motivation of hunters to support passive surveillance is of utmost importance. Using participatory methods, this study aimed to assess the acceptability of control measures for ASF in wild boar among hunters. In addition, new approaches to increase hunters' motivation to report wild boar found dead were investigated. A total of ten focus group discussions with hunters from different regions in Latvia were conducted. To assess the quantity and quality of contacts between hunters and stakeholders involved in the control of ASF, relation diagrams were used. Using ranking tools, the trust of the participants in stakeholders to implement control measures successfully was evaluated. Defined control measures were presented to the hunters and their acceptability investigated. An impact diagram and a list of defined motivation options for passive surveillance were offered to identify new ways to increase the willingness of hunters to support passive surveillance actively. A satisfactory and regular relationship was identified between the hunters, the Food and Veterinary Service (FVS) and the State Forest Service (SFS). The hunters' trust in these authorities was high. Although there is no vaccine against ASF, hunters were convinced of the potential of vaccination in controlling ASF. However, building fences was considered as useless and ineffective. To increase the willingness of hunters to support passive surveillance, reducing the infection pressure in the forests was regarded as most motivating. Furthermore, hunters would appreciate a decrease in their costs and workload. The study provides new insight into the concerns and experiences of hunters. Including their views and expectations in the further design and implementation of control and surveillance activities may help to improve current efforts to control ASF in wild boar populations. Although representing the perceptions of Latvian hunters, the main conclusions may be adaptable to adjust ASF control and surveillance in other countries.

Participatory Epidemiology: Principles, Practice, Utility, and Lessons Learnt

Participatory epidemiology (PE) evolved as a branch of veterinary epidemiology and has been largely employed for the control and early warning of infectious diseases within resource-limited settings. It was originally based on combining practitioner communication skills with participatory methods to facilitate the involvement of animal caretakers and owners (embracing their knowledge, experience, and motivations) in the identification and assessment of animal disease problems, including in the design, implementation, monitoring and evaluation of disease control programs, policies, and strategies. With the importance of understanding social perceptions and drivers receiving increasing recognition by epidemiologists, PE tools are being adapted for an increasingly wide range of settings and endeavors. More recently, PE tools have been adapted for use in food and nutrition security programs, One Health activities, wildlife disease surveillance and as part of mixed-methods research across a range of socio-economic settings. This review describes the evolution of PE (in relation to veterinary epidemiology and briefly in relation to public health epidemiology), the underpinning philosophy and principles essential to its effective application and the importance of gender-sensitive approaches and data triangulation, including conventional confirmatory testing. The article also provides illustrative examples highlighting the diversity of approaches and applications of PE, hallmarks of successful PE initiatives and the lessons we can learn when these are missing. Finally, we look forward, describing the particular utility of PE for dealing with emerging infectious diseases, gaining attention of field-level cross-sector officials who can escalate concerns to a higher level and for continuing to raise the voices of those less-heard (such as women, minority groups, and remote communities with limited exposure to formal education) in defining the problems and planning activities that will likely impact directly on their well-being and livelihoods.

Poultry farmer response to disease outbreaks in smallholder farming systems in southern Vietnam

Avian influenza outbreaks have been occurring on smallholder poultry farms in Asia for two decades. Farmer responses to these outbreaks can slow down or accelerate virus transmission. We used a longitudinal survey of 53 small-scale chicken farms in southern Vietnam to investigate the impact of outbreaks with disease-induced mortality on harvest rate, vaccination, and disinfection behaviors. We found that in small broiler flocks (≤16 birds/flock) the estimated probability of harvest was 56% higher when an outbreak occurred, and 214% higher if an outbreak with sudden deaths occurred in the same month. Vaccination and disinfection were strongly and positively correlated with the number of birds. Small-scale farmers – the overwhelming majority of poultry producers in low-income countries – tend to rely on rapid sale of birds to mitigate losses from diseases. As depopulated birds are sent to markets or trading networks, this reactive behavior has the potential to enhance onward transmission.

The past few decades have seen the circulation of avian influenza viruses increase in domesticated poultry, regularly creating outbreaks associated with heavy economic loss. In addition, these viruses can sometimes ‘jump’ into humans, potentially allowing new diseases – including pandemics – to emerge.

The Mekong river delta, in southern Vietnam, is one of the regions with the highest circulation of avian influenza. There, a large number of farmers practice poultry farming on a small scale, with limited investments in disease prevention such as vaccination or disinfection. Yet, it was unclear how the emergence of an outbreak could change the behavior of farmers.

To learn more, Delabouglise et al. monitored 53 poultry farms, with fewer than 1000 chickens per farm, monthly for over a year and a half. In particular, they tracked when outbreaks occurred on each farm, and how farmers reacted. Overall, poultry farms with more than 17 chickens were more likely to vaccinate their animals and use disinfection practices than smaller farms. However, disease outbreaks did not affect vaccination or disinfection practices.

When an outbreak occurred, farmers with fewer than 17 chickens tended to sell their animals earlier. For instance, they were 214% more likely to send their animals to market if an outbreak with sudden deaths occurred that month. Even if they do not make as much money selling immature individuals, this strategy may allow them to mitigate economical loss: they can sell animals that may die soon, saving on feeding costs and potentially avoiding further contamination. However, as animals were often sold alive in markets or to itinerant sellers, this practice increases the risk of spreading diseases further along the trade circuits.

These data could be most useful to regional animal health authorities, which have detailed knowledge of local farming systems and personal connections in the communities where they work. This can allow them to effect change. They could work with small poultry farmers to encourage them to adopt efficient disease management strategies. Ultimately, this could help control the spread of avian influenza viruses, and potentially help to avoid future pandemics.

Power, participation and their problems: A consideration of power dynamics in the use of participatory epidemiology for one health and zoonoses research

The use of Participatory Epidemiology in veterinary research intends to include livestock keepers and other local stakeholders in research processes and the development of solutions to animal health problems, including potentially zoonotic diseases. It can also be an attempt to bring some of the methods and insights of social science into a discipline largely shaped by natural science methods and ways of seeing the world. The introduction of participatory methodologies to veterinary epidemiology and disease surveillance follows a wider movement in development thinking, questioning the top-down nature of much post-second world war development efforts directed from the Global North towards the Global South. In the best cases, participatory methods can help to empower the poor and marginalised to participate in and have some control over research and interventions which affect them. Compiled from experience in multi-disciplinary One Health projects, this paper briefly traces the rise of participatory epidemiology before examining some of the limitations observed in its implementation and steps that might be taken to alleviate the problems observed. The three areas in which the operationalisation of Participatory Epidemiology in veterinary and One Health research could be improved are identified as: broadening the focus of engagement with communities beyond quantitative data extraction; taking note of the wider power structures in which research takes place, and questioning who speaks for a community when participatory methods are used. In particular, the focus falls on how researchers from different disciplines, including veterinary medicine and the social sciences, can work together to ensure that participatory epidemiology is employed in such a way that it improves the quality of life of both people and animals around the world.

COVID-19 in pastoral contexts in the greater Horn of Africa: Implications and recommendations

COVID-19 is a global pandemic that continues to spread around the world, including to Africa where cases are steadily increasing. The African Centres for Disease Control and Prevention is leading the pandemic response in Africa, with direction from the World Health Organization guidelines for critical preparedness, readiness, and response actions. These are written for national governments, lacking nuance for population and local differences. In the greater Horn of Africa, conditions unique to pastoralists such as inherent mobility and limited health and service infrastructure will influence the dynamics of COVID-19. In this paper, we present a One Health approach to the pandemic, consisting of interdisciplinary and intersectoral collaboration focused on the determinants of health and health outcomes amongst pastoralists. Our contextualized public health strategy includes community One Health teams and suggestions for where to implement targeted public health measures. We also analyse the interaction of COVID-19 impacts, including those caused directly by the disease and those that result from control efforts, with ongoing shocks and vulnerabilities in the region (e.g. desert locusts, livestock disease outbreaks, floods, conflict, and development displacement). We give recommendations on how to prepare for and respond to the COVID-19 pandemic and its secondary impacts on pastoral areas. Given that the full impact of COVID-19 on pastoral areas is unknown currently, our health recommendations focus on disease prevention and understanding disease epidemiology. We emphasize targeting pastoral toponymies with public health measures to secure market access and mobility while combating the direct health impacts of COVID-19. A contextualized approach for the COVID-19 public health response in pastoral areas in the Greater Horn of Africa, including how the pandemic will interact with existing shocks and vulnerabilities, is required for an effective response, while protecting pastoral livelihoods and food, income, and nutrition security.

Estimating foot-and-mouth disease (FMD) prevalence in central Myanmar: Comparison of village headman and farmer disease reports with serological findings

The impacts of foot-and-mouth disease (FMD) on food security in developing countries are difficult to quantify due to the scarcity of accurate data on the prevalence and incidence of affected villages. This is partly due to resource constraints as well as the logistical challenges of conducting regular diagnostic testing in remote locations. In this study, we used descriptive analysis and latent class analysis (LCA) models to analyse data collected during a field survey of 160 villages in central Myanmar in the Mandalay and Sagaing Regions over the 2012-2016 time period. We evaluated the performance of verbal reports made by village householders and headmen against serological data to retrospectively determine the FMD-infection status of our study area and to identify factors contributing to under-reporting. Blood samples were collected from approximately 30 cattle per village in both the 6- to 18-month age range and over 18-month age range to distinguish between recent and historic exposure. Village householders were asked to identify pictures of FMD-affected cattle amongst pictures of cattle affected with other common endemic diseases to assess the accuracy of their verbal reporting. The serological results confirmed that FMD is endemic in central Myanmar with village-level seroprevalence estimated at 56% for animals 6-18 months of age and 80% when all age groups were considered together. Most village householders were familiar with the clinical signs of FMD-affected cattle (72%). Based on the results from the LCA models, the village headman had a sensitivity of 77% and specificity of 75% for identifying FMD outbreaks in their village, whereas individual householders had a higher sensitivity and lower specificity of 80% and 56%, respectively. The level of disagreement between the different sources was correlated with the total number of cattle in the village and may potentially be worse in villages where endemic FMD may have led to a high level of natural immunity in cattle and subsequent masking of clinical signs. However, other regional effects such as the intensity of FMD extension efforts cannot be ruled out. Overall, the results suggest that verbal reports of FMD outbreaks from village headmen may be a useful tool to integrate into active FMD surveillance programmes in developing countries.

Endemic and emerging acute virus infections in Indonesia: an overview of the past decade and implications for the future

Being the largest archipelago country in the world, with a tropical climate and a unique flora and fauna, Indonesia habitats one of the most diverse biome in the world. These characteristics make Indonesia a popular travel destination, with tourism numbers increasing yearly. These characteristics also facilitate the transmission of zoonosis and provide ideal living and breading circumstances for arthropods, known vectors for viral diseases. A review of the past 10 years of literature, reports of the Ministry of Health, Republic of Indonesia and ProMED-mail shows a significant increase in dengue infection incidence. Furthermore, chikungunya, Japanese encephalitis and rabies are proven to be endemic in Indonesia. The combination of cohort studies, governmental data and ProMED-mail reveals an integrated overview for those working in travel medicine and public health, focusing on both endemic and emerging acute virus infections. This review summarizes the epidemiology of acute virus infections in Indonesia, including outbreak reports, as well as public health response measurements and their potential or efficacy. Knowledge about human behaviour, animal reservoirs, climate factors, environment and their role in emerging virus infection are discussed. We aim to support public health authorities and health care policy makers in a One Health approach.

Combining Participatory Influenza Surveillance with Modeling and Forecasting: Three Alternative Approaches

BACKGROUND

Influenza outbreaks affect millions of people every year and its surveillance is usually carried out in developed countries through a network of sentinel doctors who report the weekly number of Influenza-like Illness cases observed among the visited patients. Monitoring and forecasting the evolution of these outbreaks supports decision makers in designing effective interventions and allocating resources to mitigate their impact.

OBJECTIVE

Describe the existing participatory surveillance approaches that have been used for modeling and forecasting of the seasonal influenza epidemic, and how they can help strengthen real-time epidemic science and provide a more rigorous understanding of epidemic conditions.

METHODS

We describe three different participatory surveillance systems, WISDM (Widely Internet Sourced Distributed Monitoring), Influenzanet and Flu Near You (FNY), and show how modeling and simulation can be or has been combined with participatory disease surveillance to: i) measure the non-response bias in a participatory surveillance sample using WISDM; and ii) nowcast and forecast influenza activity in different parts of the world (using Influenzanet and Flu Near You).

RESULTS

WISDM-based results measure the participatory and sample bias for three epidemic metrics i.e. attack rate, peak infection rate, and time-to-peak, and find the participatory bias to be the largest component of the total bias. The Influenzanet platform shows that digital participatory surveillance data combined with a realistic data-driven epidemiological model can provide both short-term and long-term forecasts of epidemic intensities, and the ground truth data lie within the 95 percent confidence intervals for most weeks. The statistical accuracy of the ensemble forecasts increase as the season progresses. The Flu Near You platform shows that participatory surveillance data provide accurate short-term flu activity forecasts and influenza activity predictions. The correlation of the HealthMap Flu Trends estimates with the observed CDC ILI rates is 0.99 for 2013-2015. Additional data sources lead to an error reduction of about 40% when compared to the estimates of the model that only incorporates CDC historical information.

CONCLUSIONS

While the advantages of participatory surveillance, compared to traditional surveillance, include its timeliness, lower costs, and broader reach, it is limited by a lack of control over the characteristics of the population sample. Modeling and simulation can help overcome this limitation as well as provide real-time and long-term forecasting of influenza activity in data-poor parts of the world.

Climate change and cattle vector-borne diseases: Use of participatory epidemiology to investigate experiences in pastoral communities in Northern Tanzania

Climate change is predicted to increase incidence of vector-borne diseases in humans, however, little is known about the impact of such diseases in livestock. In the absence of historical data with which to examine the inter-relation between climate and disease, participatory epidemiological (PE) methods were used with Maasai pastoralists of Monduli District, northern Tanzania to establish local observations on two major vector-borne diseases of cattle, namely East Coast fever (ECF) and African animal trypanosomiasis (AAT). Data collection involving gender segregated groups (10 men groups and 9 women groups) occurred in 10 randomly selected villages between November 2014 and March 2015. ECF and AAT were ranked amongst the top 5 most important cattle diseases with strong agreement across informant groups (Kendall's W=0.40 for men and 0.45 for women; p<0.01). Matrix scoring for both men and women groups confirmed that Masaai easily recognize these diseases. All groups associated ECF with the wet and cool dry seasons. AAT was more variable throughout the year, with more cases reported in the long dry season. Likewise, pastoralists reported differences in seasonal occurrence of disease vectors (Rhipicephalus appendiculatus and Glossina spp.) by village. Comparing 2014-1984, participant groups consistently reported declines in rainfall, vegetation cover and quality pasture, as well as increases in severe droughts. Experiences with ECF/AAT and vector abundance between these time periods was more variable across villages, and likely relates to changes in climate and animal management practices over the last 30 years. This baseline study is the first to document the inter-relation between climate and cattle vector-borne disease from the pastoralist perspective. Findings from this study reveal a complex interplay between human, animal and environmental factors, understanding of which is urgently required to devise approaches to mitigate effects of climate change in these vulnerable areas.

Small Poultry Flocks in Alberta: Demographics and Practices

The distribution, composition, and management characteristics of small "backyard" poultry flocks may have important implications in the spread of both avian diseases and zoonoses of public health concern. Although the prevalence of small poultry flocks has increased in Alberta, Canada, in recent years, there is minimal demographic information available for these populations. To gain initial epidemiologic insight into this growing population and potential areas of risk, a survey was conducted to characterize the sector. Information on flock demographics and bird health, as well as production and biosecurity practices, were gathered and analyzed from 206 surveys, representing respondents from 43 counties. These results revealed great diversity of both owners and flocks, characterized by wide variations in flock sizes and composition. Laying hens were the most commonly reported type of bird (93.4%), followed by ducks and geese (35.3%), turkeys, (33.8%), and broiler chickens (33.1%). Notably, 58.1% of owners reported having more than one type of bird in their flock, with many owners never, or only sometimes, separating flocks based on species or purpose. Personal consumption (81.8%) and sale of eggs (48.2%) were the most frequently cited purposes for owning a flock. Our findings suggest that owners in Alberta are predominantly new to production; most (73.1%) have kept birds for less than 5 yr and 25.6% for less than 1 yr. Flock health parameters revealed inconsistent use of medical interventions, such as vaccinations, treatments, and veterinary consultation. Data on the sourcing, housing, and movement of birds, as well as movement of people and visitors, reveal substantial potential for contact to occur directly and indirectly between flocks and humans. Additionally, basic husbandry and biosecurity practices were found to be inconsistent and often inadequate, highlighting important gaps and opportunities to improve the health of Alberta's small poultry flocks and mitigate risks to public health. These quantitative and qualitative results provide a baseline characterization of the sector and identify risks and challenges that may serve to inform the development and delivery of future study and interventions.

Sensitivity and Specificity Estimation for the Clinical Diagnosis of Highly Pathogenic Avian Influenza in the Egyptian Participatory Disease Surveillance Program

Many developing countries lack sufficient resources to conduct animal disease surveillance. In recent years, participatory epidemiology has been used to increase the cover and decrease the costs of surveillance. However, few diagnostic performance assessments have been carried out on participatory methods. The objective of the present study was to estimate the diagnostic performance of practitioners working for the Community-Based Animal Health and Outreach (CAHO) program, which is a participatory disease surveillance system for the detection of highly pathogenic avian influenza outbreaks in Egypt. CAHO practitioners' diagnostic assessment of inspected birds was compared with real-time reverse-transcriptase polymerase chain reaction (RRT-PCR) test results at the household level. Diagnostic performance was estimated directly from two-by-two tables using RRT-PCR as a reference test in two different scenarios. In the first scenario, only results from chickens were considered. In the second scenario, results for all poultry species were analyzed. Poultry flocks in 916 households located in 717 villages were inspected by CAHO practitioners, who collected 3458 bird samples. In the first scenario, CAHO practitioners presented sensitivity (Se) and specificity (Sp) estimates of 40% (95% confidence interval [CI]: 21%-59%) and 92% (95% CI: 91%-94%), respectively. In the second scenario, diagnostic performance estimates were Se = 47% (95% CI: 29%-65%) and Sp = 88% (95% CI: 86%-90%). A significant difference was observed only between Sp estimates (P < 0.01). Practitioners' diagnostics and RRT-PCR results were in very poor agreement with kappa values of 0.16 and 0.14 for scenarios 1 and 2, respectively. However, the use of a broad case definition, the possible presence of immunity against the virus in replacement birds, and the low prevalence observed during the survey would negatively affect the practitioners' performance.

When private actors matter: Information-sharing network and surveillance of Highly Pathogenic Avian Influenza in Vietnam

The effectiveness of animal health surveillance systems depends on their capacity to gather sanitary information from the animal production sector. In order to assess this capacity we analyzed the flow of sanitary information regarding Highly Pathogenic Avian Influenza (HPAI) suspicions in poultry in Vietnam. Participatory methods were applied to assess the type of actors and likelihood of information sharing between actors in case of HPAI suspicion in poultry. While the reporting of HPAI suspicions is mandatory, private actors had more access to information than public actors. Actors of the upstream sector (medicine and feed sellers) played a key role in the diffusion of information. The central role of these actors and the influence of the information flow on the adoption by poultry production stakeholders of behaviors limiting (e.g. prevention measures) or promoting disease transmission (e.g. increased animal movements) should be accounted for in the design of surveillance and control programs.

Avian influenza from an ecohealth perspective

To understand and better control AI outbreaks, not only is it necessary to understand the biology of influenza viruses but also the natural history of the hosts in which these viruses multiply and the different environments in which the hosts and viruses interact. This includes the anthropogenic factors that have influenced where, whether and how avian influenza (AI) viruses can replicate and transmit between wild birds and poultry, and between poultry and mammals, including factors influencing uptake and application of appropriate control and preventive measures for AI. This disease represents one of the best examples of the need for a 'One Health' approach to understand and tackle disease with an increasing need to comprehend and unravel the environmental and ecology drivers that affect the virus host interactions. This forum piece seeks to bring together these aspects through a review of recent outbreaks and how a deeper understanding of all three aspects, the virus, the host and the environment, can help us better manage future outbreaks.