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Delpy L, Astbury CC, Aenishaenslin C, Ruckert A, Penney TL, Wiktorowicz M, Ciss M, Benko R, Bordier M. Integrated surveillance systems for antibiotic resistance in a One Health context: a scoping review. BMC Public Health 2024; 24:1717. [PMID: 38937706 PMCID: PMC11210117 DOI: 10.1186/s12889-024-19158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Antibiotic resistance (ABR) has emerged as a major threat to health. Properly informed decisions to mitigate this threat require surveillance systems that integrate information on resistant bacteria and antibiotic use in humans, animals, and the environment, in line with the One Health concept. Despite a strong call for the implementation of such integrated surveillance systems, we still lack a comprehensive overview of existing organizational models for integrated surveillance of ABR. To address this gap, we conducted a scoping review to characterize existing integrated surveillance systems for ABR. METHODS The literature review was conducted using the PRISMA guidelines. The selected integrated surveillance systems were assessed according to 39 variables related to their organization and functioning, the socio-economic and political characteristics of their implementation context, and the levels of integration reached, together with their related outcomes. We conducted two distinct, complementary analyses on the data extracted: a descriptive analysis to summarize the characteristics of the integrated surveillance systems, and a multiple-correspondence analysis (MCA) followed by a hierarchical cluster analysis (HCA) to identify potential typology for surveillance systems. RESULTS The literature search identified a total of 1330 records. After the screening phase, 59 references were kept from which 14 integrated surveillance systems were identified. They all operate in high-income countries and vary in terms of integration, both at informational and structural levels. The different systems combine information from a wide range of populations and commodities -in the human, animal and environmental domains, collection points, drug-bacterium pairs, and rely on various diagnostic and surveillance strategies. A variable level of collaboration was found for the governance and/or operation of the surveillance activities. The outcomes of integration are poorly described and evidenced. The 14 surveillance systems can be grouped into four distinct clusters, characterized by integration level in the two dimensions. The level of resources and regulatory framework in place appeared to play a major role in the establishment and organization of integrated surveillance. CONCLUSIONS This study suggests that operationalization of integrated surveillance for ABR is still not well established at a global scale, especially in low and middle-income countries and that the surveillance scope is not broad enough to obtain a comprehensive understanding of the complex dynamics of ABR to appropriately inform mitigation measures. Further studies are needed to better characterize the various integration models for surveillance with regard to their implementation context and evaluate the outcome of these models.
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Affiliation(s)
- Léo Delpy
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- CIRAD, UMR ASTRE, Dakar, Senegal
- National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal
| | - Chloe Clifford Astbury
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Cécile Aenishaenslin
- Research Group On Epidemiology of Zoonoses and Public Health (GREZOSP), University of Montréal, Saint-Hyacinthe, Québec, Canada
- Centre de Recherche en Santé Publique de L'Université de Montréal Et du Centre Intégré Universitaire de Santé Et de Services Sociaux (CIUSS) du Centre-Sud-de-L'île-de-Montréal, Montréal, Québec, Canada
| | - Arne Ruckert
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Tarra L Penney
- Global Food Systems & Policy Research, School of Global Health, York University, Toronto, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Mary Wiktorowicz
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
- School of Global Health, York University, Toronto, Canada
| | - Mamadou Ciss
- National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal
| | - Ria Benko
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Marion Bordier
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France.
- CIRAD, UMR ASTRE, Dakar, Senegal.
- National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal.
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2
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Nana SD, Duboz R, Diagbouga PS, Hendrikx P, Bordier M. A participatory approach to move towards a One Health surveillance system for anthrax in Burkina Faso. PLoS One 2024; 19:e0304872. [PMID: 38837969 DOI: 10.1371/journal.pone.0304872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
The One Health approach calls for collaboration across various sectors and different scales to improve understanding of complex health issues. Regarding epidemiological surveillance, this implies the development of integrated systems that link several surveillance components operating in different domains (human, domestic animals, environment) and involving several actor networks. However, surveillance continues to operate in a very compartmentalized way, with little interaction between sectoral institutions and with the community for the governance and operation of surveillance activities. This is partly explained by the insufficient consideration of the local context and the late involvement of national stakeholders when developing programmes that aimed at strengthening the integration of surveillance. In low- and middle-income countries in particular, there is a strong influence of external partners on the development of intersectoral programmes, including surveillance systems. In this context, we developed and implemented a participatory planning process to support stakeholders of the surveillance system of anthrax in Burkina Faso, in the definition of the One Health surveillance system they wish for and of the pathway to reach it. The workshop produced an action plan that reflects the views and perspectives of representatives of the different categories of stakeholders and beneficiaries of surveillance. In addition, the participation of stakeholders in this participatory co-construction process has also improved their knowledge and mutual understanding, fostering a climate of trust conducive to further collaboration for surveillance activities. However, the quality of the participation raises some questions over the results, and contextual factors may have influenced the process. This underlines the need to include a monitoring and evaluation plan in the process to assess its implementation and ability to produce One Health surveillance modalities that are appropriate, accepted and applied over the long term.
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Affiliation(s)
- Sougrenoma Désiré Nana
- UMR ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- UMR ASTRE, CIRAD, Montpellier, France
| | - Raphaël Duboz
- UMR ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- UMR ASTRE, CIRAD, Dakar, Senegal
- UMMISCO, IRD, Sorbonne University, Bondy, France
| | - Potiandi Serge Diagbouga
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
- Health Training and Research &Development, Ouagadougou, Burkina Faso
| | - Pascal Hendrikx
- High Council for Food, Agriculture and Rural Areas, Paris, France
| | - Marion Bordier
- UMR ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- UMR ASTRE, CIRAD, Dakar, Senegal
- National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal
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3
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Tegegne HA, Freeth FT, Bogaardt C, Taylor E, Reinhardt J, Collineau L, Prada JM, Hénaux V. Implementation of One Health surveillance systems: Opportunities and challenges - lessons learned from the OH-EpiCap application. One Health 2024; 18:100704. [PMID: 38496337 PMCID: PMC10940803 DOI: 10.1016/j.onehlt.2024.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
As the complexity of health systems has increased over time, there is an urgent need for developing multi-sectoral and multi-disciplinary collaborations within the domain of One Health (OH). Despite the efforts to promote collaboration in health surveillance and overcome professional silos, implementing OH surveillance systems in practice remains challenging for multiple reasons. In this study, we describe the lessons learned from the evaluation of OH surveillance using OH-EpiCap (an online evaluation tool for One Health epidemiological surveillance capacities and capabilities), the challenges identified with the implementation of OH surveillance, and the main barriers that contribute to its sub-optimal functioning, as well as possible solutions to address them. We conducted eleven case studies targeting the multi-sectoral surveillance systems for antimicrobial resistance in Portugal and France, Salmonella in France, Germany, and the Netherlands, Listeria in The Netherlands, Finland and Norway, Campylobacter in Norway and Sweden, and psittacosis in Denmark. These evaluations facilitated the identification of common strengths and weaknesses, focusing on the organization and functioning of existing collaborations and their impacts on the surveillance system. Lack of operational and shared leadership, adherence to FAIR data principles, sharing of techniques, and harmonized indicators led to poor organization and sub-optimal functioning of OH surveillance systems. In the majority of studied systems, the effectiveness, operational costs, behavioral changes, and population health outcomes brought by the OH surveillance over traditional surveillance (i.e. compartmentalized into sectors) have not been evaluated. To this end, the establishment of a formal governance body with representatives from each sector could assist in overcoming long-standing barriers. Moreover, demonstrating the impacts of OH-ness of surveillance may facilitate the implementation of OH surveillance systems.
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Affiliation(s)
- Henok Ayalew Tegegne
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
| | - Frederick T.A. Freeth
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Carlijn Bogaardt
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Emma Taylor
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Johana Reinhardt
- ANSES, Risk Assessment Department, Animal Health, Welfare, Feed and Vectors Risk Assessment Unit, 94700 Maisons-Alfort, France
| | - Lucie Collineau
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
| | - Joaquin M. Prada
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Viviane Hénaux
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
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Kuye A, Dauda M, Ameh AO, Danladi MI, Atuman YJ, Kia GSN, Häsler B. An assessment of the operationality and factors influencing the effectiveness of rabies surveillance in Gombe State, Nigeria. PLoS Negl Trop Dis 2024; 18:e0012154. [PMID: 38713728 PMCID: PMC11108123 DOI: 10.1371/journal.pntd.0012154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 05/21/2024] [Accepted: 04/16/2024] [Indexed: 05/09/2024] Open
Abstract
Rabies remains a burden in Africa, disproportionately affecting the most vulnerable despite the availability of effective vaccines. Nigeria, the most populous African country, needs rapid disease control actions and commitments to achieve the goal of eliminating dog-mediated rabies by 2030. Surveillance is an essential element of effective disease control strategies. This study examined the current state of operationality of the rabies surveillance system for early case detection and management in Gombe state, Nigeria, through a One Health lens. It further examined the barriers impeding the effectiveness of the surveillance based on the perception of surveillance workers. Qualitative and quantitative methods were used to assess the structure of the system and its functioning. Data on dog bite and rabid cases obtained from the veterinary services in Gombe state were analysed descriptively. A total of 13 key informants were interviewed using a semi-structured interview guide. Qualitative data were analysed using thematic analysis to explore in depth the factors that influenced the operationality of the system. A total of 157 potential human exposures to rabies were identified in this study, out of which two people reportedly died at the health facility after showing symptoms highly suggestive of rabies. In terms of rabies surveillance and control, cross-sectoral collaboration was found between the human health and veterinary sectors for risk assessment of potential rabies exposures and its management. Some identified factors affecting the operations of the surveillance were inadequate funding, lack of infrastructure, lack of feedback from higher authorities and insufficient knowledge of rabies prevention and management. To improve the capacity for case detection and management within the state, the appropriate authorities may focus on increasing awareness about the disease to the populace to increase the number of cases identified by the system, employ more workers and strengthen the surveillance capability of existing workers.
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Affiliation(s)
- Adebanwo Kuye
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
| | - Mishel Dauda
- Regional Disease Surveillance Enhancement Project (REDISSE), Gombe State Ministry of Agriculture and Animal husbandry, Gombe, Nigeria
| | | | | | - Yakubu Joel Atuman
- Bauchi Outstation Diagnostic Laboratory, National Veterinary Research Institute, Jos Plateau State, Vom, Nigeria
| | - Grace Sabo Nok Kia
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
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Singh S, Sharma P, Pal N, Sarma DK, Tiwari R, Kumar M. Holistic One Health Surveillance Framework: Synergizing Environmental, Animal, and Human Determinants for Enhanced Infectious Disease Management. ACS Infect Dis 2024; 10:808-826. [PMID: 38415654 DOI: 10.1021/acsinfecdis.3c00625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Recent pandemics, including the COVID-19 outbreak, have brought up growing concerns about transmission of zoonotic diseases from animals to humans. This highlights the requirement for a novel approach to discern and address the escalating health threats. The One Health paradigm has been developed as a responsive strategy to confront forthcoming outbreaks through early warning, highlighting the interconnectedness of humans, animals, and their environment. The system employs several innovative methods such as the use of advanced technology, global collaboration, and data-driven decision-making to come up with an extraordinary solution for improving worldwide disease responses. This Review deliberates environmental, animal, and human factors that influence disease risk, analyzes the challenges and advantages inherent in using the One Health surveillance system, and demonstrates how these can be empowered by Big Data and Artificial Intelligence. The Holistic One Health Surveillance Framework presented herein holds the potential to revolutionize our capacity to monitor, understand, and mitigate the impact of infectious diseases on global populations.
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Affiliation(s)
- Samradhi Singh
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Poonam Sharma
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Namrata Pal
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Devojit Kumar Sarma
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Rajnarayan Tiwari
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
| | - Manoj Kumar
- ICMR - National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal-462030, Madhya Pradesh, India
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6
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Moura P, Borck Høg B, Alban L, Sönksen UW, Ribeiro Duarte AS, Sandberg M. Evaluating the OH-EpiCap tool using the Danish integrated surveillance program for AMU and AMR as a case study. Front Public Health 2023; 11:1127701. [PMID: 38054067 PMCID: PMC10694429 DOI: 10.3389/fpubh.2023.1127701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
Antimicrobial resistance (AMR) is considered a One Health (OH) challenge, ideally demanding concerted efforts from the animal, human and environmental side. DANMAP, the Danish Integrated Antimicrobial Resistance Monitoring and Research Program, is monitoring AMR and antimicrobial use in animals and humans. OH-EpiCap is an evaluation tool, developed to address essential elements in OH surveillance systems, such as the dimensions of the organization, operational activities and the impact of the surveillance activities. We aimed to evaluate DANMAP using OH-EpiCap and hereby assessed the suitability of OH-EpiCap to evaluate integrated AMR surveillance systems. During the evaluation, the strengths and weaknesses of DANMAP concerning the "OH-ness" of the program were discussed. Furthermore, possible adaptations of the standard operating procedures and governance structure were addressed. Attention was paid to the ability and easiness of DANMAP to cope with current and future challenges connected to integrated AMR surveillance. It was concluded that DANMAP has a strong OH approach covering relevant aspects for humans and animals, whereas environmental aspects are missing. OH-EpiCap proved to be straightforward to use and provided valuable insights. The authors recommend OH-EpiCap to be used by health authorities and stakeholders. It is not suitable for the technical evaluation of a surveillance program.
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Affiliation(s)
- Pedro Moura
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Birgitte Borck Høg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Lis Alban
- Department for Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | | | - Marianne Sandberg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
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7
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Bourély C, Rousset L, Colomb-Cotinat M, Collineau L. How to move towards One Health surveillance? A qualitative study exploring the factors influencing collaborations between antimicrobial resistance surveillance programmes in France. Front Public Health 2023; 11:1123189. [PMID: 37497029 PMCID: PMC10367569 DOI: 10.3389/fpubh.2023.1123189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a major public health issue, against which international organisations and governmental bodies call for integration between surveillance programmes involved in human, animal, and environmental sectors. Collaborations are the primary feature of integration and deserve to be supported. However, little is known about the factors that can foster collaborations between surveillance programmes. This study aimed to provide a better understanding of the factors for setting-up collaborations between AMR surveillance programmes in France. Methods We performed a qualitative study based on 36 semi-structured interviews with programmes' coordinators and 15 with key-informant experts involved in AMR surveillance. Results The implementation of collaboration between sectors was multifactorial: we identified 42 factors grouped into six categories (i.e., characteristics of the overall AMR surveillance system, features of the collaborating programme, profile of the actors involved, characteristics of the collaboration itself, broader context, and AMR research activities). Collaborations were mainly fostered by good interpersonal relationship between actors, their interest in transdisciplinary approaches and the benefits of collaboration on the programmes involved. Limited resources and the complexity of the AMR surveillance system hindered collaboration. Paradoxically, coordinators generally did not perceive collaborations as a resource-pooling tool since they generally set them up only after consolidating their own programme. Discussion Since most factors identified were not specific to AMR, these results can be useful for other collaborative surveillance system. Ultimately, they provide a better understanding of stakeholders' motivations and influences driving collaboration, and can help researchers and risk managers promoting a One Health approach against public health threats.
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Affiliation(s)
- Clémence Bourély
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
| | - Léo Rousset
- Epidemiology and Support to Surveillance Unit, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University of Lyon, Lyon, France
- Claude Bernard University Lyon 1, Lyon, France
- VetAgro Sup, Marcy-L'Étoile, France
| | | | - Lucie Collineau
- Epidemiology and Support to Surveillance Unit, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University of Lyon, Lyon, France
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Moura P, Collineau L, Sandberg M, Tomassone L, De Meneghi D, Norström M, Bennani H, Häsler B, Colomb-Cotinat M, Bourély C, Filippitzi ME, Mediouni S, Boriani E, Asaduzzaman M, Caniça M, Aenishaenslin C, Alban L. Users' perception of the OH-EpiCap evaluation tool based on its application to nine national antimicrobial resistance surveillance systems. Front Public Health 2023; 11:1138645. [PMID: 37404278 PMCID: PMC10315896 DOI: 10.3389/fpubh.2023.1138645] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a One Health (OH) challenge. To achieve or maintain an effective and efficient AMR surveillance system, it is crucial to evaluate its performance in meeting the proposed objectives, while complying with resource restrictions. The OH-EpiCap tool was created to evaluate the degree of compliance of hazard surveillance activities with essential OH concepts across the following dimensions: organization, operational activities, and impact of the surveillance system. We present feedback on the application of the OH-EpiCap tool from a user's perspective, based on the use of the tool to evaluate nine national AMR surveillance systems, each with different contexts and objectives. Methods The OH-EpiCap was assessed using the updated CoEvalAMR methodology. This methodology allows the evaluation of the content themes and functional aspects of the tool and captures the user's subjective experiences via a strengths, weaknesses, opportunities, and threats (SWOT) approach. Results and Discussion The results of the evaluation of the OH-EpiCap are presented and discussed. The OH-EpiCap is an easy-to-use tool, which can facilitate a fast macro-overview of the application of the OH concept to AMR surveillance. When used by specialists in the matter, an evaluation using OH-EpiCap can serve as a basis for the discussion of possible adaptations of AMR surveillance activities or targeting areas that may be further investigated using other evaluation tools.
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Affiliation(s)
- Pedro Moura
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Lucie Collineau
- University of Lyon - French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
| | - Marianne Sandberg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | - Daniele De Meneghi
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | | | - Houda Bennani
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Barbara Häsler
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | | | - Clémence Bourély
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
| | - Maria-Eleni Filippitzi
- Laboratory of Animal Health Economics, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Veterinary Epidemiology Unit, Sciensano, Brussels, Belgium
| | - Sarah Mediouni
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | | | - Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cécile Aenishaenslin
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Lis Alban
- Department of Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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Tegegne HA, Bogaardt C, Collineau L, Cazeau G, Lailler R, Reinhardt J, Freeth FTA, Taylor E, Prada JM, Hénaux V. OH-EpiCap: a semi-quantitative tool for the evaluation of One Health epidemiological surveillance capacities and capabilities. Front Public Health 2023; 11:1053986. [PMID: 37250092 PMCID: PMC10213933 DOI: 10.3389/fpubh.2023.1053986] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/06/2023] [Indexed: 05/31/2023] Open
Abstract
Although international health agencies encourage the development of One Health (OH) surveillance, many systems remain mostly compartmentalized, with limited collaborations among sectors and disciplines. In the framework of the OH European Joint Programme "MATRIX" project, a generic evaluation tool called OH-EpiCap has been developed to enable individual institutes/governments to characterize, assess and monitor their own OH epidemiological surveillance capacities and capabilities. The tool is organized around three dimensions: organization, operational activities, and impact of the OH surveillance system; each dimension is then divided into four targets, each including four indicators. A semi-quantitative questionnaire enables the scoring of each indicator, with four levels according to the degree of satisfaction in the studied OH surveillance system. The evaluation is conducted by a panel of surveillance representatives (during a half-day workshop or with a back-and-forth process to reach a consensus). An R Shiny-based web application facilitates implementation of the evaluation and visualization of the results, and includes a benchmarking option. The tool was piloted on several foodborne hazards (i.e., Salmonella, Campylobacter, Listeria), emerging threats (e.g., antimicrobial resistance) and other zoonotic hazards (psittacosis) in multiple European countries in 2022. These case studies showed that the OH-EpiCap tool supports the tracing of strengths and weaknesses in epidemiological capacities and the identification of concrete and direct actions to improve collaborative activities at all steps of surveillance. It appears complementary to the existing EU-LabCap tool, designed to assess the capacity and capability of European microbiology laboratories. In addition, it provides opportunity to reinforce trust between surveillance stakeholders from across the system and to build a good foundation for a professional network for further collaboration.
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Affiliation(s)
- Henok Ayalew Tegegne
- University of Lyon - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, Lyon, France
| | - Carlijn Bogaardt
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Lucie Collineau
- University of Lyon - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, Lyon, France
| | - Géraldine Cazeau
- University of Lyon - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, Lyon, France
| | - Renaud Lailler
- University of Paris Est - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory for Food Safety, Maisons-Alfort, France
| | - Johana Reinhardt
- University of Lyon - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, Lyon, France
| | - Frederick T. A. Freeth
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Emma Taylor
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Joaquin M. Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Viviane Hénaux
- University of Lyon - Agence Nationale de Sécurité Sanitaire de L'Alimentation, de L'Environnement et du Travail (ANSES), Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, Lyon, France
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Lakhotia D, Tun YM, Mongkol N, Likhit O, Suthisawat S, Mangmee S, Tongthainan D, Fungfuang W, Tulayakul P, Boonnak K. A Serosurvey of Japanese Encephalitis Virus in Monkeys and Humans Living in Proximity in Thailand. Viruses 2023; 15:v15051125. [PMID: 37243211 DOI: 10.3390/v15051125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Japanese encephalitis virus (JEV) is a member of the Flaviviridae family and one of Asia's most common causes of encephalitis. JEV is a zoonotic virus that is transmitted to humans through the bite of infected mosquitoes of the Culex species. While humans are dead-end hosts for the virus, domestic animals such as pigs and birds are amplification hosts. Although JEV naturally infected monkeys have been reported in Asia, the role of non-human primates (NHPs) in the JEV transmission cycle has not been intensively investigated. In this study, we demonstrated neutralizing antibodies against JEV in NHPs (Macaca fascicularis) and humans living in proximity in two provinces located in western and eastern Thailand by using Plaque Reduction Neutralization Test (PRNT). We found a 14.7% and 5.6% seropositive rate in monkeys and 43.7% and 45.2% seropositive rate in humans living in west and east Thailand, respectively. This study observed a higher seropositivity rate in the older age group in humans. The presence of JEV neutralizing antibodies in NHPs that live in proximity to humans shows the occurrence of natural JEV infection, suggesting the endemic transmission of this virus in NHPs. According to the One Health concept, regular serological studies should be conducted especially at the animal-human interface.
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Affiliation(s)
- Divya Lakhotia
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Yin May Tun
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nanthanida Mongkol
- Division of Microbiology and Parasitology, Faculty of Medicine, Siam University, Bangkok 10160, Thailand
| | - Oranit Likhit
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sarocha Suthisawat
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Suthee Mangmee
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Daraka Tongthainan
- Faculty of Veterinary Medicine, Rajamangala University of Technology Tawan-ok, Chonburi 20110, Thailand
| | - Wirasak Fungfuang
- Department of Zoology, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Phitsanu Tulayakul
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Kobporn Boonnak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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11
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Pinto J, Dissanayake RB, Dhand N, Rojo-Gimeno C, Falzon LC, Akwar H, Alambeji RB, Beltran-Alcrudo D, Castellan DM, Chanachai K, Guitian J, Hilmers A, Larfaoui F, Loth L, Motta P, Rasamoelina H, Salyer S, Shadomy S, Squarzoni C, Rwego I, Santos CV, Wongsathapornchai K, Lockhart C, Okuthe S, Kane Y, Gilbert J, Soumare B, Dhingra M, Sumption K, Tiensin T. Development of core competencies for field veterinary epidemiology training programs. Front Vet Sci 2023; 10:1143375. [PMID: 37089403 PMCID: PMC10118009 DOI: 10.3389/fvets.2023.1143375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
A workforce with the adequate field epidemiology knowledge, skills and abilities is the foundation of a strong and effective animal health system. Field epidemiology training is conducted in several countries to meet the increased global demand for such a workforce. However, core competencies for field veterinary epidemiology have not been identified and agreed upon globally, leading to the development of different training curricula. Having a set of agreed core competencies can harmonize field veterinary epidemiology training. The Food and Agriculture Organization of the United Nations (FAO) initiated a collective, iterative, and participative process to achieve this and organized two expert consultative workshops in 2018 to develop core competencies for field veterinary epidemiology at the frontline and intermediate levels. Based on these expert discussions, 13 competencies were identified for the frontline and intermediate levels. These competencies were organized into three domains: epidemiological surveillance and studies; field investigation, preparedness and response; and One Health, communication, ethics and professionalism. These competencies can be used to facilitate the development of field epidemiology training curricula for veterinarians, adapted to country training needs, or customized for training other close disciplines. The competencies can also be useful for mentors and employers to monitor and evaluate the progress of their mentees, or to guide the selection process during the recruitment of new staff.
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Affiliation(s)
- Julio Pinto
- Food and Agriculture Organization of the United Nations, Rome, Italy
- Food and Agriculture Organization of the United Nations, Liaison Office for the United Nations, Geneva, Switzerland
- *Correspondence: Julio Pinto
| | | | - Navneet Dhand
- Food and Agriculture Organization of the United Nations, Rome, Italy
- Sydney School of Veterinary Science, The University of Sydney, Camden, NSW, Australia
| | | | | | - Holy Akwar
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | | | - Daniel Beltran-Alcrudo
- Food and Agriculture Organization Regional Office for Europe and Central Asia, Budapest, Hungary
| | - David Mario Castellan
- Institute for Infectious Animal Diseases, Texas A&M University, College Station, TX, United States
| | - Karoon Chanachai
- Department of Disease Control/Department of Livestock Development, Ministry of Agriculture and Cooperatives, Bangkok, Thailand
| | | | - Angela Hilmers
- Training Programs in Epidemiology and Public Health Interventions Network, Atlanta, GA, United States
| | - Fairouz Larfaoui
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Leo Loth
- Food and Agriculture Organization Emergency Center for Transboundary Animal Diseases, Hanoi, Vietnam
| | - Paolo Motta
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | | | - Stephanie Salyer
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sean Shadomy
- Food and Agriculture Organization of the United Nations, Rome, Italy
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Cécile Squarzoni
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement, La Réunion, France
| | - Innocent Rwego
- University of Minnesota/One Health Central and Eastern Africa, Makerere University, Kampala, Uganda
| | - Carmen Varela Santos
- Public Health Capacity and Communication Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Kachen Wongsathapornchai
- Food and Agriculture Organization, Emergency Center for Transboundary Animal Diseases, Bangkok, Thailand
| | - Caryl Lockhart
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Sam Okuthe
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Yaghouba Kane
- Food and Agriculture Organization of the United Nations Regional Office for Africa, Accra, Ghana
| | - Jeffrey Gilbert
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Baba Soumare
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Madhur Dhingra
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Keith Sumption
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Thanawat Tiensin
- Food and Agriculture Organization of the United Nations, Rome, Italy
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12
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Latinne A, Nga NTT, Long NV, Ngoc PTB, Thuy HB, Long NV, Long PT, Phuong NT, Quang LTV, Tung N, Nam VS, Duoc VT, Thinh ND, Schoepp R, Ricks K, Inui K, Padungtod P, Johnson CK, Mazet JAK, Walzer C, Olson SH, Fine AE. One Health Surveillance Highlights Circulation of Viruses with Zoonotic Potential in Bats, Pigs, and Humans in Viet Nam. Viruses 2023; 15:v15030790. [PMID: 36992498 PMCID: PMC10053906 DOI: 10.3390/v15030790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
A One Health cross-sectoral surveillance approach was implemented to screen biological samples from bats, pigs, and humans at high-risk interfaces for zoonotic viral spillover for five viral families with zoonotic potential in Viet Nam. Over 1600 animal and human samples from bat guano harvesting sites, natural bat roosts, and pig farming operations were tested for coronaviruses (CoVs), paramyxoviruses, influenza viruses, filoviruses and flaviviruses using consensus PCR assays. Human samples were also tested using immunoassays to detect antibodies against eight virus groups. Significant viral diversity, including CoVs closely related to ancestors of pig pathogens, was detected in bats roosting at the human-animal interfaces, illustrating the high risk for CoV spillover from bats to pigs in Viet Nam, where pig density is very high. Season and reproductive period were significantly associated with the detection of bat CoVs, with site-specific effects. Phylogeographic analysis indicated localized viral transmission among pig farms. Our limited human sampling did not detect any known zoonotic bat viruses in human communities living close to the bat cave and harvesting bat guano, but our serological assays showed possible previous exposure to Marburg virus-like (Filoviridae), Crimean-Congo hemorrhagic fever virus-like (Bunyaviridae) viruses and flaviviruses. Targeted and coordinated One Health surveillance helped uncover this viral pathogen emergence hotspot.
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Affiliation(s)
- Alice Latinne
- Wildlife Conservation Society, Viet Nam Country Program, Hanoi 11111, Viet Nam
- Wildlife Conservation Society, Health Program, Bronx, NY 10460, USA
| | | | - Nguyen Van Long
- Wildlife Conservation Society, Viet Nam Country Program, Hanoi 11111, Viet Nam
| | - Pham Thi Bich Ngoc
- Wildlife Conservation Society, Viet Nam Country Program, Hanoi 11111, Viet Nam
| | - Hoang Bich Thuy
- Wildlife Conservation Society, Viet Nam Country Program, Hanoi 11111, Viet Nam
| | - Nguyen Van Long
- Department of Animal Health, Ministry of Agricultural and Rural Development of Viet Nam, Hanoi 11519, Viet Nam
| | - Pham Thanh Long
- Department of Animal Health, Ministry of Agricultural and Rural Development of Viet Nam, Hanoi 11519, Viet Nam
| | | | - Le Tin Vinh Quang
- Regional Animal Health Office No. 6, Ho Chi Minh City 72106, Viet Nam
| | - Nguyen Tung
- Department of Animal Health, Ministry of Agricultural and Rural Development of Viet Nam, Hanoi 11519, Viet Nam
| | - Vu Sinh Nam
- National Institute of Hygiene and Epidemiology, Ministry of Health, Hanoi 11611, Viet Nam
| | - Vu Trong Duoc
- National Institute of Hygiene and Epidemiology, Ministry of Health, Hanoi 11611, Viet Nam
| | - Nguyen Duc Thinh
- National Institute of Hygiene and Epidemiology, Ministry of Health, Hanoi 11611, Viet Nam
| | - Randal Schoepp
- Diagnostic Systems Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA
| | - Keersten Ricks
- Diagnostic Systems Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702, USA
| | - Ken Inui
- Food and Agriculture Organization of the United Nations (FAO), Country Office for Viet Nam, Hanoi 11112, Viet Nam
| | - Pawin Padungtod
- Food and Agriculture Organization of the United Nations (FAO), Country Office for Viet Nam, Hanoi 11112, Viet Nam
| | - Christine K Johnson
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Jonna A K Mazet
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - Chris Walzer
- Wildlife Conservation Society, Health Program, Bronx, NY 10460, USA
- Research Institute of Wildlife Ecology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - Sarah H Olson
- Wildlife Conservation Society, Health Program, Bronx, NY 10460, USA
| | - Amanda E Fine
- Wildlife Conservation Society, Viet Nam Country Program, Hanoi 11111, Viet Nam
- Wildlife Conservation Society, Health Program, Bronx, NY 10460, USA
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13
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Mremi IR, Rumisha SF, Sindato C, Kimera SI, Mboera LEG. Comparative assessment of the human and animal health surveillance systems in Tanzania: Opportunities for an integrated one health surveillance platform. Glob Public Health 2023; 18:2110921. [PMID: 35951768 DOI: 10.1080/17441692.2022.2110921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/02/2022] [Indexed: 11/04/2022]
Abstract
Globally, there have been calls for an integrated zoonotic disease surveillance system. This study aimed to assess human and animal health surveillance systems to identify opportunities for One Health surveillance platform in Tanzania. A desk review of policies, acts and strategies addressing disease surveillance that support inter-sectoral collaboration was conducted. A semi-structured questionnaire was administered to key informants from the two sectors. Databases with potential relevance for surveillance were assessed. One Health-focused policies, acts, strategic plans and guidelines emphasising inter-sectoral collaboration strengthening were in place. Stable systems for collecting surveillance data with trained staff to implement surveillance activities at all levels in both sectors were available. While the human surveillance system was a mix of paper-based and web-based, the animal health system was mainly paper-based. The laboratory information system existed in both sectors, though not integrated with the epidemiological surveillance systems. Both the animal and human surveillance systems had low sensitivity to alert outbreaks. The findings indicate that individual, organisational, and infrastructure opportunities that support the integration of surveillance systems from multiple sectors exist. Challenges related to data sharing and quality need to be addressed for the effective implementation of the platform.
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Affiliation(s)
- Irene R Mremi
- SACIDS Foundation for One Health, Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Susan F Rumisha
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Malaria Atlas Project, Geospatial Health and Development, Telethon Kids Institute, West Perth, Australia
| | - Calvin Sindato
- SACIDS Foundation for One Health, Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
- National Institute for Medical Research, Tabora Research Centre, Tabora, Tanzania
| | - Sharadhuli I Kimera
- SACIDS Foundation for One Health, Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Leonard E G Mboera
- SACIDS Foundation for One Health, Africa Centre of Excellence for Infectious Diseases of Human and Animals, Sokoine University of Agriculture, Morogoro, Tanzania
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14
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Kosoltanapiwat N, Tongshoob J, Ampawong S, Reamtong O, Prasittichai L, Yindee M, Tongthainan D, Tulayakul P, Boonnak K. Simian adenoviruses: Molecular and serological survey in monkeys and humans in Thailand. One Health 2022; 15:100434. [PMID: 36277107 PMCID: PMC9582551 DOI: 10.1016/j.onehlt.2022.100434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
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15
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Nana SD, Caffin JH, Duboz R, Antoine-Moussiaux N, Binot A, Diagbouga PS, Hendrikx P, Bordier M. Towards an integrated surveillance of zoonotic diseases in Burkina Faso: the case of anthrax. BMC Public Health 2022; 22:1535. [PMID: 35962327 PMCID: PMC9372945 DOI: 10.1186/s12889-022-13878-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Anthrax is a zoonotic disease that causes frequent outbreaks in livestock and fatal human cases in Burkina Faso. Effective surveillance of this disease calls for the establishment of an integrated surveillance system, in line with the One Health concept. However, despite a strong technical and financial support from international partners, surveillance is still poorly conducted within an integrated approach. Based on stakeholder perspectives, the study has for objective to deepen our understanding of the anthrax surveillance system and to identify the obstacles and levers towards a more integrated approach to anthrax surveillance in Burkina Faso. Methods The data was collected from a literature review and interviews with surveillance stakeholders. We first conducted a qualitative descriptive analysis of the data to characterize the surveillance system (programmes, actors, collaboration). In a second step, we conducted a thematic analysis of the informants' discourse in order to identify what represents an obstacle or, conversely, a lever for a more integrated approach to anthrax surveillance. Results The surveillance system of anthrax in Burkina Faso includes three programmes (in the livestock, wildlife and human sectors), which involves 30 actors. These sectoral programmes operate almost independently from one another, although some collaborations are existing for the governance and implementation of surveillance activities. Analysis of the discourse of key stakeholders led to the identification of four categories of factors that may influence the implementation of an integrated surveillance system in the country: knowledge; technical, organizational and social capacities; motivation; intersectoral governance. Conclusions This study highlights the difficulty of translating One Health governance to the national level and the need to better articulate the visions of all categories of stakeholders. This study also reveals the need to develop specific evaluation systems for integrated policies in order to provide credible evidence of their added value for a better management of zoonotic diseases. Finally, our study underlines the need to act upstream the emergence of zoonoses and allocate more resources to the prevention of zoonoses than to their control. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13878-3.
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Affiliation(s)
- Sougrenoma Désiré Nana
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France.,CIRAD, UMR ASTRE, Montpellier, France
| | | | - Raphaël Duboz
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France.,CIRAD, UMR ASTRE, Dakar, Senegal.,IRD, Sorbonne University, UMMISCO, Bondy, France.,National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal
| | - Nicolas Antoine-Moussiaux
- Fundamental and Applied Research for Animals and Health Research Unit, Faculty of Veterinary Medicine, University of Liege, Liege, Belgium
| | - Aurélie Binot
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France.,CIRAD, UMR ASTRE, Montpellier, France
| | - Potiandi Serge Diagbouga
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso.,Etudes Formation Et Recherches Développement en Santé, Ouagadougou, Burkina Faso
| | - Pascal Hendrikx
- High Council for Food, Agriculture and Rural Areas, Paris, France
| | - Marion Bordier
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France. .,CIRAD, UMR ASTRE, Dakar, Senegal. .,National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal.
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16
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Benedetti G, Jokelainen P, Ethelberg S. Search term “One Health” remains of limited use to identify relevant scientific publications: Denmark as a case study. Front Public Health 2022; 10:938460. [PMID: 35968488 PMCID: PMC9368311 DOI: 10.3389/fpubh.2022.938460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/01/2022] [Indexed: 12/01/2022] Open
Abstract
One Health has become a popular approach, and scientific advancements in the field should be easily findable and accessible to a wide range of relevant audiences, from researchers to policymakers, and across sectors. We conducted a systematic narrative review of available scientific publications concerning One Health in the setting of Denmark that were retrievable using “One Health” as the key search term. Three searches in two databases yielded 30 retrieved publications, 13 of which were included in the review. The included publications had been published between 2015 and 2021. Twelve of the included publications were co-authored in collaboration across institutes from different sectors. Three of the included publications had focus on antimicrobial resistance, three on disease surveillance and/or control, and five were assessments or evaluations. The overall number of publications identified by a search using “One Health” as the key search term was small, and the search identified some publications that were not relevant to One Health. Our work thus highlights a missed scientific and communication opportunity of signposting articles as relevant to One Health. Using the expression “One Health” as keyword could help making One Health research more easily findable and thereby obtaining an overview of research in the field.
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Affiliation(s)
- Guido Benedetti
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- *Correspondence: Guido Benedetti
| | - Pikka Jokelainen
- Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
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17
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A generalizable one health framework for the control of zoonotic diseases. Sci Rep 2022; 12:8588. [PMID: 35597789 PMCID: PMC9124177 DOI: 10.1038/s41598-022-12619-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/13/2022] [Indexed: 11/08/2022] Open
Abstract
Effectively preventing and controlling zoonotic diseases requires a One Health approach that involves collaboration across sectors responsible for human health, animal health (both domestic and wildlife), and the environment, as well as other partners. Here we describe the Generalizable One Health Framework (GOHF), a five-step framework that provides structure for using a One Health approach in zoonotic disease programs being implemented at the local, sub-national, national, regional, or international level. Part of the framework is a toolkit that compiles existing resources and presents them following a stepwise schematic, allowing users to identify relevant resources as they are required. Coupled with recommendations for implementing a One Health approach for zoonotic disease prevention and control in technical domains including laboratory, surveillance, preparedness and response, this framework can mobilize One Health and thereby enhance and guide capacity building to combat zoonotic disease threats at the human-animal-environment interface.
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18
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Boudreau LeBlanc A, Williams-Jones B, Aenishaenslin C. Bio-Ethics and One Health: A Case Study Approach to Building Reflexive Governance. Front Public Health 2022; 10:648593. [PMID: 35372246 PMCID: PMC8971560 DOI: 10.3389/fpubh.2022.648593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics.
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Affiliation(s)
- Antoine Boudreau LeBlanc
- Bioethics Programs, Department of Social and Preventive Medicine, Public Health School, Université de Montréal, Montréal, QC, Canada
- *Correspondence: Antoine Boudreau LeBlanc
| | - Bryn Williams-Jones
- Bioethics Programs, Department of Social and Preventive Medicine, Public Health School, Université de Montréal, Montréal, QC, Canada
| | - Cécile Aenishaenslin
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Montréal, QC, Canada
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Gomes BM, Rebelo CB, Alves de Sousa L. Public health, surveillance systems and preventive medicine in an interconnected world. One Health 2022. [DOI: 10.1016/b978-0-12-822794-7.00006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Grajeda LM, McCracken JP, Berger-González M, López MR, Álvarez D, Méndez S, Pérez O, Cordón-Rosales C, Zinsstag J. Sensitivity and representativeness of one-health surveillance for diseases of zoonotic potential at health facilities relative to household visits in rural Guatemala. One Health 2021; 13:100336. [PMID: 34703874 PMCID: PMC8524745 DOI: 10.1016/j.onehlt.2021.100336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 10/31/2022] Open
Abstract
Most human and animal disease notification systems are unintegrated and passive, resulting in underreporting. Active surveillance can complement passive efforts, but because they are resource-intensive, their attributes must be evaluated. We assessed the sensitivity and representativeness of One-Health surveillance conducted at health facilities compared to health facilities plus monthly household visits in three rural communities of Guatemala. From September 2017 to November 2018, we screened humans for acute diarrheal, febrile and respiratory infectious syndromes and canines, swine, equines and bovines for syndromic events or deaths. We estimated the relative sensitivity as the incidence rate ratio of detecting an event in health facility surveillance compared to household surveillance from Poisson models. We used interaction terms between the surveillance method and sociodemographic factors or time trends to assess effect modification as a measure of relative representativeness. We used generalized additive models with smoothing splines to model incidence over time by surveillance method. We randomized 216 households to health facility surveillance and 198 to health facility surveillance plus monthly household visits. Health facility surveillance alone was less sensitive than when combined with household surveillance by 0.42 (95% CI: 0.34, 0.53), 0.56 (95% CI: 0.39, 0.79), 0.02 (95% CI: 0.00, 0.10), 0.28 (95% CI: 0.15, 0.50) and 0.22 (95% CI: 0.03, 0.92) times for human acute infections, human severe acute infections, and deaths in canines, swine and equines, respectively. Health facility surveillance alone underrepresented Spanish speakers (interaction p-value = 0.0003) and persons in higher economic assets (interaction p-values = 0.0008). The trend in incidence over time was different between the two study groups, with a larger decrease in the group with household surveillance (all interaction p-values <0.10). Surveillance at health facilities under ascertains syndromes in humans and animals which leads to underestimation of the burden of zoonotic disease. The magnitude of under ascertainment was differentially by sociodemographic factors, yielding an unrepresentative sample of health events. However, it is less time-intensive, thus might be sustained over time longer than household surveillance. The choice between methodologies should be evaluated against surveillance goals and available resources.
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Affiliation(s)
- Laura M. Grajeda
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
- Global Health Institute, College of Public Health, University of Georgia, GA, USA
| | - John P. McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
- Global Health Institute, College of Public Health, University of Georgia, GA, USA
| | - Mónica Berger-González
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
| | - María Reneé López
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
| | - Danilo Álvarez
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
| | - Salvador Méndez
- Ministry of Public Health and Social Welfare, Petén, Guatemala
| | - Oscar Pérez
- Ministry of Agriculture, Livestock and Food, Petén, Guatemala
| | - Celia Cordón-Rosales
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, PO Box, CH-4002 Basel, Switzerland
- University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
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21
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Bennani H, Cornelsen L, Stärk KDC, Häsler B. Evaluating Integrated Surveillance for Antimicrobial Use and Resistance in England: A Qualitative Study. Front Vet Sci 2021; 8:743857. [PMID: 34805336 PMCID: PMC8596565 DOI: 10.3389/fvets.2021.743857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Integrated surveillance systems for antimicrobial use (AMU) and antimicrobial resistance (AMR) require regular evaluation to ensure the effectiveness and efficiency of the system. An important step in the evaluation is to choose an appropriate tool for the purpose of the evaluation. The “Integrated Surveillance System Evaluation” (ISSE) framework is a conceptual framework that was developed to evaluate One Health (OH) integration in surveillance system for AMU/AMR. This study aimed to evaluate the performance and value of integrated surveillance system for AMU/AMR in England by applying the ISSE framework, which was used to develop data collection protocols and define the study design. A qualitative study using semi-structured interviews was conducted to collect the data and analyse it thematically. Eighteen stakeholders from human, animal, food and environment sectors that are involved in AMU/AMR surveillance were interviewed. Four main themes emerged from the analysis: (1) Cross-sectoral integration in the surveillance system for AMU/AMR; (2) Production of OH outputs and outcomes; (3) Drivers and barriers to cross-sectoral collaboration; and 4) Need for more cross-sectoral collaboration. The findings showed that there were links between integrated surveillance information, decision making and interventions. However, there were only few OH examples, such as the UK AMR contingency plan, where the potential of cross-sectoral collaboration was fully exploited. A lot of the benefits described were related to the generation of information and increase in knowledge and understanding without links to how the information generated was used. While these intangible benefits have a value on their own, being able to link surveillance information and mitigation measures would help to enhance the value of integrated surveillance. In terms of improvement, the main areas identified were the development of more harmonised methods for data collection and analysis, provision of resources dedicated to cross-sectoral collaboration, improved coordination, and collection of surveillance data from the environment and from companion animals. By identifying links between OH surveillance information produced and various outputs and outcomes; this study helped to understand the wider benefits of integrated surveillance for AMU/AMR in England and provided insights on how the system could be improved and efficiency increased.
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Affiliation(s)
- Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Laura Cornelsen
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katharina D C Stärk
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom.,Department of Animal Health, Federal Food Safety and Veterinary Office, Bern, Switzerland
| | - Barbara Häsler
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
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22
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Kiiti RW, Komba EV, Msoffe PL, Mshana SE, Rweyemamu M, Matee MIN. Antimicrobial Resistance Profiles of Escherichia coli Isolated from Broiler and Layer Chickens in Arusha and Mwanza, Tanzania. Int J Microbiol 2021; 2021:6759046. [PMID: 34721584 PMCID: PMC8556130 DOI: 10.1155/2021/6759046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
The rise in the spread of antibiotic-resistant pathogens such as Escherichia coli is one of the very important dynamics off-putting treatment and prophylaxis possibilities, hence posing a threat to the modern human medicine, veterinary medicine, and food safety. Therefore, the aim of this study was to determine antimicrobial resistance profiles in E. coli isolates obtained from broiler and layer chickens in Mwanza and Arusha regions in Tanzania. A cross-sectional study was carried out from February to March, 2021, in 402 poultry farms in Mwanza (201) and Arusha (201) regions in Tanzania. All samples that tested positive for E. coli were confirmed using MALDI-TOF MS, and two hundred and four (204) E. coli isolates were randomly chosen and subjected to antimicrobial susceptibility testing by disc diffusion method. Data were entered in Microsoft Excel® and analyzed using SPSS version 20. Isolates were tested against seven antimicrobial agents belonging to seven classes of antimicrobials. All the tested isolates (n = 204) were resistant to at least one antimicrobial agent. Overall, the highest resistance was observed in ampicillin (100%), whereas the lowest resistance was recorded for gentamicin (10.3%). Majority of the isolates (86.76%) were multidrug resistant. Antimicrobial resistance of E. coli to four classes of antimicrobial agents was the highest in this study (31.1%). Six of the 177 tested isolates (2.9%) were resistant to the seven classes of antimicrobial agents. 21 of the 204 (10.29%) isolates were ESBL producers where 21/21 (100%) isolates expressed bla TEM genes and only two isolates expressed (2/21) bla CTX-M gene. The isolates obtained in this study displayed high resistance to commonly used antimicrobial agents in veterinary and human medicine. This implies that there is existence of practices that accelerate antimicrobial resistance in the production of the sampled birds and therefore integration of appropriate use of antimicrobial agents and other measures that curb the spread of resistant genes is necessary.
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Affiliation(s)
- Ruth W. Kiiti
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Erick V. Komba
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Peter L. Msoffe
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Stephen E. Mshana
- Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza 33109, Tanzania
| | - Mark Rweyemamu
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania
| | - Mecky I. N. Matee
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania
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23
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Abuzerr S, Zinszer K, Assan A. Implementation challenges of an integrated One Health surveillance system in humanitarian settings: A qualitative study in Palestine. SAGE Open Med 2021; 9:20503121211043038. [PMID: 34504706 PMCID: PMC8422815 DOI: 10.1177/20503121211043038] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/13/2021] [Indexed: 12/07/2022] Open
Abstract
Objectives Several factors have changed interactions between people, animals, plants, and the environment - renewing the relevance of the One Health surveillance system in the fight against zoonotic diseases such as COVID-19. Therefore, this study aimed to explore barriers to implementing an integrated One Health surveillance system in Palestine. Methods This qualitative study was conducted from April 2020 until August 2020. Data were collected using semi-structured interview guides. Seven key stakeholders were interviewed during data collection. A thematic analysis was performed. Results Four overarching themes emerged explaining barriers to integrated implementation of the One Health surveillance system. They are lack of policy coherence, limited financial resources, poor governance and leadership, and lack of One Health training programmes. Conclusion Improved understanding of the transmission and effective control (including One Health approach) of zoonotic disease and better governance and leadership are critical in the diseases that threaten public health, such as the COVID-19.
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Affiliation(s)
- Samer Abuzerr
- Visiting Scholar with the School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada.,Quality Improvement and Infection Control Unit, Ministry of Health, Gaza, Palestine
| | - Kate Zinszer
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Abraham Assan
- Global Policy and Advocacy Network (GLOOPLAN), Accra, Ghana
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24
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Crump L, Maidane Y, Mauti S, Tschopp R, Ali SM, Abtidon R, Bourhy H, Keita Z, Doumbia S, Traore A, Bonfoh B, Tetchi M, Tiembré I, Kallo V, Paithankar V, Zinsstag J. From reverse innovation to global innovation in animal health: A review. Heliyon 2021; 7:e08044. [PMID: 34622053 PMCID: PMC8479615 DOI: 10.1016/j.heliyon.2021.e08044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 11/02/2022] Open
Abstract
Reverse innovation refers to learning from or diffusion of innovations developed in low income settings and further translated to industrialized countries. There is lack of consensus regarding terminology, but the idea that innovations in low-income countries are promising for adoption in high-income contexts is not new. However, in healthcare literature globally, the vast majority of publications referring to 'disruptive innovation' were published in the last ten years. To assess the potential of innovative developments and technologies for improving animal health, we initiated a literature review in 2020. We used a combined approach, incorporating targeted searching in PubMed using a key word algorithm with a snowball technique, to identify 120 relevant publications and extract data for qualitative coding. Heterogeneity of articles precluded meta-analysis, quality scoring and risk of bias analysis. We can distinguish technical innovations like new digital devices, diagnostic tests and procedures, and social innovations of intersectoral cooperation. We profile two case studies to describe potential global innovations: an integrated surveillance and response system in Somali Regional State, Ethiopia and a blockchain secured One Health intervention to optimally provide post-exposure prophylaxis for rabies exposed people in West Africa. Innovation follows no borders and can also occur in low-income settings, under constraints of cost, lack of services and infrastructure. Lower administrative and legal barriers may contribute to produce innovations that would not be possible under conditions of high density of regulation. We recommend using the term global innovation, which highlights those emanating from international partnership to solve problems of global implications.
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Affiliation(s)
- Lisa Crump
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Yahya Maidane
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- Jigjiga University, Jigjiga, Ethiopia
| | - Stephanie Mauti
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Seid Mohammed Ali
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- Jigjiga University, Jigjiga, Ethiopia
| | - Rahma Abtidon
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- Jigjiga University, Jigjiga, Ethiopia
| | - Hervé Bourhy
- Institut Pasteur, 25-28 Rue du Dr Roux, 75015, Paris, France
| | - Zakaria Keita
- Université des Sciences, des Techniques et des Technologies de Bamako, BP, 1805, Bamako, Mali
| | - Seydou Doumbia
- Université des Sciences, des Techniques et des Technologies de Bamako, BP, 1805, Bamako, Mali
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP, 1303, Abidjan, Cote d'Ivoire
| | - Mathilde Tetchi
- Institut National d'Hygiène Publique, 23 BP, 3838, Abidjan, Cote d'Ivoire
| | - Issaka Tiembré
- Institut National d'Hygiène Publique, 23 BP, 3838, Abidjan, Cote d'Ivoire
| | - Vessaly Kallo
- Ministère de Resources Animales et Halieutiques, Abidjan, Cote d'Ivoire
| | - Vega Paithankar
- Health Information Traceability Stiftung, Gotthardstrasse 26, Zug, Switzerland
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
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25
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Rhoden K, Alonso J, Carmona M, Pham M, Barnes AN. Twenty years of waterborne and related disease reports in Florida, USA. One Health 2021; 13:100294. [PMID: 34368415 PMCID: PMC8326185 DOI: 10.1016/j.onehlt.2021.100294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 11/06/2022] Open
Abstract
Florida represents a unique challenge for preventing and responding to infectious disease associated with water. This study cataloged the prevalence of reportable waterborne and water-related disease within Florida residents over the last twenty years and identified relationships between confirmed cases by location and additional risk factors. Data was collected through FLHealthCHARTS for confirmed cases between January 1, 1999 and December 31, 2019. Case records were compiled and analyzed by year, county, pathogen name and disease category, patient age, and where the infection was acquired. During this time, 218,707 cases of water-related disease were recorded with 214,745 due to waterborne disease, 3255 cases of water-related vector-borne disease, and 707 cases caused by a water-based toxin. Children aged 0–4 and the elderly demonstrated a higher proportion of waterborne disease while 45–49 year olds had increased rates of water-based toxins and water-related vector-borne disease. Most cases were reported in the southeast region. Across the state, opportunities for water contact have led to high rates of water-related infectious disease. Public health initiatives and response efforts should target the pathogens of greatest impact for each region, largely zoonotic waterborne diseases, using a One Health approach. Over 200,000 cases of water-related disease have been reported to the Florida Department of Health over the last 20 years Most reported disease is due to waterborne pathogens followed by water-related vector-borne disease and water-based toxins Salmonellosis makes up the largest reported water-related disease burden for Florida Children and seniors have higher risk for waterborne disease; adults have higher risk for toxins and vector-borne disease Water disease prevention and response must use a One Health model for collaboration with human and animal health providers
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Affiliation(s)
- Kelly Rhoden
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Jose Alonso
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Meg Carmona
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Michelle Pham
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Amber N Barnes
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
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26
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Sandberg M, Hesp A, Aenishaenslin C, Bordier M, Bennani H, Bergwerff U, Chantziaras I, De Meneghi D, Ellis-Iversen J, Filippizi ME, Mintiens K, Nielsen LR, Norström M, Tomassone L, van Schaik G, Alban L. Assessment of Evaluation Tools for Integrated Surveillance of Antimicrobial Use and Resistance Based on Selected Case Studies. Front Vet Sci 2021; 8:620998. [PMID: 34307513 PMCID: PMC8298032 DOI: 10.3389/fvets.2021.620998] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/21/2021] [Indexed: 01/18/2023] Open
Abstract
Regular evaluation of integrated surveillance for antimicrobial use (AMU) and resistance (AMR) in animals, humans, and the environment is needed to ensure system effectiveness, but the question is how. In this study, six different evaluation tools were assessed after being applied to AMU and AMR surveillance in eight countries: (1) ATLASS: the Assessment Tool for Laboratories and AMR Surveillance Systems developed by the Food and Agriculture Organization (FAO) of the United Nations, (2) ECoSur: Evaluation of Collaboration for Surveillance tool, (3) ISSEP: Integrated Surveillance System Evaluation Project, (4) NEOH: developed by the EU COST Action "Network for Evaluation of One Health," (5) PMP-AMR: The Progressive Management Pathway tool on AMR developed by the FAO, and (6) SURVTOOLS: developed in the FP7-EU project "RISKSUR." Each tool was scored using (i) 11 pre-defined functional aspects (e.g., workability concerning the need for data, time, and people); (ii) a strengths, weaknesses, opportunities, and threats (SWOT)-like approach of user experiences (e.g., things that I liked or that the tool covered well); and (iii) eight predefined content themes related to scope (e.g., development purpose and collaboration). PMP-AMR, ATLASS, ECoSur, and NEOH are evaluation tools that provide a scoring system to obtain semi-quantitative results, whereas ISSEP and SURVTOOLS will result in a plan for how to conduct evaluation(s). ISSEP, ECoSur, NEOH, and SURVTOOLS allow for in-depth analyses and therefore require more complex data, information, and specific training of evaluator(s). PMP-AMR, ATLASS, and ISSEP were developed specifically for AMR-related activities-only ISSEP included production of a direct measure for "integration" and "impact on decision making." NEOH and ISSEP were perceived as the best tools for evaluation of One Health (OH) aspects, and ECoSur as best for evaluation of the quality of collaboration. PMP-AMR and ATLASS seemed to be the most user-friendly tools, particularly designed for risk managers. ATLASS was the only tool focusing specifically on laboratory activities. Our experience is that adequate resources are needed to perform evaluation(s). In most cases, evaluation would require involvement of several assessors and/or stakeholders, taking from weeks to months to complete. This study can help direct future evaluators of integrated AMU and AMR surveillance toward the most adequate tool for their specific evaluation purpose.
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Affiliation(s)
- Marianne Sandberg
- Department for Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Ayla Hesp
- Department of Bacteriology and Epidemiology, Host Pathogen Interaction and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
- Department of Infectious Diseases and Immunology, Utrecht University, Utrecht, Netherlands
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Marion Bordier
- UMR Astre, Cirad, INRAE, University of Montpellier, Montpellier, France
| | - Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Ursula Bergwerff
- Department of Farm Animal Health, Utrecht University, Utrecht, Netherlands
| | - Ilias Chantziaras
- Unit of Animal Science and Unit of Social Science, Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), Merelbeke, Belgium
- Department of Reproduction, Obstetrics and Herd Health, University of Ghent, Ghent, Belgium
| | | | | | - Maria-Eleni Filippizi
- Veterinary Epidemiology Unit, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen Mintiens
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Liza R. Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Madelaine Norström
- Department of Epidemiology, Norwegian Veterinary Institute, Oslo, Norway
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Gerdien van Schaik
- Department of Farm Animal Health, Utrecht University, Utrecht, Netherlands
- Royal GD Animal Health, Deventer, Netherlands
| | - Lis Alban
- Department for Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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27
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Geffroy M, Pagès N, Chavernac D, Dereeper A, Aubert L, Herrmann-Storck C, Vega-Rúa A, Lecollinet S, Pradel J. Shifting From Sectoral to Integrated Surveillance by Changing Collaborative Practices: Application to West Nile Virus Surveillance in a Small Island State of the Caribbean. Front Public Health 2021; 9:649190. [PMID: 34178915 PMCID: PMC8222804 DOI: 10.3389/fpubh.2021.649190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/11/2021] [Indexed: 11/13/2022] Open
Abstract
After spreading in the Americas, West Nile virus was detected in Guadeloupe (French West Indies) for the first time in 2002. Ever since, several organizations have conducted research, serological surveys, and surveillance activities to detect the virus in horses, birds, mosquitoes, and humans. Organizations often carried them out independently, leading to knowledge gaps within the current virus' situation. Nearly 20 years after the first evidence of West Nile virus in the archipelago, it has not yet been isolated, its impact on human and animal populations is unknown, and its local epidemiological cycle is still poorly understood. Within the framework of a pilot project started in Guadeloupe in 2019, West Nile virus was chosen as a federative model to apply the "One Health" approach for zoonotic epidemiological surveillance and shift from a sectorial to an integrated surveillance system. Human, animal, and environmental health actors involved in both research and surveillance were considered. Semi-directed interviews and a Social Network Analysis were carried out to learn about the surveillance network structure and actors, analyze information flows, and identify communication challenges. An information system was developed to fill major gaps: users' needs and main functionalities were defined through a participatory process where actors also tested and validated the tool. Additionally, all actors shared their data, which were digitized, cataloged, and centralized, to be analyzed later. An R Shiny server was integrated into the information system, allowing an accessible and dynamic display of data showcasing all of the partners' information. Finally, a series of virtual workshops were organized among actors to discuss preliminary results and plan the next steps to improve West Nile Virus and vector-borne or emerging zoonosis surveillance. The actors are willing to build a more resilient and cooperative network in Guadeloupe with improved relevance, efficiency, and effectiveness of their work.
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Affiliation(s)
- Mariana Geffroy
- CIRAD, UMR, ASTRE, Petit-Bourg, France.,ASTRE, CIRAD, INRAE. Univ Montpellier, Montpellier, France
| | - Nonito Pagès
- ASTRE, CIRAD, INRAE. Univ Montpellier, Montpellier, France
| | | | - Alexis Dereeper
- CIRAD, UMR, ASTRE, Petit-Bourg, France.,ASTRE, CIRAD, INRAE. Univ Montpellier, Montpellier, France
| | - Lydéric Aubert
- CIRE Antilles, Santé Publique France, Pointe-à-Pitre, France
| | - Cecile Herrmann-Storck
- Centre Hospitalier Universitaire, Department of Bacteriology, Virology and Parasitology, Pointe-à-Pitre, France
| | - Anubis Vega-Rúa
- Institut Pasteur de Guadeloupe, Laboratory of Vector Control Research, Unit Transmission, Reservoirs and Pathogen Diversity, Les Abymes, France
| | - Sylvie Lecollinet
- Anses, Laboratory for Animal Health, UMR1161 Virology, INRAE, Anses, ENVA, Maisons-Alfort, France
| | - Jennifer Pradel
- CIRAD, UMR, ASTRE, Petit-Bourg, France.,ASTRE, CIRAD, INRAE. Univ Montpellier, Montpellier, France
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28
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Thomas LF, Rushton J, Bukachi SA, Falzon LC, Howland O, Fèvre EM. Cross-Sectoral Zoonotic Disease Surveillance in Western Kenya: Identifying Drivers and Barriers Within a Resource Constrained Setting. Front Vet Sci 2021; 8:658454. [PMID: 34169106 PMCID: PMC8217437 DOI: 10.3389/fvets.2021.658454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Collaboration between the human and animal health sectors, including the sharing of disease surveillance data, has the potential to improve public health outcomes through the rapid detection of zoonotic disease events prior to widespread transmission in humans. Kenya has been at the forefront of embracing a collaborative approach in Africa with the inception of the Zoonotic Disease Unit in 2011. Joint outbreak responses have been coordinated at the national level, yet little is currently documented on cross-sectoral collaboration at the sub-national level. Methods: Key informant interviews were conducted with 28 disease surveillance officers from the human and animal health sectors in three counties in western Kenya. An inductive process of thematic analysis was used to identify themes relating to barriers and drivers for cross-sectoral collaboration. Results: The study identified four interlinking themes related to drivers and barriers for cross-sectoral collaboration. To drive collaboration at the sub-national level there needs to be a clear identification of “common objectives,” as currently exemplified by the response to suspected rabies and anthrax cases and routine meat hygiene activities. The action of collaboration, be it integrated responses to outbreaks or communication and data sharing, require “operational structures” to facilitate them, including the formalisation of reporting lines, supporting legislation and the physical infrastructure, from lab equipment to mobile phones, to facilitate the activities. These structures in turn require “appropriate resources” to support them, which will be allocated based on the “political will” of those who control the resources. Conclusions: Ongoing collaborations between human and animal disease surveillance officers at the sub-national level were identified, driven by common objectives such as routine meat hygiene and response to suspected rabies and anthrax cases. In these areas a suitable operational structure is present, including a supportive legislative framework and clearly designated roles for officers within both sectors. There was support from disease surveillance officers to increase their collaboration, communication and data sharing across sectors, yet this is currently hindered by the lack of these formal operational structures and poor allocation of resources to disease surveillance. It was acknowledged that improving this resource allocation will require political will at the sub-national, national and international levels.
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Affiliation(s)
- Lian Francesca Thomas
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Jonathan Rushton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
| | - Salome A Bukachi
- Institute of Anthropology, Gender & African Studies, University of Nairobi, Nairobi, Kenya
| | - Laura C Falzon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Olivia Howland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Eric M Fèvre
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya.,Centre of Excellence for Sustainable Food Systems, University of Liverpool, Liverpool, United Kingdom
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Bordier M, Goutard FL, Antoine-Moussiaux N, Pham-Duc P, Lailler R, Binot A. Engaging Stakeholders in the Design of One Health Surveillance Systems: A Participatory Approach. Front Vet Sci 2021; 8:646458. [PMID: 34109232 PMCID: PMC8180848 DOI: 10.3389/fvets.2021.646458] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/02/2021] [Indexed: 12/30/2022] Open
Abstract
Many One Health surveillance systems have proven difficult to enforce and sustain, mainly because of the difficulty of implementing and upholding collaborative efforts for surveillance activities across stakeholders with different values, cultures and interests. We hypothesize that only the early engagement of stakeholders in the development of a One Health surveillance system can create an environment conducive to the emergence of collaborative solutions that are acceptable, accepted and therefore implemented in sustainable manner. To this end, we have designed a socio-technical framework to help stakeholders develop a common vision of their desired surveillance system and to forge the innovation pathway toward it. We implemented the framework in two case studies: the surveillance of antimicrobial resistance in Vietnam and that of Salmonella in France. The socio-technical framework is a participatory and iterative process that consists of four distinct steps implemented during a workshop series: (i) definition of the problem to be addressed, (ii) co-construction of a common representation of the current system, (iii) co-construction of the desired surveillance system, (iv) identification of changes and actions required to progress from the current situation to the desired situation. In both case studies, the process allowed surveillance stakeholders with different professional cultures and expectations regarding One Health surveillance to gain mutual understanding and to reconcile their different perspectives to design the pathway toward their common vision of a desired surveillance system. While the proposed framework is structured around four essential steps, its application can be tailored to the context. Workshop facilitation and representativeness of participants are key for the success of the process. While our approach lays the foundation for the further implementation of the desired One Health surveillance system, it provides no guarantee that the proposed actions will actually be implemented and bring about the required changes. The engagement of stakeholders in a participatory process must be sustained in order to ensure the implementation of co-constructed solutions and evaluate their effectiveness and impacts.
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Affiliation(s)
- Marion Bordier
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France.,CIRAD, UMR ASTRE, Montpellier, France
| | - Flavie Luce Goutard
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France.,Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand.,CIRAD, UMR ASTRE, Bangkok, Thailand
| | - Nicolas Antoine-Moussiaux
- Fundamental and Applied Research for Animals and Health Research Unit, Faculty of Veterinary Medicine, University of Liege, Liege, Belgium
| | - Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.,Institute of Environmental Health and Sustainable Development (IEHSD), Hanoi, Vietnam
| | - Renaud Lailler
- Laboratoire de Sécurité des Aliments, Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail (ANSES), Maisons-Alfort, France.,Université Paris-Est Créteil Val de Marne, Créteil, France
| | - Aurelie Binot
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France.,CIRAD, UMR ASTRE, Montpellier, France
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Aenishaenslin C, Häsler B, Ravel A, Parmley EJ, Mediouni S, Bennani H, Stärk KDC, Buckeridge DL. Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework. Front Vet Sci 2021; 8:611931. [PMID: 33842569 PMCID: PMC8024545 DOI: 10.3389/fvets.2021.611931] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/08/2021] [Indexed: 11/26/2022] Open
Abstract
It is now widely acknowledged that surveillance of antimicrobial resistance (AMR) must adopt a "One Health" (OH) approach to successfully address the significant threats this global public health issue poses to humans, animals, and the environment. While many protocols exist for the evaluation of surveillance, the specific aspect of the integration of a OH approach into surveillance systems for AMR and antimicrobial Use (AMU), suffers from a lack of common and accepted guidelines and metrics for its monitoring and evaluation functions. This article presents a conceptual framework to evaluate the integration of OH in surveillance systems for AMR and AMU, named the Integrated Surveillance System Evaluation framework (ISSE framework). The ISSE framework aims to assist stakeholders and researchers who design an overall evaluation plan to select the relevant evaluation questions and tools. The framework was developed in partnership with the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). It consists of five evaluation components, which consider the capacity of the system to: [1] integrate a OH approach, [2] produce OH information and expertise, [3] generate actionable knowledge, [4] influence decision-making, and [5] positively impact outcomes. For each component, a set of evaluation questions is defined, and links to other available evaluation tools are shown. The ISSE framework helps evaluators to systematically assess the different OH aspects of a surveillance system, to gain comprehensive information on the performance and value of these integrated efforts, and to use the evaluation results to refine and improve the surveillance of AMR and AMU globally.
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Affiliation(s)
- Cécile Aenishaenslin
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- Research Group on Epidemiology of Zoonoses and Public Health, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Barbara Häsler
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
| | - André Ravel
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- Research Group on Epidemiology of Zoonoses and Public Health, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - E. Jane Parmley
- Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, ON, Canada
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Sarah Mediouni
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- Research Group on Epidemiology of Zoonoses and Public Health, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Houda Bennani
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
| | - Katharina D. C. Stärk
- Department of Animal Health, Federal Office for Food Safety and Veterinary Affairs, Bern, Switzerland
| | - David L. Buckeridge
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Schwind JS, Norman SA, Rahman MK, Richmond HL, Dixit SM, Rajbhandari RM, Wagner SK, Karmacharya D. Health Reporting Characteristics among Journalists in Nepal Utilizing a One Health Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052784. [PMID: 33803397 PMCID: PMC7967283 DOI: 10.3390/ijerph18052784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022]
Abstract
Journalists play a crucial role in the dissemination of health-related information. In developing countries, such as Nepal, the media are integral in shaping the national agenda and informing the public of important health issues. With an increasing need for a collaborative effort to attain optimal health for people, animals, and the environment, the One Health approach was used to characterize health reporting in Nepal. A comprehensive survey was administered to health journalists regarding their public, animal, and environmental health reporting habits. Seventy-one journalists completed the survey across three study sites. Many journalists indicated a history of reporting across all three sectors but did not routinely focus on health reporting in general. The majority of journalists perceived the quality and overall coverage of health-related topics increased over the last five years. However, few journalists reported receiving specialized training in any health sector. Although the overall quality of health reporting in the Nepali media showed improvements, many journalists acknowledged a lack of understanding of common health topics and a desire to learn more skills related to accurate health reporting. One Health provides a conceptual framework for understanding and promoting health communication through mass media to benefit humans, animals, and ecosystems.
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Affiliation(s)
- Jessica S. Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Correspondence:
| | - Stephanie A. Norman
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Marine-Med, Bothell, WA 98021, USA
| | - Munshi Khaledur Rahman
- Department of Geology and Geography, College of Science and Mathematics, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Holly L. Richmond
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
| | - Sameer M. Dixit
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
| | - Rajesh M. Rajbhandari
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
| | - Sarah K. Wagner
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
| | - Dibesh Karmacharya
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
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One Health Surveillance Codex: promoting the adoption of One Health solutions within and across European countries. One Health 2021; 12:100233. [PMID: 33786360 PMCID: PMC7994538 DOI: 10.1016/j.onehlt.2021.100233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022] Open
Abstract
Cross-sector communication, collaboration and knowledge exchange are still significant challenges for practical adoption of the One Health paradigm. To address these needs the “One Health Surveillance Codex” (OHS Codex) was established to provide a framework for the One Health community to continuously share practical solutions (e.g. tools, technical resources, guidance documents and experiences) applicable for national and international stakeholders from different One Health Surveillance sectors. Currently, the OHS Codex provides a number of resources that support the adoption of the OH paradigm in areas linked to the harmonization and interpretation of surveillance data. The OHS Codex framework comprises four high-level “action” principles, which respectively support collaboration, knowledge exchange, data interoperability, and dissemination. These principles match well with priority areas identified in the “Tripartite Guide to Addressing Zoonotic Diseases in Countries” published by WHO, FAO and OIE. Within each of the four principles, the OHS Codex provides a collection of useful resources as well as pointers to success stories for the application of these resources. As the OHS Codex is designed as an open community framework, it will continuously evolve and adapt to the needs of the OH community in the future. The One Health Surveillance (OHS) Codex supports the WHO/FAO/OIE Tripartite Guide. The resources in the OHS Codex support OHS data interpretation and harmonization. The OHS Codex is a community resource supporting the adoption of the OH paradigm. The OHS Codex allows sharing of practical experiences from various OH efforts. The OHS Codex is an open resource continuously updated by and for the community.
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Molia S, Saillard J, Dellagi K, Cliquet F, Bart JM, Rotureau B, Giraudoux P, Jannin J, Debré P, Solano P. Practices in research, surveillance and control of neglected tropical diseases by One Health approaches: A survey targeting scientists from French-speaking countries. PLoS Negl Trop Dis 2021; 15:e0009246. [PMID: 33661894 PMCID: PMC7963066 DOI: 10.1371/journal.pntd.0009246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/16/2021] [Accepted: 02/16/2021] [Indexed: 12/24/2022] Open
Abstract
One health (OH) approaches have increasingly been used in the last decade in the fight against zoonotic neglected tropical diseases (NTDs). However, descriptions of such collaborations between the human, animal and environmental health sectors are still limited for French-speaking tropical countries. The objective of the current survey was to explore the diversity of OH experiences applied to research, surveillance and control of NTDs by scientists from French-speaking countries, and discuss their constraints and benefits. Six zoonotic NTDs were targeted: echinococcoses, trypanosomiases, leishmaniases, rabies, Taenia solium cysticercosis and leptospiroses. Invitations to fill in an online questionnaire were sent to members of francophone networks on NTDs and other tropical diseases. Results from the questionnaire were discussed during an international workshop in October 2019. The vast majority (98%) of the 171 respondents considered OH approaches relevant although only 64% had implemented them. Among respondents with OH experience, 58% had encountered difficulties mainly related to a lack of knowledge, interest and support for OH approaches by funding agencies, policy-makers, communities and researchers. Silos between disciplines and health sectors were still strong at both scientific and operational levels. Benefits were reported by 94% of respondents with OH experience, including increased intellectual stimulation, stronger collaborations, higher impact and cost-efficiency of interventions. Recommendations for OH uptake included advocacy, capacity-building, dedicated funding, and higher communities' involvement. Improved research coordination by NTD networks, production of combined human-animal health NTD impact indicators, and transversal research projects on diagnostic and reservoirs were also considered essential.
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Affiliation(s)
- Sophie Molia
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | | | - Koussai Dellagi
- Institut Pasteur International Network, Institut Pasteur, Paris, France
| | - Florence Cliquet
- ANSES, Nancy Laboratory for Rabies and Wildlife, Malzéville, France
| | | | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Department of Parasites and Insect Vectors and INSERM U1201, Institut Pasteur, Paris, France
| | - Patrick Giraudoux
- Chrono-environnement Université de Bourgogne Franche-Comté/CNRS, Besançon, France
| | - Jean Jannin
- Société de Pathologie Exotique, Paris, France
| | | | - Philippe Solano
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
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Michalon J. Accounting for One Health: Insights from the social sciences. ACTA ACUST UNITED AC 2020; 27:56. [PMID: 33141659 PMCID: PMC7608981 DOI: 10.1051/parasite/2020056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/21/2020] [Indexed: 01/01/2023]
Abstract
This paper discusses the relationship between One Health (OH) and the social sciences. Using a comparison between three narratives of the history of OH, it is argued that OH can be studied as a social phenomenon. The narrative of OH by its promoters (folk narratives) emphasizes two dimensions: OH as a renewal of veterinary medicine and OH as an institutional response to global health crises. Narratives from empirical social science work explore similar dimensions, but make them more complex. For political sociology, OH is the result of negotiations between the three international organisations (WHO, OIE and FAO), in a context of a global health crisis, which led to the reconfiguration of their respective mandates and scope of action: OH is a response to an institutional crisis. For the sociology of science, OH testifies to the evolution of the profession and veterinary science, enabling it to position itself as a promoter of interdisciplinarity, in a context of convergence between research and policy. In the Discussion section, I propose an approach to OH as an “epistemic watchword”: a concept whose objective is to make several actors work together (watchword), in a particular direction, that of the production of knowledge (epistemic).
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Affiliation(s)
- Jérôme Michalon
- UMR Triangle - ENS de Lyon site Descartes, Bat D4 (recherche) - 2ème étage, 15 parvis René Descartes, 69342 Lyon cedex 07 - France
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Bhatia R. Need for integrated surveillance at human-animal interface for rapid detection & response to emerging coronavirus infections using One Health approach. Indian J Med Res 2020; 151:132-135. [PMID: 32202259 PMCID: PMC7357400 DOI: 10.4103/ijmr.ijmr_623_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Rajesh Bhatia
- Former Director, Communicable Diseases, World Health Organization South-East Asia Region Office, New Delhi 110 002, India
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Donkersley P, Elsner-Adams E, Maderson S. A One-Health Model for Reversing Honeybee ( Apis mellifera L.) Decline. Vet Sci 2020; 7:E119. [PMID: 32867044 PMCID: PMC7560035 DOI: 10.3390/vetsci7030119] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022] Open
Abstract
Global insect decline impacts ecosystem resilience; pollinators such as honeybees (Apis mellifera L.) have suffered extensive losses over the last decade, threatening food security. Research has focused discretely on in-hive threats (e.g., Nosema and Varroa destructor) and broader external causes of decline (e.g., agrochemicals, habitat loss). This has notably failed to translate into successful reversal of bee declines. Working at the interdisciplinary nexus of entomological, social and ecological research, we posit that veterinary research needs to adopt a "One-Health" approach to address the scope of crises facing pollinators. We demonstrate that reversing declines will require integration of hive-specific solutions, a reappraisal of engagement with the many stakeholders whose actions affect bee health, and recontextualising both of these within landscape scale efforts. Other publications within this special issue explore novel technologies, emergent diseases and management approaches; our aim is to place these within the "One-Health" context as a pathway to securing honeybee health. Governmental policy reform offers a particularly timely pathway to achieving this goal. Acknowledging that healthy honeybees need an interdisciplinary approach to their management will enhance the contributions of veterinary research in delivering systemic improvements in bee health.
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Affiliation(s)
- Philip Donkersley
- Lancaster Environment Centre, Lancaster University, Lancaster LA14YQ, UK
| | | | - Siobhan Maderson
- Department of Geography & Earth Sciences, Aberystwyth University, Aberystwyth SY233FL, UK;
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Affiliation(s)
- Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, Camden, NSW, Australia
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Enhancing Preparedness for Arbovirus Infections with a One Health Approach: The Development and Implementation of Multisectoral Risk Assessment Exercises. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4832360. [PMID: 32382554 PMCID: PMC7191441 DOI: 10.1155/2020/4832360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 01/10/2020] [Indexed: 01/25/2023]
Abstract
Background One Health is receiving attention for arbovirus infection prevention and control and for defining national “intersectoral” priorities. Increasing awareness of intersectoral priorities through multisectorial risk assessments (MRA) is promising, where data are not systematically shared between sectors. Towards this aim, the MediLabSecure project organized three MRA exercises (hereby called exercises): one on West Nile virus, one on Crimean–Congo haemorrhagic fever, and one on Rift Valley fever, assessing the added value of this approach. Methods The exercises relied on RA methodologies of international organisations. Country representatives of the human and animal virology, medical entomology, and public health sectors (hereby called “sectors”) involved in the surveillance of vector-borne diseases participated in the exercises. Background documentation was provided before each exercise, and a guide was developed for the facilitators. All three exercises included technical and methodological presentations and a guided RA directed at bringing into play the different sectors involved. To assess the added value of the approach, each participant was asked to rank the level of perceived benefit of the multisectoral collaboration for each “risk question” included in the exercises. Results In total, 195 participants from 19 non-EU countries in the Mediterranean and Black Sea regions took part in the exercises. The participants assessed the multisectoral approach as valuable in analysing comprehensively the situation by having access to information and knowledge provided by each of the sectors involved. Sharing of information and discussion facilitated reaching a consensus on the level of risk in each country. Conclusions Increasing awareness of intersectoral priorities, including cross-border ones, through MRA is relevant to reduce gaps due to unavailability of shared data and information. Given that six out of the ten threats to global health listed by WHO are occurring at the human-animal-environmental interfaces, comprehensive regional RA with a One Health approach made by national authorities can be a relevant added value for the global health security.
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Amato L, Dente MG, Calistri P, Declich S. Integrated Early Warning Surveillance: Achilles' Heel of One Health? Microorganisms 2020; 8:E84. [PMID: 31936412 PMCID: PMC7022449 DOI: 10.3390/microorganisms8010084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 01/02/2023] Open
Abstract
Emerging and re-emerging infectious diseases and zoonoses indicate the importance of the One Health (OH) approach for early warning. At present, even when surveillance data are available, they are infrequently timeously shared between the health sectors. In the context of the MediLabSecure (MLS) Project, we investigated the collection of a set of surveillance indicators able to provide data for the implementation of integrated early warning systems in the 22 MLS countries of the Mediterranean, Black Sea and Sahel regions. We used an online questionnaire (covering vector, human, and animal sectors), focusing on seven relevant arboviruses, that was submitted to 110 officially appointed experts. Results showed that West Nile virus was perceived as the most relevant zoonotic pathogen, while Dengue virus was the most relevant non-zoonotic pathogen in the study area. Data collection of early warning indicators is in place at a different level for all the investigated pathogens and in almost all the MLS Countries. Further assessments on the reliability of the collection in place and on the feasibility of piloting an integrated early warning system for arbovirus could verify if integrated early warning really represents the Achilles' heel of OH.
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Affiliation(s)
- Laura Amato
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
- Public Health and Infectious Diseases Department, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Grazia Dente
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
| | - Paolo Calistri
- National Reference Center for Veterinary Epidemiology, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ′G.Caporale′, 64100 Teramo, Italy;
| | - Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
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George J, Häsler B, Mremi I, Sindato C, Mboera L, Rweyemamu M, Mlangwa J. A systematic review on integration mechanisms in human and animal health surveillance systems with a view to addressing global health security threats. ONE HEALTH OUTLOOK 2020; 2:11. [PMID: 33829132 PMCID: PMC7993536 DOI: 10.1186/s42522-020-00017-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 05/05/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Health surveillance is an important element of disease prevention, control, and management. During the past two decades, there have been several initiatives to integrate health surveillance systems using various mechanisms ranging from the integration of data sources to changing organizational structures and responses. The need for integration is caused by an increasing demand for joint data collection, use and preparedness for emerging infectious diseases. OBJECTIVE To review the integration mechanisms in human and animal health surveillance systems and identify their contributions in strengthening surveillance systems attributes. METHOD The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 checklist. Peer-reviewed articles were searched from PubMed, HINARI, Web of Science, Science Direct and advanced Google search engines. The review included articles published in English from 1900 to 2018. The study selection considered all articles that used quantitative, qualitative or mixed research methods. Eligible articles were assessed independently for quality by two authors using the QualSyst Tool and relevant information including year of publication, field, continent, addressed attributes and integration mechanism were extracted. RESULTS A total of 102 publications were identified and categorized into four pre-set integration mechanisms: interoperability (35), convergent integration (27), semantic consistency (21) and interconnectivity (19). Most integration mechanisms focused on sensitivity (44.1%), timeliness (41.2%), data quality (23.5%) and acceptability (17.6%) of the surveillance systems. Generally, the majority of the surveillance system integrations were centered on addressing infectious diseases and all hazards. The sensitivity of the integrated systems reported in these studies ranged from 63.9 to 100% (median = 79.6%, n = 16) and the rate of data quality improvement ranged from 73 to 95.4% (median = 87%, n = 4). The integrated systems were also shown improve timeliness where the recorded changes were reported to be ranging from 10 to 91% (median = 67.3%, n = 8). CONCLUSION Interoperability and semantic consistency are the common integration mechanisms in human and animal health surveillance systems. Surveillance system integration is a relatively new concept but has already been shown to enhance surveillance performance. More studies are needed to gain information on further surveillance attributes.
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Affiliation(s)
- Janeth George
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology, Economics, and Public Health Group, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL97TA UK
| | - Irene Mremi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
| | - Calvin Sindato
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
- National Institute for Medical Research, Tabora Research Centre, Tabora, Tanzania
| | - Leonard Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
| | - Mark Rweyemamu
- SACIDS Foundation for One Health, Sokoine University of Agriculture, P.O. Box 3297, Morogoro, Tanzania
| | - James Mlangwa
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
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Abstract
AbstractIncreasing recognition of interdependencies of the health of humans, other organisms and ecosystems, and of their importance to socio-ecological systems, necessitates application of integrative concepts such as One Health and EcoHealth. These concepts open new perspectives for research and practice but also generate confusion and divergent opinion, prompting new theories, and call for empirical clarification and evaluation. Through a semi-systematic evaluation of knowledge generation in scientific publications (comprised of literature reviews, conceptual models and analyses of communities of practice), we show how integrative concepts and approaches to health evolve and are adopted. Our findings indicate that while their contexts, goals and rationales vary, integrative concepts of health essentially arise from shared interests in living systems. Despite recent increased attention to ecological and societal aspects of health including broader sustainability issues, the focus remains anthropocentric and oriented towards biomedicine. Practices reflect and in turn transform these concepts, which together with practices also influence ways of integration. Overarching narratives vary between optimism and pessimism towards integrated health and knowledge. We conclude that there is an urgent need for better, coherent and more deeply integrative health concepts, approaches and practices to foster the well-being of humans, other animals and ecosystems. Consideration of these concepts and practices has methodological and political importance, as it will transform thinking and action on both society and nature and specifically can enrich science and practice, expanding their scope and linking them better. Transdisciplinary efforts are crucial to developing such concepts and practices to properly address the multiple facets of health and to achieve their appropriate integration for the socio-ecological systems at stake. We propose the term “transdisciplinary health” to denote the new approaches needed.
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Houe H, Nielsen SS, Nielsen LR, Ethelberg S, Mølbak K. Opportunities for Improved Disease Surveillance and Control by Use of Integrated Data on Animal and Human Health. Front Vet Sci 2019; 6:301. [PMID: 31572735 PMCID: PMC6753377 DOI: 10.3389/fvets.2019.00301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/27/2019] [Indexed: 12/21/2022] Open
Abstract
The global challenges and threats from infectious diseases including antimicrobial drug resistance and emerging infections due to the rapidly changing climate require that we continuously revisit the fitness of our infrastructure. The databases used for surveillance represent an important infrastructure. Historically, many databases have evolved from different needs and from different organizations. Despite growing data storage and computing capacities, data are, however, rarely used to their full potential. The objective of this review was to outline different data sources available in Denmark. We applied a one-health perspective and included data sources on animal demographics and movements, medicine prescription, diagnostic test results as well as relevant data on human health. Another objective was to suggest approaches for fit-for-purpose integration of data as a resource for risk assessment and generation of evidence for policies to protect animal and human health. Danish databases were reviewed according to a systematic procedure including ownership, intended purposes of the database, target and study populations, metrics and information used, measuring methods (observers, diagnostic tests), recording procedures, data flow, database structure, and control procedures to ensure data quality. Thereby, structural metadata were gathered across available Danish databases including animal health, zoonotic infections, antimicrobial use, and relevant administrative data that can support the overall aim of supporting risk assessment and development of evidence. Then illustrative cases were used to assess how combinations and integration of databases could improve existing evidence to support decisions in animal health policies (e.g., combination of information on diseases in different herds or regions with information on isolation of pathogens from humans). Due to the complexity of databases, full integration at the individual level is often not possible. Still, integration of data at a higher level (e.g., municipality or region) can provide important information on risks and hence risk management. We conclude by discussing how databases by linkage can be improved in the future, and emphasize that legal issues are important to address in order to optimize the use of the available data.
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Affiliation(s)
- Hans Houe
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Saxmose Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Liza Rosenbaum Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kåre Mølbak
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Falzon LC, Alumasa L, Amanya F, Kang'ethe E, Kariuki S, Momanyi K, Muinde P, Murungi MK, Njoroge SM, Ogendo A, Ogola J, Rushton J, Woolhouse MEJ, Fèvre EM. One Health in Action: Operational Aspects of an Integrated Surveillance System for Zoonoses in Western Kenya. Front Vet Sci 2019; 6:252. [PMID: 31417918 PMCID: PMC6684786 DOI: 10.3389/fvets.2019.00252] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 07/12/2019] [Indexed: 01/25/2023] Open
Abstract
Surveillance of diseases in Kenya and elsewhere in East Africa is currently carried out by both human and animal health sectors. However, a recent evaluation highlighted the lack of integration between these sectors, leading to disease under-reporting and inefficiencies. This project aimed to develop an integrated and cost-effective surveillance and reporting system for 15 zoonotic diseases piloted in the counties of Bungoma, Busia, and Kakamega in western Kenya. Specifically, in this paper we describe the operational aspects of such a surveillance system. Interviews were carried out with key informants, and this was followed by field visits to identify sentinel sites and liaise with relevant stakeholders. Based on this information, a sampling strategy comprising 12 sentinel sites, 4 in each county, was developed. Each sentinel site comprised of a livestock market, 1-2 neighboring slaughter houses/slabs, and a hospital in the vicinity; each of the 12 sites, comprising 12 × 3 = 36 sampling locations, was visited every 4 weeks for 20 cycles. At each site, animal or patient sampling included a clinical examination and collection of blood, feces, and nasal swabs; in slaughtered animals, mesenteric lymph nodes, hydatid cysts, and flukes were also collected. At the end of each field visit, data on staff involved and challenges encountered were recorded, while biological samples were processed and tested for 15 zoonotic diseases in the field laboratory in Busia, Kenya. Public engagement sessions were held at each sentinel site to share preliminary results and provide feedback to both stakeholders and study participants. A livestock market visit lasted just over 3 h, and the most common challenge was the frequent refusals of animal owners to participate in the study. At the slaughterhouses, visits lasted just under 4 h, and challenges included poorly engaged meat inspectors or slaughter processes that were too quick for sampling. Finally, the hospital visits lasted around 4 h, and the most frequent challenges included low patients turn-out, frequent staff turn-over leading to poor institutional memory, and difficulty in obtaining patient stool samples. Our experiences have highlighted the importance of engaging with local stakeholders in the field, while also providing timely feedback through public engagement sessions, to ensure on-going compliance.
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Affiliation(s)
- Laura C. Falzon
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Lorren Alumasa
- International Livestock Research Institute, Nairobi, Kenya
| | | | - Erastus Kang'ethe
- Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | | | - Kelvin Momanyi
- International Livestock Research Institute, Nairobi, Kenya
| | - Patrick Muinde
- International Livestock Research Institute, Nairobi, Kenya
| | | | | | - Allan Ogendo
- Veterinary Department, Busia County Government, Busia, Kenya
| | - Joseph Ogola
- Veterinary Department, Bungoma County Government, Bungoma, Kenya
| | - Jonathan Rushton
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Mark E. J. Woolhouse
- Centre for Immunity, Infection and Evolution and Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Eric M. Fèvre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
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dos S. Ribeiro C, van de Burgwal LH, Regeer BJ. Overcoming challenges for designing and implementing the One Health approach: A systematic review of the literature. One Health 2019; 7:100085. [PMID: 31016220 PMCID: PMC6475629 DOI: 10.1016/j.onehlt.2019.100085] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 01/29/2023] Open
Abstract
Collaborative approaches in health, such as One Health (OH), are promising; nevertheless, several authors point at persistent challenges for designing and implementing OH initiatives. Among other challenges, OH practitioners struggle in their efforts to collaborate across disciplines and domains. This paper aims to provide insights into the existing challenges for designing and implementing OH initiatives, their causes and solutions, and points out strategic solutions with the potential to solve practical challenges. A systematic literature search was performed for emerging challenges and proposed solutions in the process of conducting OH initiatives. Next, a thematic and a causal analysis were performed to unravel challenges and their causes. Finally, solutions were discriminated on whether they were only recommended, or implemented as a proof-of-principle. The 56 included papers describe 21 challenges endured by OH initiatives that relate to different themes (policy and funding; education and training; surveillance; multi-actor, multi-domain, and multi-level collaborations; and evidence). These challenges occur in three different phases: the acquisition of sufficient conditions to start an initiative, its execution, and its monitoring and evaluation. The findings indicate that individual challenges share overlapping causes and crosscutting causal relations. Accordingly, solutions for the successful performance of OH initiatives should be implemented to tackle simultaneously different types of challenges occurring in different phases. Still, promoting collaboration between the wide diversity of stakeholders, as a fundamental aspect in the OH approach, is still by far the most challenging factor in performing OH initiatives. Causes for that are the difficulties in promoting meaningful and equal participation from diverse actors. Solutions proposed for this challenge focused on guiding stakeholders to think and collaborate beyond their professional and cultural silos to generate knowledge co-creation and innovative methodologies and frameworks. Finally, the biggest knowledge gap identified, in terms of proposed solutions, was for monitoring and evaluating OH initiatives. This highlights the need for future research on evaluation methods and tools specific for the OH approach, to provide credible evidence on its added value. When considering challenges endured by former OH initiatives and the proposed solutions for these challenges, practitioners should be able to plan and structure such initiatives in a more successful way, through the strategic pre-consideration of solutions or simply by avoiding known barriers.
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Affiliation(s)
- Carolina dos S. Ribeiro
- The Netherlands National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, Netherlands
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Linda H.M. van de Burgwal
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Barbara J. Regeer
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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45
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Bordier M, Delavenne C, Nguyen DTT, Goutard FL, Hendrikx P. One Health Surveillance: A Matrix to Evaluate Multisectoral Collaboration. Front Vet Sci 2019; 6:109. [PMID: 31106210 PMCID: PMC6492491 DOI: 10.3389/fvets.2019.00109] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/25/2019] [Indexed: 11/27/2022] Open
Abstract
The international community and governmental organizations are actively calling for the implementation of One Health (OH) surveillance systems to target health hazards that involve humans, animals, and their environment. In our view, the main characteristic of a OH surveillance system is the collaboration across institutions and disciplines operating within the different sectors to plan, coordinate, and implement the surveillance process. However, the multisectoral organizational models and possible collaborative modalities implemented throughout the surveillance process are multi-fold and depend on the objective and context of the surveillance. The purpose of this study is to define a matrix to evaluate the quality and appropriateness of multisectoral collaboration through an in-depth analysis of its organization, implementation, and functions. We developed a first list of evaluation attributes based on (i) the characteristics of the organization, implementation, and functionality of multisectoral surveillance systems; and (ii) the existing attributes for the evaluation of health surveillance systems and OH initiatives. These attributes were submitted to two rounds of expert-opinion elicitation for review and validation. The final list of attributes consisted of 23 organizational attributes and 9 functional attributes, to which 3 organizational indexes were added measuring the overall organization of collaboration. We then defined 75 criteria to evaluate the level of satisfaction for the attributes and indexes. The criteria were scored following a four-tiered scoring grid. Graphical representations allowed for an easy overview of the evaluation results for both attributes and indexes. This evaluation matrix is the first to allow an in-depth analysis of collaboration in a multisectoral surveillance system and is the preliminary step toward the creation of a fully standalone tool for the evaluation of collaboration. After its practical application and adaptability to different contexts are field-tested, this tool could be very useful in identifying the strengths and weaknesses of collaboration occurring in a multisectoral surveillance system.
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Affiliation(s)
- Marion Bordier
- Centre de Coopération Internationale en Recherche Agronomique Pour le Développement, UMR ASTRE, Hanoi, Vietnam.,ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France.,National Institute of Veterinary Research, Hanoi, Vietnam
| | - Camille Delavenne
- Centre de Coopération Internationale en Recherche Agronomique Pour le Développement, UMR ASTRE, Hanoi, Vietnam.,National Institute of Veterinary Research, Hanoi, Vietnam
| | - Dung Thuy Thi Nguyen
- CIRAD, UMR ASTRE, Bangkok, Thailand.,Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Flavie Luce Goutard
- ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France.,CIRAD, UMR ASTRE, Bangkok, Thailand.,Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Pascal Hendrikx
- French Agency for Food, Environmental and Occupational Health Safety (ANSES), UCAS, Lyon, France
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46
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Baradaran-Seyed Z, Pishraft-Sabet L. A chance to implement One Health in the Middle East and north Africa. Lancet Planet Health 2019; 3:e161-e162. [PMID: 30948253 PMCID: PMC7129679 DOI: 10.1016/s2542-5196(18)30285-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Zahra Baradaran-Seyed
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran.
| | - Leila Pishraft-Sabet
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
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47
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Dente MG, Riccardo F, Bolici F, Colella NA, Jovanovic V, Drakulovic M, Vasic M, Mamlouk H, Maazaoui L, Bejaoui M, Zakhashvili K, Kalandadze I, Imnadze P, Declich S. Implementation of the One Health approach to fight arbovirus infections in the Mediterranean and Black Sea Region: Assessing integrated surveillance in Serbia, Tunisia and Georgia. Zoonoses Public Health 2019; 66:276-287. [PMID: 30724030 PMCID: PMC6850493 DOI: 10.1111/zph.12562] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/21/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
Background In the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter‐sectoral collaboration; however, no standardized methodology exists to study One Health surveillance. Methods We designed a situation analysis study to document how integration of laboratory/clinical human, animal and entomological surveillance of arboviruses was being implemented in the Region. We applied a framework designed to assess three levels of integration: policy/institutional, data collection/data analysis and dissemination. We tested the use of Business Process Modelling Notation (BPMN) to graphically present evidence of inter‐sectoral integration. Results Serbia, Tunisia and Georgia participated in the study. West Nile Virus surveillance was analysed in Serbia and Tunisia, Crimea‐Congo Haemorrhagic Fever surveillance in Georgia. Our framework enabled a standardized analysis of One Health surveillance integration, and BPMN was easily understandable and conducive to detailed discussions among different actors/institutions. In all countries, we observed integration across sectors and levels except in data collection and data analysis. Data collection was interoperable only in Georgia without integrated analysis. In all countries, surveillance was mainly oriented towards outbreak response, triggered by an index human case. Discussion The three surveillance systems we observed prove that integrated surveillance can be operationalized with a diverse spectrum of options. However, in all countries, the integrated use of data for early warning and inter‐sectoral priority setting is pioneeristic. We also noted that early warning before human case occurrence is recurrently not operationally prioritized.
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Affiliation(s)
| | | | | | | | - Verica Jovanovic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Mitra Drakulovic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Milena Vasic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Habiba Mamlouk
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | - Latifa Maazaoui
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | - Mondher Bejaoui
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | | | - Irine Kalandadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Paata Imnadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
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Aenishaenslin C, Häsler B, Ravel A, Parmley J, Stärk K, Buckeridge D. Evidence needed for antimicrobial resistance surveillance systems. Bull World Health Organ 2019; 97:283-289. [PMID: 30940985 PMCID: PMC6438253 DOI: 10.2471/blt.18.218917] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/02/2019] [Accepted: 01/04/2019] [Indexed: 11/27/2022] Open
Abstract
One Health surveillance for antimicrobial resistance has been promoted by the scientific community and by international organizations for more than a decade. In this article, we highlight issues that need to be addressed to improve the understanding of the effectiveness of One Health surveillance for antimicrobial resistance. We also outline the evidence needed to support countries planning to increase the level of integration of their surveillance system. Based on experience in Canada and other countries, we argue that more effort is needed to understand and measure the added value of One Health for antimicrobial resistance surveillance and to identify the most effective integration strategies. To date, guidelines for the development of One Health surveillance have focused mainly on the types of data that should be integrated. However, it may be necessary to apply the concept of One Health to surveillance tasks beyond data integration to realize the full value of the approach. Integration can be enhanced across different surveillance activities (data collection, analysis, interpretation and dissemination), taking account of the different skills and perspectives of experts and stakeholders involved. More research is needed to investigate the mechanisms through which a One Health approach to surveillance can increase the performance of antimicrobial resistance surveillance and, ultimately, improve health outcomes.
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Affiliation(s)
- Cécile Aenishaenslin
- Research Group on Epidemiology of Zoonoses and Public Health, Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicoitte, Saint-Hyacinthe, J2S 2M2, Quebec, Canada
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London, England
| | - André Ravel
- Research Group on Epidemiology of Zoonoses and Public Health, Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicoitte, Saint-Hyacinthe, J2S 2M2, Quebec, Canada
| | | | | | - David Buckeridge
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
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Bordier M, Uea-Anuwong T, Binot A, Hendrikx P, Goutard FL. Characteristics of One Health surveillance systems: A systematic literature review. Prev Vet Med 2018; 181:104560. [PMID: 30528937 DOI: 10.1016/j.prevetmed.2018.10.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/10/2018] [Indexed: 10/28/2022]
Abstract
The concept of One Health (OH) promotes the decompartmentalisation of human, animal, and ecosystem health for the more efficient and sustainable governance of complex health issues. This means that traditional boundaries between disciplines and sectors must be transgressed and that all relevant stakeholders must be involved in the definition and management of health problems. International efforts have been made to strengthen collaboration across sectors and disciplines and OH surveillance is strongly encouraged at global, national and local-level to efficiently manage hazards involving humans, animals and ecosystems. This concept is intuitively appealing and would suggest the enhanced performance and cost-effectiveness of surveillance systems, as compared to more conventional approaches. Nevertheless, confusion and uncertainty regarding the practical application, outcomes and impacts prevail. We believe that this is due to the lack of a conceptual and methodological framework which would (i) define the characteristics of OH surveillance, and (ii) identify the appropriate mechanisms for inter-sectoral and multi-disciplinary collaboration, to ensure that the surveillance system performs well, with regard to the objective, the context and the health hazard under surveillance. The objective of the study is to define the organisational and functional characteristics of OH surveillance systems, the context in which they are implemented, as well as the influential factors which may obstruct or support their implementation and performance. To achieve this, a systematic literature review of existing OH surveillance systems was conducted using the Prisma guidelines. The selected systems were assessed according to 38 predetermined variables. These allowed the characterisation of their objectives, organisation, functioning, performance and benefits. Data extraction was conducted using a spreadsheet and a database was built using an electronic multiple-choice questionnaire. The literature search identified a total of 1635 records. After the screening phase, 31 references were kept and 22 additional references retrieved from bibliographies were added. From these 53 selected documents, we retrieved 41 different surveillance systems in line with the definition proposed in this study. The analysis of this database enabled the identification of different dimensions and areas of collaboration. Barriers and levers for the implementation of OH surveillance systems were also identified and discussed. Based on our results, we propose a framework to characterise the organisation of collaboration for the governance and operation of an effective OH surveillance system.
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Affiliation(s)
- Marion Bordier
- Centre de Coopération Internationale en Recherche Agronomique Pour le Développement (CIRAD), UMR ASTRE, Hanoi, Viet Nam; ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France; National Institute of Veterinary Research (NIVR), 86 Truong Chinh, Hanoi, Viet Nam.
| | - Theethawat Uea-Anuwong
- CIRAD, UMR ASTRE, 10900 Bangkok, Thailand; Kasetsart University, Faculty of Veterinary medicine, 50 Phaholyothin Rd., Ladyao, Jatujak, Bangkok, 10900 Thailand.
| | - Aurélie Binot
- ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France; CIRAD, ASTRE, Campus international de Baillarguet, 34398 Montpellier cedex 05, France.
| | - Pascal Hendrikx
- French Agency for Food, Environmental and Occupational Health Safety (ANSES), UCAS, 31 Avenue Tony Garnier, 69394 Lyon Cedex 07, France.
| | - Flavie L Goutard
- ASTRE, Univ Montpellier, CIRAD, INRA, Montpellier, France; CIRAD, UMR ASTRE, 10900 Bangkok, Thailand; Kasetsart University, Faculty of Veterinary medicine, 50 Phaholyothin Rd., Ladyao, Jatujak, Bangkok, 10900 Thailand.
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50
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Léger A, Stärk KD, Rushton J, Nielsen LR. A One Health Evaluation of the University of Copenhagen Research Centre for Control of Antibiotic Resistance. Front Vet Sci 2018; 5:194. [PMID: 30186842 PMCID: PMC6110841 DOI: 10.3389/fvets.2018.00194] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 07/27/2018] [Indexed: 12/14/2022] Open
Abstract
We applied the evaluation framework developed by the EU COST Action "Network of Evaluation of One Health" (NEOH) to assess the operations, supporting infrastructures and outcomes of a research consortium "University of Copenhagen Research Centre for Control of Antibiotic Resistance" (UC-CARE). This 4-year research project was a One Health (OH) initiative with participants from 14 departments over four faculties as well as stakeholders from industry and health authorities aiming to produce new knowledge to reduce the development of antimicrobial resistance (AMR). This was a case study focusing on assessing beneficial and counter-productive characteristics that could affect the OH outcomes. The study was also used to provide feedback to NEOH about the evaluation framework. The framework and evaluation tools are described in the introduction paper of this special journal issue. Data for the evaluation were extracted from the funding research proposal, the mid-term UC-CARE project evaluation report and supplemented with opinions elicited from project participants and stakeholders. Here, we describe the underlying system, theory of change behind the initiative and adapted questions from the NEOH tools that we used for semi-open interviews with consortium members throughout the evaluation process. An online survey was used to obtain information from stakeholders. The NEOH evaluation tools were then used for the qualitative and quantitative evaluation of the OH characteristics of UC-CARE. Senior UC-CARE researchers were interested and willing to be interviewed. Young scientists were more difficult to engage in interviews, and only 25% of stakeholders answered the online survey. Interviewees mentioned that the main benefit of UC-CARE was an increased awareness and general understanding of AMR issues. All interviewees stated that the adopted OH approach was relevant given the complexity of AMR. However, some questioned the applicability, and identified potentially counter-productive issues mainly related to the information sharing, collaboration and working methods across the consortium. A more integrated project organization, more stakeholder involvement and time for the project, flexibility in planning and a dedicated OH coordinator were suggested to allow for more knowledge exchange, potentially leading to a higher societal impact.
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Affiliation(s)
| | | | - Jonathan Rushton
- Faculty of Health and Life Science, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Liza R. Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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