Awareness and Practices Relating to Zoonotic Diseases Among Smallholder Farmers in Nepal

Regional variation in knowledge and practice regarding common zoonoses among livestock farmers of selective districts in Nepal

BACKGROUND

The majority of Nepalese people are involved in farming. However, due to limited knowledge of zoonoses and poor preventive practices on the part of livestock farmers, vulnerabilities to zoonotic diseases are very high. The main objective of this study was to assess the regional variation in zoonoses-related knowledge and preventive practices of livestock farmers in different ecological regions of Nepal.

MATERIAL AND METHODS

Descriptive cross-sectional quantitative research design was followed in the study. The total sample size was 380 livestock farmers from randomly selected three ecological regions of Nepal. Systematic sampling techniques were applied for data collection. Data were entered into an excel sheet and then imported into Statistical Package for Social Sciences (SPSS) software. The data were calculated using descriptive statistics. Univariate, and bivariate analyses were performed, and the result of the study was presented in the form of text and tables based on their nature.

RESULTS

Of the studied six zoonotic diseases, most of the respondents (95.8%) knew about zoonotic bird flu; 90.7% of them, were about rabies; and 54.2% knew about swine flu. However, a few respondents knew about bovine tuberculosis, neurocysticercosis, and brucellosis. Ecologically, the highest number of respondents in Nawalpur had knowledge of rabies (95.3%), and swine flu (61.6%), whereas 98.3% of them had knowledge of avian influenza in Tanahun; and 12.5% of neurocysticercosis in Manang. Regarding zoonoses preventive practices such as regular hand washing with soap water, mask-wearing, gloves, boots, the respondents' representation of 60.8%, 6.6%, 1.8%, and 1.3% respectively in such practices show that although these are easy and cost-effective, personal protective equipment (PPE), such preventive practices were extremely underperformed. Not only that, only 12% of respondents maintain a standard distance (>15m.) between their house and shed. Similarly, 17% still consumed meat from sick animals, and vaccination of livestock was also found poor coverage (36%) in the study.

CONCLUSIONS

Livestock farmers need to be more knowledgeable about many common zoonotic diseases, and their preventive practices still need improvement, with significant regional variation in the study. This has invited various zoonosis threats for them. Therefore, it is recommended that the interventional programs related to common zoonoses be conducted for livestock farmers to solve the problem.

Association between Pet Ownership and Threatened Abortion in Pregnant Women: The China Birth Cohort Study

Background: The aim of this study was to assess the association between pet ownership and threatened abortion (TA) in pregnant Chinese women. Materials and Methods: We enrolled pregnant women from 18 provinces and autonomous regions across China between November 2017 and December 2020. Participants were grouped based on the presence or absence of pet ownership. Pet owners were further sub-grouped based on the presence or absence of close contact with their pets. Pet species included cats, dogs, and both. Generalised linear mixed models, with province as a random effect, were used to estimate the associations between pet ownership and TA. Results: Pet ownership, whether or not one had close contact with pets, was associated with greater odds of TA (OR: 1.30, 95% CI: 1.21, 1.40). Keeping pet cats (OR: 1.24, 95% CI: 1.11, 1.40), dogs (OR: 1.29, 95% CI: 1.18, 1.41), or both cats and dogs (OR: 1.36, 95% CI: 1.04, 1.68) during pregnancy were all risk factors for TA. We observed significant group differences (p for difference < 0.05) in pre-pregnancy body mass index, education levels, and annual household income. Conclusions: Cat or dog ownership during pregnancy was associated with an increased risk of TA, especially among overweight, less educated, or lower-income participants.

Research Participation Influences Willingness to Reduce Zoonotic Exposure in Uganda

The majority of emerging and re-emerging infectious diseases in people are zoonotic. Despite substantial research in communities adjacent to protected areas with high levels of biodiversity, limited data exist on people's knowledge, attitudes, and practices to avoid exposure to infections from domestic and wild animals. We used a modified grounded-theory framework in QS NVivo to develop a Knowledge, Attitude, and Practices (KAP) survey administered at two time points, KAPT1 (April-July 2016) and KAPT2 (February-May 2018) to participants living at the edge of Kibale National Park, Uganda. We measured the difference in willingness to engage in protective behaviors around zoonotic exposure between an Intervention group (n = 61) and a Comparison group (n = 125). Prior to KAPT1, the Intervention group engaged in a human-centered design (HCD) activity identifying behaviors that reduce zoonotic exposure (March-May 2016). Using a difference-in-difference approach, we compared the Intervention and Comparison groups to assess sustained willingness and use of protective behaviors against domestic and wild animal exposures. At KAPT1, Comparison group participants had a significantly lower (p < 0.05) level of willingness to engage in behaviors that increase exposure to zoonoses from domestic animals; Intervention group participants had a significantly higher (p < 0.01) level of willingness to engage in behaviors that increase exposure to zoonoses from wild animals. At KAPT2, the treatment effect was significant (p < 0.01) for sustained willingness to engage in protective behaviors for domestic animal exposure in the Intervention group. There were no significant differences in practices to avoid domestic and wild animal zoonotic exposure between the Intervention and Comparison groups.

Knowledge and perception of veterinary students on One Health: A first nationwide multi-institutional survey in Nepal

Background and Aim: One Health (OH) is a collaborative, multisectoral, and holistic approach for the prevention and control of emerging and re-emerging zoonotic diseases affecting animals and humans. In Nepal, the OH concept remains rudimentary. However, the recently formed "One Health Strategy" is a ray of hope. Veterinary students are the future of animal health, a major component of OH. This study aimed to determine the knowledge and perception of Nepalese veterinary students toward OH. Materials and Methods: A cross-sectional questionnaire survey was conducted among veterinary students in all four veterinary colleges in Nepal to obtain knowledge on OH and zoonotic disease and understand the perception of the benefits of OH obtained using an online survey tool through a convenience sampling technique. Data collected were subjected to descriptive statistics, Chi-Square test, and logistic regression analysis. Results: A total of 333 participants, including recent graduates (mean age: 22.3±2.2 years) participated in this study. The mean knowledge score was 19.8±3.8 and about half of the respondents, 185 (55.6%) demonstrated satisfactory scores on OH. Most of the respondents have a positive perception of the benefits of OH as participants largely agreed that the OH approach needs to become a regular, routine, and institutionalized process at the project, program, and policy levels; is useful in addressing complex challenges that threaten human and animal health, food security, poverty, and the environments where diseases flourish; and it creates added value in terms of human and animal health, financial savings or social and environmental benefits from closer professional cooperation. Binary logistic regression analysis revealed that age, educational, and academic levels were significant factors influencing satisfactory knowledge on OH among respondents. Conclusion: Nepalese veterinary students demonstrated satisfactory knowledge of OH and a good level of perception of the benefits of OH. An apprehensive understanding of the current status of the OH approach in Nepal through studies like this is crucial for the future improvement of public and animal health.

Medicinal Plants in Semi-Natural Grasslands: Impact of Management

Semi-natural grasslands (SNG) are valuable for their high biodiversity, cultural and landscape values. Quantitative information about medicinal plants (MP) in SNG facilitates the evaluation of ecosystem services of these habitats. Different literature sources were used to assess the ratio and frequency of MP species in several Estonian SNG and to evaluate the impact of management on these values. Lists of MP species according to different MP definition scenarios are available. The ratio of MP species in the local plant species list was the largest in alvars, followed by floodplain and wooded meadows. The average number of MP species in wooded meadows and alvars was about twice of that found in naturally growing broadleaved forest (according to the most detailed MP species list, 7.2, 7.8 and 4.3 plot⁻¹, respectively). Fertilization of wooded meadows had no significant impact on MP species ratio, but decreased the percentage of MP biomass. Coastal meadows had few MP species and the impact of management quality depended on adopted MP scenarios. Comparison of Ellenberg indicator values revealed that MP species were more drought-tolerant, with higher commonness and more anthropophyte than the rest of studied grassland species.

An exploratory assessment of human and animal health concerns of smallholder farmers in rural communities of Chimborazo, Ecuador

Background

Livestock play important economic and cultural roles in smallholder communities of Ecuador, yet they also serve as potential sources of zoonotic infections. Understanding the animal and human health concerns of smallholder farmers is important in guiding strategies for improvement of the health and livelihoods of these resource-poor farmers. Therefore, the objectives of this study were to: (a) assess the health concerns of smallholder farmers; (b) explore animal and waste management practices; and (c) identify predictors of pediatric and livestock diarrhea on smallholder farms in Ecuador.

Methods

This is a cross-sectional survey of 58 smallholder farmers in three communities of Chimborazo province, Ecuador. Data were collected on household demographics, smallholding characteristics, type of animals owned, human-animal interactions, health concerns, and 30-day occurrence of human as well as animal diarrhea. Summary statistics were computed and logistic models used to investigate predictors of pediatric and animal diarrhea.

Results

All respondents reported keeping animals. Animals kept included cattle, pigs, poultry, dogs, guinea pigs, cats, sheep, horses, rabbits, donkeys, or other livestock. More than half of the respondents named diseases as their greatest personal (55.2%) or family (58.6%) health concern, while an even greater percentage (60.3%) reported physiological stress as the primary health concern for their animals. Occurrence of diarrhea in the 30 days prior to the study was reported by 12.1% of the respondents. Additionally, 15.2% and 55.2% of the households reported diarrhea among children and animals, respectively. The majority (65.5%) of the households had toilets, while the remainder had either latrines (27.6%) or no sanitation facilities (6.9%). However, only 9.1% of the smallholdings had either a toilet (3.6%) or a latrine (5.5%) onsite and yet the farmers tended to spend most of the day at the smallholdings. Potential exposures to gastrointestinal pathogens included food- or water-borne sources (93.5% of children; 91.4% of adults) and blood-borne or fecal sources (80.4% of children; 100% of adults). Although 98.3% of the respondents kept cattle, only 27.6% had animal enclosures and even fewer (15.5%) had animal waste management plans. The odds of animal diarrhea were significantly higher (Odds Ratio [OR] = 8.7; 95% Confidence Interval [1.0–75.0]; p = .049) among households that had animal waste management plans compared to those that did not. None of the variables investigated were significant predictors of pediatric diarrhea.

Conclusions

Ongoing surveillance is needed to develop estimates of diarrhea incidence among smallholder families and their livestock. The impact of different animal management strategies on the potential pathogen exposure of smallholders warrants further investigations. Improving sanitation infrastructure and animal waste management strategies is recommended.

Drivers of zoonotic disease risk in the Indian subcontinent: A scoping review

Literature on potential anthropogenic drivers of zoonotic disease risk in the Indian subcontinent is sparse. We conducted a scoping review to identify primary sources, published 2000-2020, to clarify what research exists and on which areas future research should focus. We summarised findings thematically by disease. Of 80 sources included, 78 (98%) were original research articles and two were conference abstracts. Study designs and methods were not always clearly described, but 74 (93%) were quantitative (including one randomised trial), five (6%) were mixed-methods, and one was qualitative. Most sources reported research from India (39%) or Bangladesh (31%), followed by Pakistan (9%), Nepal (9%), Bhutan and Sri Lanka (6% each). Topically, most focused on rabies (18; 23%), Nipah virus (16; 20%) or leptospirosis (11; 14%), while 12 (15%) did not focus on a disease but instead on knowledge in communities. People generally did not seek post-exposure prophylaxis for rabies even when vaccination programmes were available and they understood that rabies was fatal, instead often relying on traditional medicines. Similarly, people did not take precautions to protect themselves from leptospirosis infection, even when they were aware of the link with rice cultivation. Nipah was correlated with presence of bats near human habitation. Official information on diseases, modes of transmission and prevention was lacking, or shared informally between friends, relatives, and neighbours. Behaviour did not correspond to disease knowledge. This review identifies various human behaviours which may drive zoonotic disease risk in the Indian subcontinent. Increasing community knowledge and awareness alone is unlikely to be sufficient to successfully change these behaviours. Further research, using interdisciplinary and participatory methods, would improve understanding of risks and risk perceptions and thus help in co-designing context-specific, relevant interventions.

Prioritizing smallholder animal health needs in East Africa, West Africa, and South Asia using three approaches: Literature review, expert workshops, and practitioner surveys

Managing the health needs of livestock contributes to reducing poverty and improving the livelihoods of smallholder and pastoralist livestock keepers globally. Animal health practitioners, producers, policymakers, and researchers all must prioritize how to mobilize limited resources. This study employed three approaches to prioritize animal health needs in East and West Africa and South Asia to identify diseases and syndromes that impact livestock keepers. The approaches were a) systematic literature review, b) a series of expert workshops, and c) a practitioner survey of veterinarians and para-veterinary professionals. The top constraints that emerged from all three approaches include endo/ ectoparasites, foot and mouth disease, brucellosis, peste des petits ruminants, Newcastle disease, and avian influenza. Expert workshops additionally identified contagious caprine pleuropneumonia, contagious bovine pleuropneumonia, mastitis, and reproductive disorders as constraints not emphasized in the literature review. Practitioner survey results additionally identified nutrition as a constraint for smallholder dairy and pastoralist small ruminant production. Experts attending the workshops agreed most constraints can be managed using existing veterinary technologies and best husbandry practices, which supports a shift away from focusing on individual diseases and new technologies towards addressing systemic challenges that limit access to veterinary services and inputs. Few research studies focused on incidence/ prevalence of disease and impact, suggesting better incorporation of socio-economic impact measures in future research would better represent the interests of livestock keepers.

Livestock and Poultry Production in Nepal and Current Status of Vaccine Development

The livestock and poultry sectors are an integral part of Nepalese economy and lifestyle. Livestock and poultry populations have continuously been increasing in the last decade in Nepal and are likely to follow that trend as the interests in this field is growing. Infectious diseases such as Foot and Mouth Disease (FMD), Peste des Petits Ruminants (PPR), hemorrhagic septicemia (HS), black quarter (BQ), swine fever, avian influenza, and Newcastle disease (ND) constitute one of the major health challenges to the Nepalese livestock and poultry industry. Vaccinations are an efficient means of preventing the occurrence and spread of several diseases in animals and birds. Considering this fact, the government of Nepal began the production of veterinary vaccines in the 1960s. Nepal is self-reliant in producing several vaccines for cattle and buffaloes, sheep and goats, pigs, and poultry. Despite these efforts, the demand for vaccines is not met, especially in the commercial poultry sector, as Nepal spends billions of rupees in vaccine imports each year. There is a need of strengthening laboratory facilities for the isolation and characterization of field strains of pathogens and capacity building for the production of different types of vaccines using the latest technologies to be self-reliant in veterinary vaccine production in the future in Nepal.

Brucellosis in the Middle East: Current situation and a pathway forward

Brucellosis is a bacterial endemic zoonotic disease of global significance with detrimental impacts on public health and food animal production. It is caused by Brucella spp., an expanding group of pathogens able to infect various host species. Bovines and small ruminants, which excrete the bacteria in milk and in reproductive discharges, are major sources of infection for humans and other animals. Contact with contaminated animals and consumption of unpasteurized dairy products are the main routes for human infection. In spite of the considerable progress of knowledge gained and success achieved in brucellosis control in the developed world, this disease continues to be an important burden in the Middle East (ME). Common risk factors implicated in the difficulty and complexity of brucellosis control within the region include (1) social and political instabilities; (2) insufficient resources and infrastructure for appropriate diagnosis, reporting, and implementation of control measures; (3) variation of livestock husbandry systems and their commingling with other livestock and wildlife; and (4) traditional cultural practices, including consumption of unpasteurized dairy products. Development of core interdisciplinary competencies is required for a true One Health–based endeavor against the disease. National awareness and educational programs addressing all population sectors from consumers to decision-makers seem to be the next logical, sustainable, and economically viable approach toward improving disease status in this region. In the present review, we describe the current situation of brucellosis in the ME, focusing on the major limitations and shortcomings regarding disease control. We propose a regional approach toward public awareness of brucellosis as the first step in mitigating the disease and discuss the potential benefits, and components of such a strategy, which can further be used as a model for other endemic zoonotic diseases.

Exploring the Mental Model of Cattle Farmers in Disease Prevention and Control Practices

Farmers play an integral role in minimizing disease threats and managing ongoing diseases on their farms. Various environmental factors influence the decision-making processes of farmers. Deciphering the mental models of farmers allows us to understand the motivations and reasons behind disease prevention and control choices. This study aimed to explore the mental models of cattle farmers in implementing disease prevention and control practices. Using qualitative in-depth, semi-structured interviews, seven cattle farmers from a university’s foster farm extension program were sampled. Interview transcripts were analyzed using inductive content analysis. Results revealed 23 dimensions comprising the mental model of cattle farmers. The dimensions were conceptualized under four major themes. Farmers were most influenced by perceived risk of disease, perceived effectiveness and benefits of disease prevention and control practices, experience, knowledge and emotions, subjective norms and perceived economic loss. The decision-making processes of farmers are complex and are influenced by various factors. While additional research is needed to confirm the findings using quantitative methods and larger sample sizes, insights gained from the study can be used as inputs to tailor communication and training strategies for improved disease prevention and control interventions.