Awareness and attitude toward zoonoses with particular reference to anthrax among cattle owners in selected rural communities of Zimbabwe

Modelling climate change impacts on the spatial distribution of anthrax in Zimbabwe

BACKGROUND

In Zimbabwe, anthrax is endemic with outbreaks being reported almost annually in livestock, wildlife, and humans over the past 40 years. Accurate modelling of its spatial distribution is key in formulating effective control strategies. In this study, an Ensemble Species Distribution Model was used to model the current and future distribution of anthrax occurrence in Zimbabwe.

METHODS

Bioclimatic variables derived from the Beijing Climate Centre Climate System Model were used to model the disease. Collinearity testing was conducted on the 19 bioclimatic variables and elevation to remove redundancy. Variables that had no collinearity were used for anthrax habitat suitability modelling. Two future climate change scenarios for different Representative Concentration Pathways (RCP), RCP4.5 and RCP8.5 were used. Model evaluation was done using true skill, Kappa statistics and receiver operating characteristics.

RESULTS

The results showed that under current bioclimatic conditions, eastern and western districts of Zimbabwe were modelled as highly suitable, central districts moderately suitable and southern parts marginally suitable for anthrax occurrence. Future predictions demonstrated that the suitable (8%) and highly suitable (7%) areas for anthrax occurrence would increase under RCP4.5 scenario. In contrast, a respective decrease (11%) and marginal increase (0.6%) of suitable and highly suitable areas for anthrax occurrence were predicted under the RCP8.5 scenario. The percentage contribution of the predictors varied for the different scenarios; Bio6 and Bio18 for the current scenario, Bio2, Bio4 and Bio9 for the RCP4.5 and Bio3 and Bio15 for the RCP8.5 scenarios.

CONCLUSIONS

The study revealed that areas currently suitable for anthrax should be targeted for surveillance and prevention. The predicted future anthrax distribution can be used to guide and prioritise surveillance and control activities and optimise allocation of limited resources. In the marginally to moderately suitable areas, effective disease surveillance systems and awareness need to be put in place for early detection of outbreaks. Targeted vaccinations and other control measures including collaborative 'One Health' strategies need to be implemented in the predicted highly suitable areas. In the southern part where a high decrease in suitability was predicted, continued monitoring would be necessary to detect incursions early.

Knowledge, Attitudes, and Practices of Communal Livestock Farmers regarding Animal Health and Zoonoses in Far Northern KwaZulu-Natal, South Africa

The presence of zoonotic diseases adversely affects livestock production and farmers' livelihood in communal areas. A lack of awareness about zoonotic diseases among rural farmers results in economic losses and health risks. The far north-eastern corner of KwaZulu-Natal (KZN) province, South Africa, is home to large numbers of communal livestock farmers who live adjacent to wildlife reserves and international borders. There have been reports of zoonotic and trade-sensitive diseases in the area, but farmers' knowledge, attitudes, and practices (KAP) in this regard are poorly understood. This study investigated the KAPs of communal livestock farmers in far northern KZN regarding livestock and zoonotic diseases found in the livestock-wildlife interface and determined the constraints and challenges faced by communal livestock farmers. A cross-sectional questionnaire survey was conducted among 504 livestock farmers at 45 dip tanks between August and November 2020, using a closed-ended questionnaire. Although the overall level of knowledge regarding animal disease transmission was fairly good (score: 53.2%), 25.4% and 21.4% of farmers had moderate and poor knowledge, respectively, about zoonotic disease transmission and prevention. Over 40% of the farmers were not aware of the zoonotic nature of wildlife and livestock diseases. Older farmers, despite their lower level of education, were more knowledgeable on animal diseases and had better practices in regard to zoonotic disease prevention and management compared to younger ones. The majority of farmers cited the lack of water, insufficient grazing land, stock theft, the restriction of animal movement, and animal diseases as the most significant challenges they faced regarding animal production. The results indicate the need for extension programs that target educating livestock farmers to improve their knowledge of these diseases.

Evaluation of knowledge, attitudes and practices regarding neosporosis and toxoplasmosis among farmers and animal health practitioners in Namibia

This study assessed the knowledge, attitudes and practices of livestock farmers in Namibia's Khomas region and animal health practitioners (veterinarians and animal health technicians) in the whole country concerning neosporosis and toxoplasmosis. Structured questionnaires were used, and a total of 63 farmers and 51 animal health practitioners responded out of an estimated 560 farmers in the Khomas region and 300 veterinarians and veterinary technicians in the country. Only 15.9% of the livestock farmers (n = 63) had heard about neosporosis or toxoplasmosis or knew how animals get infected (p < 0.0001). Only 5% of the farmers knew the risks associated with keeping dogs and cats concerning neosporosis and toxoplasmosis, respectively (p < 0.0001). None of the 51 animal health practitioners routinely requested Neospora caninum or Toxoplasma gondii laboratory tests in cases of cattle, sheep or goat abortions. Although all animal health practitioners indicated they routinely interacted with livestock farmers, none regularly discussed neosporosis or toxoplasmosis. Only 3.9% of animal health practitioners (n = 51) indicated that they had ever discussed either neosporosis or toxoplasmosis at a farmers' gathering (p < 0.0001), and only 21.6% had talked to at least one cat owner about toxoplasmosis in the previous 12 months (p < 0.0001). The authors concluded that farmers in the Khomas region were generally unaware of neosporosis and toxoplasmosis but could change their attitudes and practices if educated. The animal health practitioners lacked a deeper understanding and appreciation of the two diseases, which is required to cultivate enough confidence to educate farmers. Sharing this research and other relevant information on the two diseases at farmers' meetings, veterinary congresses, journals and newsletters could help educate farmers and animal health practitioners. Such platforms are likely to succeed because both these groups use these forums to get new information.

First PCR Confirmed anthrax outbreaks in Ethiopia—Amhara region, 2018–2019

Background

Anthrax is a disease that affects humans and animals. In Ethiopia, anthrax is a reportable disease and assumed to be endemic, although laboratory confirmation has not been routinely performed until recently. We describe the findings from the investigation of two outbreaks in Amhara region.

Methods

Following reports of suspected outbreaks in Wag Hamra zone (Outbreak 1) and South Gondar zone (Outbreak 2), multi-sectoral teams involving both animal and public health officials were deployed to investigate and establish control programs. A suspect case was defined as: sudden death with rapid bloating or bleeding from orifice(s) with unclotted blood (animals); and signs compatible with cutaneous, ingestion, or inhalation anthrax ≤7 days after exposure to a suspect animal (humans). Suspect human cases were interviewed using a standard questionnaire. Samples were collected from humans with suspected anthrax (Outbreak 1 and Outbreak 2) as well as dried meat of suspect animal cases (Outbreak 2). A case was confirmed if a positive test was returned using real-time polymerase chain reaction (qPCR).

Results

In Outbreak 1, a total of 49 cows died due to suspected anthrax and 22 humans developed symptoms consistent with cutaneous anthrax (40% attack rate), two of whom died due to suspected ingestion anthrax. Three people were confirmed to have anthrax by qPCR. In Outbreak 2, anthrax was suspected to have caused the deaths of two livestock animals and one human. Subsequent investigation revealed 18 suspected cases of cutaneous anthrax in humans (27% attack rate). None of the 12 human samples collected tested positive, however, a swab taken from the dried meat of one animal case (goat) was positive by qPCR.

Conclusion

We report the first qPCR-confirmed outbreaks of anthrax in Ethiopia. Both outbreaks were controlled through active case finding, carcass management, ring vaccination of livestock, training of health professionals and outreach with livestock owners. Human and animal health authorities should work together using a One Health approach to improve case reporting and vaccine coverage.

Anthrax prevention practice and associated factors among farmers in Farta district, South Gondar, Amhara region, Northwest Ethiopia

Background

Anthrax is a zoonotic disease endemic in Ethiopia. Despite anthrax preventive measures are the key activities to control the disease, several outbreaks have occurred in Ethiopia recently. The objective of the study was therefore to assess the anthrax preventive practice and its associated factors among farmers in Farta district, South Gondar zone, Northwest Ethiopia.

Method

A community-based cross-sectional study was conducted among farmers in Farta District from June 7 to 21/2020. A multi-stage sampling technique, with systematic random sampling, was used to select 1,338 study participants. Data were collected through a face-to-face interview using a structured questionnaire. The data were cleaned, coded, and entered into the Epi-data v 3.1 and then exported to SPSS v 23 for analysis. In the bi-variable regression analysis, the variables having a p-value of less than 0.2 were entered into a multivariable logistic regression to control the effect of confounding. Those independent variables with P-value less than 0.05 were taken as statistically significant factors associated with anthrax prevention practice.

Results

The proportion of farmers who had good anthrax prevention practice was 35.8% [95% CI 33%, 38%]. Being female (AOR = 2.96; 95% CI 2.18, 4.02), able to read and write (AOR = 1.48, 95% CI 1.08, 2.03), time spent to arrive at a nearby veterinary clinic (AOR = 1.35; 95%CI 1.01, 1.79), heard about anthrax (AOR = 4.54; 95%CI 2.96, 6.95), and had a favorable attitude towards anthrax preventions (AOR = 3.70; 95%CI 2.77, 4.94) were significantly associated with anthrax prevention practice.

Conclusions

The practice of anthrax prevention was low. Sex, educational status, time spent to arrive at the nearby veterinary clinic, knowledge about anthrax, and attitude towards anthrax prevention were significantly associated with anthrax prevention practice. Health education to create a favorable attitude and the establishment of veterinary clinics in the nearby locations are recommended to improve anthrax preventive practices in the study area.

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

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

Investigation of an anthrax outbreak in Makoni District, Zimbabwe

BACKGROUND

Anthrax continues to be a disease of public health importance in Zimbabwe, with sporadic outbreaks reported annually in many parts of the country. A human anthrax outbreak occurred in wards 22 and 23 of Makoni District from mid-June 2013 to end of January 2014, following cattle deaths in the wards. Laboratory tests confirmed anthrax as the cause for the cattle deaths. This study investigated the clinical characteristics, distribution of cases (places, person and time) and risk factors for contracting the anthrax disease. We also assessed the environment, district preparedness and response, and outbreak prevention and control measures.

METHODS

We conducted an outbreak investigation using a mixed-methods design. A 1:1 case-control study was used to assess risk factors for contracting anthrax. The controls were frequency matched to cases by sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response, and outbreak prevention and control measures were assessed using a checklist, observations, and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax.

RESULTS

We interviewed 37 of the 64 cases, along with 37 controls. All the cases had cutaneous anthrax, with the hand being the most common site of the eschar (43%). Most of the cases (89%) were managed according to the national guidelines. Multivariable analysis demonstrated that meat sourced from other villages [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)], and belonging to religions that permit eating meat from cattle killed due to unknown causes or butchered after unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The poor availability of resources in the district caused a delayed response to the outbreak.

CONCLUSION

The described anthrax outbreak was caused due to contact with infected cattle meat. Although the outbreak was eventually controlled through cattle vaccination and health education and awareness campaigns, the response of the district office was initially delayed and insufficient. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaigns and improve surveillance, especially during outbreak seasons.

The pattern of anthrax at the wildlife-livestock-human interface in Zimbabwe

Anthrax is an important but neglected zoonosis in southern Africa and elsewhere which occurs naturally in herbivorous wildlife and livestock. Fatal outbreaks in animals are spaced by potentially extended periods of non-activity during which the bacterium is maintained in soil. The ecology of the pathogen in the multi-host system and the environment is still not fully understood. This study investigated the patterns of anthrax in Zimbabwe in order to better understand the occurrence of disease in susceptible wildlife and livestock and hence its control. The study used available data in governmental reports between 1995 and 2018 and structured interviewer-administered questionnaires of local communities in three porous wildlife-livestock-human interface sites where livestock/wildlife interactions were documented from previous researches. Two non-interface sites were also included for comparison based on known previous anthrax outbreaks. Respondents from non-interface sites had significantly higher odds (χ² = 23.2, OR = 3.5, 2.1<OR<5.8, p<0.001) of reporting anthrax outbreaks than their counterparts at the interface. Overall 20.0% (74/372) of the respondents reported that some anthrax carcasses were left to dissipate into the environment indicating a risk of environmental contamination. In livestock a total of 214 outbreaks with 2911 losses (mainly cattle) were recorded between 2000 and 2018, while 10 outbreaks with 3171 deaths were noted in wildlife. In humans 99 outbreaks were recorded involving 903 individual cases with 16 fatalities due to enteric infections following the consumption of infected meat between 2010 and 2018. Since its first incidence in wildlife in 2004–2005 in the south-eastern Lowveld of Zimbabwe, anthrax appears to be establishing endemic status along the Zambezi River basin. The disease has expanded spatially affecting 45 (72.6%) of the country’s 62 rural districts in a single decade. Thus, robust multi-disciplinary efforts are encouraged for surveillance and disease containment measures to minimize its impact on livestock, wildlife and humans.

Anthrax is an expanding zoonotic and tropical disease which negatively impacts livestock, wildlife and human health ultimately impacting livelihoods and biodiversity conservation. In this work we have shown it to be a serious disease in Zimbabwe where its surveillance and control are sub-optimum even though it is causing serious losses in animals and human health. Observed practices such as the non-burial of infected carcasses subsequently contaminating the environment following anthrax outbreaks in animals, have most likely contributed to its expansion in geographic range and the increase in frequency of outbreaks. Since the late 1970s, the disease status has changed from that causing a low-level mortality in livestock, probably due to underreporting, to a common disease in livestock, wildlife and humans. It is hoped that by quantifying the impact of the disease across livestock, wildlife and human health and livelihoods, and establishing factors responsible for its continued expansion, adequate resources for surveillance and containment of anthrax will be allocated in order to improve rural livelihoods and also enhance wildlife conservation.

Perceptions and Practices towards Anthrax in Selected Agricultural Communities in Arua District, Uganda

Background

Anthrax is globally recognized as an important public health and economic challenge in many agricultural communities. A cross-sectional study was conducted in three subcounties in Arua district to assess the community's awareness, cultural norm, and practices regarding anthrax. This followed a report of active cases of human cutaneous anthrax in the district.

Methods

The study was conducted in subcounties of Pawor, Rigbo, and Rhino Camp, Arua district, using focus group discussion.

Results

The affected communities had limited knowledge about anthrax, especially its clinical manifestation and modes of transmission both in humans and animals. The community also had no knowledge of the anthrax vaccine or treatment and where they can be accessed from. Poor practices associated with anthrax outbreaks included poor disposal of carcasses and ruminal wastes, occupational hazards (butchers, slaughter men, and herdsmen), consumption of meat from infected animals, communal herding, and cultural norms encouraging consumption of dead animals.

Conclusion

This study shows that there is a knowledge gap about anthrax among the people in the affected communities. Key drivers for the anthrax outbreak such as poor cultural beliefs and practices and wildlife-livestock-human interactions were observed in all the three subcounties studied. All these findings could imply a high risk of outbreak of anthrax in Arua and Ugandan agricultural communities where the public health programs are less standardized and less effective.

Evaluation of the sensitivity and specificity of the lateral flow assay, Rose Bengal test and the complement fixation test for the diagnosis of brucellosis in cattle using Bayesian latent class analysis

This study was conducted to evaluate the sensitivity (Se) and specificity (Sp) of the Rose Bengal test (RBT), complement fixation test (CFT), the serum lateral flow assay (LFA_serum) and the blood lateral flow assay (LFA_blood) for the detection of antibodies to Brucella spp. using Bayesian latent class models (BLCMs). Sera and whole blood were collected from naturally infected cattle reared in smallholder, small-scale commercial and large-scale commercial farms in Zimbabwe (n = 1022) and Botswana (n = 770). The BLCMs were fitted under the assumption that conditional dependences existed between the tests. Based on the conditional dependence model, the RBT had the highest Se of 0.897 (95 % Probability Intervals: 0.854; 0.932) compared to 0.827 (0.773; 0.872), 0.812 (0.76; 0.858) and 0.809 (0.785; 0.832) for the LFA_serum, LFA_blood and CFT, respectively. The CFT recorded a higher Sp of 0.999 (0.995; 1.000) than the LFA_serum 0.996 (0.99; 1.000), the LFA_blood 0.984 (0.976; 0.991) and the RBT 0.969 (0.959; 0.978). The data indicated that both the Se and Sp of RBT and CFT and the Sp of LFA_serum and LFA_blood were conditionally independent, while the Se appeared to be conditionally dependent. These results indicated that none of the evaluated tests had perfect Se and Sp and consequently could not be used alone for the diagnosis of brucellosis in cattle from the studied farming sectors. Thus, based on high Se and Sp, respectively, a brucellosis testing regimen using the RBT (screening) and the LFA (confirmatory) may be considered.

The Landscape of Anthrax Prevention and Control: Stakeholders' Perceptive in Odisha, India

The prevalence and outbreaks of anthrax are interlinked with the animal-environment-human context, which signifies the need for collaborative, trans-disciplinary and multi-sectoral approaches for the prevention and control of anthrax. In India, there are hardly any shreds of evidence on the role of various stakeholders' on anthrax prevention and control. Therefore, this study addressed the experiences of various stakeholders on anthrax prevention and control strategies in Odisha, India. A qualitative explorative study was carried out using 42 in-depth-interviews among the stakeholders from health, veterinary and general administrative departments from the block, district, and state level. Two major themes emerged: (1) Epidemiological investigation of anthrax in Odisha, India, and (2) Biological and social prevention strategies for anthrax in Odisha, India. The study emphasizes setting up the surveillance system as per standard guideline, and strengthening the diagnostic facility at a regional medical college laboratory to avoid delay. Moreover, it emphasizes step-up inter-sectoral co-ordination, collaboration and sensitization among health, veterinary, forestry, education, nutrition and tribal welfare departments at all levels in order to reduce the prevalence and control the outbreaks of anthrax in Odisha state. It also recommends raising community literacy, in particular on safe carcass disposal, changing behavior on dead-livestock consumption, and compliance with livestock vaccinations.

Seroprevalence and associated risk factors of Rift Valley fever in cattle and selected wildlife species at the livestock/wildlife interface areas of Gonarezhou National Park, Zimbabwe

A study was conducted to investigate the seroprevalence and associated risk factors of Rift Valley fever (RVF) infection in cattle and some selected wildlife species at selected interface areas at the periphery of the Great Limpopo Transfrontier Conservation Area in Zimbabwe. Three study sites were selected based on the type of livestock–wildlife interface: porous livestock–wildlife interface (unrestricted); non-porous livestock–wildlife interface (restricted by fencing) and livestock–wildlife non-interface (totally absent contact or control). Sera were collected from cattle aged ≥ 2 years representing both female and intact male. Sera were also collected from selected wild ungulates from Mabalauta (porous interface) and Chipinda Pools (non-interface) areas of the Gonarezhou National Park. Sera were tested for antibodies to Rift Valley fever virus (RVFV) using a competitive enzyme-linked immunosorbent assay (ELISA) test. AX2 test was used to assess differences between categories, and p < 0.05 was considered as significant. In cattle, the overall seroprevalence was 1.7% (17/1011) (95% confidence interval [CI]: 1.01–2.7). The porous interface recorded a seroprevalence of 2.3% (95% CI: 1.2–4.3), the non-porous interface recorded a prevalence of 1.8% (95% CI: 0.7–4.3) and the non-interface area recorded a seroprevalence of 0.4% (955 CI: 0.02–2.5), but the difference in seroprevalence according to site was not significant (p > 0.05). All impala and kudu samples tested negative. The overall seroprevalence in buffaloes was 11.7% (95% CI: 6.6–19.5), and there was no significant (p = 0.38) difference between the sites (Mabalauta, 4.4% [95% CI: 0.2–24] vs. Chipinda, 13.6% [95% CI: 7.6–23]). The overall seroprevalence in buffaloes (11.7%, 13/111) was significantly (p < 0.0001) higher than in cattle (1.7%, 17/1011). The results established the presence of RVFV in cattle and selected wildlife and that sylvatic infections may be present in buffalo populations. Further studies are required to investigate if the virus is circulating between cattle and wildlife.

Qualitative Research for One Health: From Methodological Principles to Impactful Applications

The One Health concept has inspired a rich vein of applied research and scholarly reflection over the past decade, yet with little influence from qualitative methodologists. With this overview, we describe the underpinning assumptions, purposes, and potential pitfalls of data collection techniques and methods of data analysis in key qualitative research methodologies. Our aim is to enhance One Health collaborations involving qualitative researchers, veterinary epidemiologists, and veterinary economists. There exist several distinct traditions of qualitative research, from which we draw selectively for illustrative purposes. Notwithstanding important distinctions, we emphasize commonalities and the potential for collaborative impact. The most important commonality is a shared focus on contextualizing human behavior and experience–culturally, economically, historically, and socially. We demonstrate that in-depth attention to context can assist veterinary economists and epidemiologists in drawing lessons from the implementation of policies and programs. In other words, qualitative researchers can assist One Health teams in distilling insights from “success stories,” but also from adverse events and unintended consequences. As a result, qualitative researchers can contribute to One Health research and policy discussions by formulating more accurate and contextually-relevant parameters for future quantitative studies. When performed well, qualitative methodologies can help veterinary economists and epidemiologists to develop impactful research questions, to create more accurate and contextually-relevant parameters for quantitative studies, and to develop policy recommendations and interventions that are attuned to the political and socio-cultural context of their implementation. In sketching out the properties and features of influential methodologies, we underscore the value of working with seasoned qualitative researchers to incorporate questions about “what,” “how,” and “why” in mixed-methods research designs.

Livestock owners' anthrax prevention practices and its associated factors in Sekota Zuria district, Northeast Ethiopia

BACKGROUND

In Ethiopia, the second most prioritized of the zoonotic diseases next to rabies is anthrax. About 50.6% of anthrax cases and 33.3% of deaths of livestock have been reported from Wag-Himra Zone, where appropriate anthrax prevention practices are not implemented by the owners of the animals. Thus, the aim of this study was to determine the extent of appropriate anthrax prevention practices of livestock owners and associated factors in Sekota Zuria district, northwest Ethiopia.

RESULTS

Twenty-five percent (95% CI: 25.2, 26.1%) of the livestock owners implemented appropriate anthrax prevention. Three quarters (74%) of the owners consumed infected meat; more than three quarters (78%) used the skins and hides of animals found dead with anthrax. The odds of appropriate anthrax prevention practices were higher among livestock owners with positive attitude (AOR = 4.16, 95% CI: 2.72, 6.37), who received health education (AOR = 2.00, 95% CI: 1.21, 3.28) and owners who lived in urban areas (AOR = 2.62, 95% CI: 1.43, 4.77) compared to their counterparts. Ability to read and write (AOR = 2.76, 95% CI: 1.74, 4.37), and primary (AOR = 3.6, 95% CI: 1.74, 4.37) or secondary school and above education (AOR = 4.24, 95% CI: 1.61, 11.13) were significantly associated with appropriate anthrax prevention practices.

CONCLUSION

In Sekota Zuria district, only one quarter of the livestock owners were aware of appropriate anthrax prevention practices. Thus, implementing effective health education and creating positive attitude are vital to improve anthrax prevention practices in the area.

Brucellosis awareness and knowledge in communities worldwide: A systematic review and meta-analysis of 79 observational studies

BACKGROUND

Brucellosis is regarded as a major zoonotic infection worldwide. Awareness and knowledge of brucellosis among occupational workers is considered an important aspect of brucellosis control in both humans and animals. The aim of this study was to explore the distributions of the pooled awareness level and the knowledge level of the disease worldwide.

METHODS

A meta-analysis was carried out to obtain pooled brucellosis awareness levels and knowledge levels of respondents regarding the zoonotic nature of brucellosis, mode of brucellosis transmission, and brucellosis symptoms in animals and humans. The analysis was conducted and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines.

RESULTS

A total of seventy-nine original articles reporting the brucellosis awareness levels of in populations from 22 countries were assessed. The total pooled awareness level of brucellosis was 55.5%, and the pooled awareness levels regarding the zoonotic nature of brucellosis, mode of brucellosis transmission, signs of human brucellosis and signs of animal brucellosis were 37.6%, 35.9%, 41.6%, and 28.4% respectively. The pooled awareness level was higher than the brucellosis-related knowledge level. Subgroup analyses showed that no obvious differences in brucellosis awareness levels between high-risk populations in Asia and Africa. Health workers (including human health workers and veterinarians) had the greatest overall awareness and knowledge of human brucellosis. The overall awareness levels and knowledge levels of livestock owners (farmers) and herders were higher than those of dairy farmers and abattoir workers. In addition, awareness and knowledge levels were higher among people who were involved in bovine, caprine and ovine animal production or in caprine and ovine animal production than among people who were involved in only bovine animal production.

CONCLUSIONS

Insufficient awareness and knowledge of brucellosis were observed in the original studies conducted mainly in Asia and Africa. Interventions to improve public knowledge about brucellosis are urgently needed.

Knowledge, attitude and practices relating to zoonotic diseases among livestock farmers in Punjab, India

Zoonotic diseases cause significant health and economic impact in developing countries such as India. Many zoonotic diseases are prevalent in the livestock and as an occupational zoonosis in the livestock farmers in India. Lack of knowledge on the disease transmission, prevention and control measures is a potential high risk for the occurrence of zoonotic diseases in the livestock and its keepers in India. We conducted this study to understand knowledge, attitude and practices of livestock farmers regarding zoonoses. Five villages from each of the 22 districts of the state were conveniently selected (n = 110). Farmers available at village community sites were enrolled in the study and requested to complete a custom designed questionnaire (n = 558). In addition, livestock farmers attending basic livestock husbandry training were also surveyed (n = 301). Data from questionnaires was used to create three index variables: (a) knowledge score; (b) attitude score and (c) practice score. Association between demographic and other explanatory variables with knowledge score was evaluated using linear regression analyses. Similarly, the association between knowledge and attitude score with practice score was evaluated. Of the 859 participants, 685 (80%) livestock farmers had heard the term 'zoonoses' but only 345 (40%), 264 (31%) and 214 (25%) farmers were aware of the zoonotic nature of tuberculosis, Japanese encephalitis and taeniosis, respectively. For practices, 23% farmers reported consumption of raw milk and only 10% and 8% livestock farmers ever got their animals tested for brucellosis and tuberculosis, respectively. The low level of education and being a cattle farmer were negatively associated with the farmer's knowledge on zoonotic diseases. The attitude score was positively associated with the practice score of the participants. The results indicate need for educating the livestock farmers particularly those with a low level of education to reduce the health and economic impact of zoonotic diseases in India.

Risk factors for human cutaneous anthrax outbreaks in the hotspot districts of Northern Tanzania: an unmatched case-control study

Bacillus anthracis is an aerobic, Gram-positive and spore-forming bacterium, which causes anthrax in herbivores. Humans get infected after coming into contact with infected animals' products. An unmatched case-control study was conducted to identify the importance of demographic, biological and/or behavioural factors associated with human cutaneous anthrax outbreaks in the hotspot areas of Northern Tanzania. A semi-structured questionnaire was administered to both cases and controls. The age range of participants was 1-80 years with a median age of 32 years. In the younger group (1-20 years), the odds of being infected were 25 times higher in the exposed group compared to the unexposed group (OR= 25, 95% CI = 1.5-410). By contrast, the odds of exposure in the old group (≥20 years) were three times lower in the exposed group compared to the unexposed group (OR = 3.2, 95% CI = 1.28-8.00). Demographic characteristics, sleeping on animal's skins, contacting with infected carcasses through skinning and butchering, and not having formal education were linked to exposure for anthrax infection. Hence, a One Health approach is inevitable for the prevention and control of anthrax outbreaks in the hotspot areas of Northern Tanzania.

Investigation of anthrax in an endemic region in Kenya: a mixed methods approach

In Kenya, human anthrax cases most often occur linked to animal anthrax. In most cases, human behaviors, especially slaughter and consumption of meat from animal anthrax cases, has been implicated. This case study is based on an anthrax outbreak investigation conducted in an endemic region in Kenya in May 2016.The case study simulates how a mixed methods approach can be used in epidemiologic research.To fully benefit from this case study, participants should have had prior lectures or other instruction in quantitative and qualitative study designs and sampling approachesused in epidemiologic research. The case study is ideally suited for trainees at intermediate or advance level training in field epidemiology who should be able to complete the case study in approximately 3 hours.

Role of Food Insecurity in Outbreak of Anthrax Infections among Humans and Hippopotamuses Living in a Game Reserve Area, Rural Zambia

In September 2011, a total of 511 human cases of anthrax (Bacillus anthracis) infection and 5 deaths were reported in a game management area in the district of Chama, Zambia, near where 85 hippopotamuses (Hippopotamus amphibious) had recently died of suspected anthrax. The human infections generally responded to antibiotics. To clarify transmission, we conducted a cross-sectional, interviewer-administered household survey in villages where human anthrax cases and hippopotamus deaths were reported. Among 284 respondents, 84% ate hippopotamus meat before the outbreak. Eating, carrying, and preparing meat were associated with anthrax infection. Despite the risk, 23% of respondents reported they would eat meat from hippopotamuses found dead again because of food shortage (73%), lack of meat (12%), hunger (7%), and protein shortage (5%). Chronic food insecurity can lead to consumption of unsafe foods, leaving communities susceptible to zoonotic infection. Interagency cooperation is necessary to prevent outbreaks by addressing the root cause of exposure, such as food insecurity.

Sero-prevalence of chlamydiosis in cattle and selected wildlife species at a wildlife/livestock interface area of Zimbabwe

A study was conducted to investigate the seroprevalence and associated risk factors of Chlamydia abortus infection in cattle and some selected wildlife species at selected interface areas at the periphery of the Great Limpopo Transfrontier Conservation Area in Zimbabwe. Three study sites were selected based on the type of livestock-wildlife interface, porous livestock-wildlife interface (unrestricted), non-porous livestock-wildlife interface (restricted by fencing), and livestock-wildlife non-interface (totally absent or control). Sera were collected from cattle aged ≥ 2 years representing both female and intact male. Sera were also collected from selected wild ungulates from Mabalauta (porous interface) and Chipinda Pools (non-interface) areas of the Gonarezhou National Park. Sera were tested for antibodies to Chlamydia abortus using a CFT. A X ² test was used to assess differences between categories and p < 0.05 was considered as significant. In cattle, the overall seroprevalence was 32.7% (327/1011; 95% CI 29.5-35.3). A significantly lower seroprevalence was recorded for the porous interface (24.2%) compared to the non-porous (42.5%) (p < 0.0001) and the non-interface (36.2%) (p = 0.001). Overall, the wet season recorded a significantly (p = 0.015) higher seroprevalence than the dry season. In wildlife, antibodies were detected in buffaloes (47.7%) and impalas (43.8%) but not in kudus. Buffaloes from Chipinda Pools (53.4%) had a significantly (p = 0.036) higher seroprevalence than those from Mabalauta (26.1%). The results established the presence of chlamydiosis in cattle and selected wildlife and that independent infections may be maintained in buffalo populations. Further studies are required to clarify chlamydiae circulating between cattle and wildlife.

Seroprevalence of brucellosis in cattle and selected wildlife species at selected livestock/wildlife interface areas of the Gonarezhou National Park, Zimbabwe

A study was conducted to investigate seroprevalence and risk factors for Brucella species infection in cattle and some wildlife species in communities living at the periphery of the Great Limpopo Transfrontier Conservation Area in south eastern Zimbabwe. Three study sites were selected based on the type of livestock-wildlife interface: porous livestock-wildlife interface (unrestricted); non-porous livestock-wildlife interface (restricted by fencing); and livestock-wildlife non-interface (totally absent or control). Sera were collected from cattle aged≥2years representing both female and intact male animals. Sera were also collected from selected wild ungulates from Mabalauta (porous interface) and Chipinda (non-interface) areas of the Gonarezhou National Park. Samples were screened for Brucellaantibodies using the Rose Bengal plate test and confirmed by the complement fixation test. Data were analysed by descriptive statistics and multivariate logistic regression modelling. In cattle, brucellosis seroprevalence from all areas was 16.7% (169/1011; 95% CI: 14.5-19.2%). The porous interface recorded a significantly (p=0.03) higher seroprevalence (19.5%; 95% CI: 16.1-23.4%) compared to the non-interface area (13.0%; 95% CI: 9.2-19.9%).The odds of Brucellaseropositivity increased progressively with parity of animals and were also three times higher (OR=3.0, 2.0<OR<4.6, p<0.0001) in cows with history of abortion compared to those without.Brucella antibodies were detected in buffaloes; 20.7% (95% CI: 13.9-29.7%) form both study sites, but no antibodies were detected from impalas and kudus. These results highlight the importance of porous interface in the interspecies transmission of Brucella species and that independent infections may be maintained in buffalo populations. Thus, brucellosis control aimed at limiting animal inter-species mixing may help reduce the risk of human brucellosis in interface areas. Further studies should aim at establishing subspecies identity and direction of possible transmission of brucellosis between wildlife and livestock.

Assessment of community awareness and risk perceptions of zoonotic causes of abortion in cattle at three selected livestock–wildlife interface areas of Zimbabwe

A study was conducted to assess the awareness of cattle abortions due to brucellosis, Rift Valley fever (RVF) and leptospirosis, and to compare frequencies of reported abortions in communities living at the periphery of the Great Limpopo Transfrontier Conservation Area in southeastern Zimbabwe. Three study sites were selected based on the type of livestock–wildlife interface: porous livestock–wildlife interface (unrestricted); non-porous livestock–wildlife interface (restricted by fencing); and livestock–wildlife non-interface (totally absent or control). Respondents randomly selected from a list of potential cattle farmers (N = 379) distributed at porous (40·1%), non-interface (35·5%) and non-porous (26·4%), were interviewed using a combined close- and open-ended questionnaire. Focus group discussions were conducted with 10–12 members of each community. More abortions in the last 5 years were reported from the porous interface (52%) and a significantly higher per cent of respondents from the porous interface (P < 0·05) perceived wildlife as playing a role in livestock abortions compared with the other interface types. The odds of reporting abortions in cattle were higher in large herd sizes (odds ratio (OR) = 2·6; 95% confidence interval (CI) 1·5–4·3), porous (OR = 1·9; 95% CI 1·0–3·5) and non-porous interface (OR = 2·2; 95% CI 1·1–4·3) compared with livestock–wildlife non-interface areas. About 21·6% of the respondents knew brucellosis as a cause of abortion, compared with RVF (9·8%) and leptospirosis (3·7%). These results explain to some extent, the existence of human/wildlife conflict in the studied livestock–wildlife interface areas of Zimbabwe, which militates against biodiversity conservation efforts. The low awareness of zoonoses means the public is at risk of contracting some of these infections. Thus, further studies should focus on livestock–wildlife interface areas to assess if the increased rates of abortions reported in cattle may be due to exposure to wildlife or other factors. The government of Zimbabwe needs to launch educational programmes on public health awareness in these remote areas at the periphery of transfrontier conservation areas where livestock–wildlife interface exists to help mitigate the morbidity and mortality of people from some of the known zoonotic diseases.

Cattle farmer awareness and behavior regarding prevention of zoonotic disease transmission in Senegal

Livestock farmers are known to be at high risk of exposure to zoonosis. A convenience survey to assess Senegalese traditional cattle farmers' knowledge and attitudes regarding zoonotic diseases with reference to bovine brucellosis was conducted. A total of 222 cattle farmers were interviewed. Just over a quarter (30.1%) of the study participants knew or had heard of zoonotic diseases, whereas 6.8% knew at least one mode of transmission. Rabies was the most named zoonotic disease by farmers who knew zoonosis. Meanwhile, no farmer had heard of bovine brucellosis. Identification of zoonotic disease varied significantly by farmer's main activity. All farmers reported that they drink milk produced on their cattle farms, and 95.0% drank fresh milk without prior heat treatment. A majority of farmers (70.3%) regularly assist animals during parturition and abortion without protective gloves. Farmers were less likely to assist animals if they had attended formal education. This study reports low knowledge of zoonotic infections and low compliance to control practices. Investigations on possible zoonotic infections, tailored zoonotic disease control programs including disease awareness creation and improved farm management are strongly recommended.

Bovine dermatophilosis: Awareness, perceptions and attitudes in the small-holder sector of north-west Zimbabwe

A cross-sectional study was conducted to assess cattle owners' awareness, perceptions, attitudes and drug-usage practices with regard to bovine dermatophilosis. Knowledge of these farmers' attributes is important for animal health policy makers in their endeavours to provide optimum disease control strategies that are acceptable to the communities. Data on cattle owner awareness of bovine dermatophilosis, causes, treatment practices, perceptions about its importance and potential dangers to humans were collected using an interviewer-administered questionnaire. A total of 185 stockowners and cattle herds were involved in the study, with bovine dermatophilosis determined clinically by veterinarians. The results showed that 45.4% of the herds were clinically positive for dermatophilosis, and most farmers (79.5%) were generally aware that dermatophilosis was a cattle disease. In the event of a dermatophilosis outbreak in a herd, 74.1% of the farmers treated their cattle using antibiotics; the proportion of farmers treating cattle did not differ (p > 0.05) across the diptanks. Fifty-two farmers (52/63) indicated that drugs had to be administered four to seven times before an animal recovered from infection. Tetracyclines were the antibiotics used by most farmers (79.3%) to treat dermatophilosis, with 19.1% using penicillins. Concerns were raised by farmers about the effectiveness of these drugs against bovine dermatophilosis. Across the study sites, 48.6% and 27.6% of the farmers perceived bovine dermatophilosis to be an important disease at the herd and area level, respectively. A small proportion (12.4%) of the farmers regarded bovine dermatophilosis as a potentially zoonotic disease. The high level of stockowners' general awareness, with regards to bovine dermatophilosis, sets ideal conditions for the mobilisation of farmers by animal health authorities in the control of the disease. However, further research needs to be undertaken to investigate effective antibiotic delivery protocols and the potential zoonotic impact of bovine dermatophilosis in a situation of high disease prevalence.

Living at the edge of an interface area in Zimbabwe: cattle owners, commodity chain and health workers' awareness, perceptions and practices on zoonoses

Background

In the great Limpopo transfrontier conservation area (GLTFCA), there is an increased interface between wildlife and domestic animals, because rural households move their cattle into the game park in search of grazing and watering resources. This creates opportunities for inter-species transmission of infectious diseases, including zoonoses like brucellosis and tuberculosis, which may also pose a health risk to the local rural communities. This study investigated the awareness, perceptions and practices on zoonoses amongst rural cattle owners, commodity chain- and health-workers in three different localities around Gonarezhou National Park (GNP), Zimbabwe, where the interface between wild and domestic animals varies.

Methods

A cross-sectional study was conducted in Malipati, Chikombedzi and Chiredzi that are considered to be high-, medium- and low-domestic animal-wildlife interface areas, respectively. Data was collected from cattle owners, commodity chain and health-workers using a semi-structured questionnaire. To determine the public health risk of food-borne zoonoses, their practices with regard to meat and milk consumptions, and measures they take to prevent exposure to infections were assessed. Data were analyzed using descriptive statistics and principal component analysis.

Results

Most respondents (52.8 %, 102/193) were cattle owners, followed by health (30.1 %, 58/193) and lastly commodity chain workers (17.1 %, 33/193). Overall 67.4 % (130/193) of the respondents were aware of zoonoses with respective 48, 81.8, and 93.1 % of cattle owners, commodity chain, and health workers, being aware. Significantly more cattle owners (P < 0.05) from medium and low interface areas were aware of zoonoses compared to those from high interface areas. All categories of respondents cited anthrax (69.2 %), rabies (57.7 %), tuberculosis (41.5 %) and brucellosis (23.9 %) as important zoonoses. About half (46.1 %; 89/193) of the respondents perceive wildlife as important reservoirs of zoonoses. High proportions 98.4 % (190/193) and 96.4 % (186/193) of the respondents indicated that they consume meat and milk, respectively. Access to game meat and milk from informal markets was closely associated with consumption of raw meat and milk.

Conclusions

Fewer cattle owners from a high interface area of Malipati are aware of zoonoses compared to other areas due to combined effects of limited education and other factors disadvantaging these marginalised areas. This may increase their risk of exposure to zoonoses, considering that consumption of raw meat and milk is common. Thus, awareness campaigns may reduce the public health impact of zoonoses at the interface.

First Autochthonous Coinfected Anthrax in an Immunocompetent Patient

Cutaneous anthrax has a mortality rate of 20% if no antibacterial treatment is applied. The clinical manifestations of cutaneous anthrax are obviously striking, but coinfection may produce atypical lesions and mask the clinical manifestations and proper laboratory diagnosis. Anthrax is known to be more common in the Middle East and Iran is one of the countries in which the zoonotic form of anthrax may still be encountered. We report a case of a 19-years-old male who used to apply Venetian ceruse on his skin. Venetian ceruse (also known as Spirits of Saturn) is an old cosmetic product used for skin whitening traditionally made from sheep's spinal cord. The patient referred to the Referral Laboratory, Mazandaran University of Medical Sciences, Sari, Iran, with atypical dermatosis, pronounced pain, and oedema of the affected tissue. It was confirmed by both conventional and molecular analysis that culture was a mixture of Bacillus anthracis and Trichophyton interdigitale. The patient was initially treated with ceftriaxone (1000 mg/day for two weeks), gentamicin (1.5–2 mg/kg/day), terbinafine (200 mg/week for one month), and 1% clotrimazole cream (5 weeks) two times per day which resulted in gradual improvement. No relapse could be detected after one-year follow-up. Anthrax infection might present a broader spectrum of symptoms than expected by clinicians. These unfamiliar characteristics may lead to delayed diagnosis, inadequate treatment, and higher mortality rate. Clinicians need to be aware of this issue in order to have successful management over this infection.

Communal farmers' perceptions of tick-borne diseases affecting cattle and investigation of tick control methods practiced in Zimbabwe

Tick borne diseases (TBDs) are responsible for huge economic losses in cattle production in most African countries where the majority of cattle owners are the resource poor communal farmers. Governments have initiated and co-ordinate tick control programs with farmers required to contribute funds for their sustenance. The success of these programs will hinge upon the involvement of communal farmers in their design, implementation and evaluation. To this end, 313 communal farmers (approximately 8.4% response rate) were interviewed and 3 focus group discussions were carried out in the southern low-veld part of Zimbabwe with the objectives of investigating communal farmers' perceptions on TBDs affecting cattle, level of participation in government initiated tick control programs, other tick control methods practiced, types of acaricides used and their perceived effectiveness. There was a general awareness of TBDs with 67.7% (n=212) farmers being able to describe tick diseases with names or clinical and post-mortem signs. The diseases or problems frequently associated with ticks were cowdriosis (38%, n=119), mastitis (36.7%, n=115), anaplasmosis (36.1%, n=113), body damage (28.4%, n=89), babesiosis (24.6%, n=77) and poor body condition (16.6%, n=52). Cattle mortalities due to TBDs were reported by 23.8% (n=74) of the farmers. The plunge dip was consistently used by farmers (70.3%, n=220) to control ticks. Other tick control methods practiced were the hand spraying (67.4%, n=211), hand dressing (16.6%, n=52), traditional methods (5.4%, n=17), use of pour-ons (4.5%, n=14) and smearing (2.2%, n=7). The formamidines were the most common class of acaricide used (59.4%, n=186), followed by synthetic pyrethroids (29.1%, n=91), macro cyclic lactones (12.8%, n=40) and organophosphates (4.5%, n=14). Most farmers (75.2%, n=231) perceived these acaricides to be effective in controlling ticks. The results of focus group discussions showed that a number of factors influenced the success of government initiated tick control programs and these included inconsistent supply of acaricides, unaffordable dipping fees, lack of water, long distance to the dip tank, lack of information on dipping procedures and lack of knowledge on strategies for delaying acaricide resistance. This study demonstrates that while farmers can be a valuable source of information with regards to the epidemiology of tick borne diseases affecting their cattle, there is still need for further training in understanding the TBDs and strategies for their control.