Challenges and economic implications in the control of foot and mouth disease in sub-saharan Africa: lessons from the zambian experience

Foot and mouth disease vaccine efficacy in Africa: a systematic review and meta-analysis

Background

Several factors, such as diverse serotypes, vaccination methods, weak biosecurity, and animal movements, contribute to recurrent Foot-and-Mouth Disease Virus (FMDV) outbreaks in Africa, establishing endemicity. These outbreaks cost over $2 billion annually, prompting a high-priority focus on FMDV vaccination. Despite extensive efforts, vaccine efficacy varies. This study aims to evaluate routine foot and mouth disease (FMD) vaccines in Africa via systematic review and meta-analysis.

Methods

A systematic review and meta-analysis were carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was conducted to assess the efficacy of FMDV vaccination using the meta for package of R.

Results

Vaccinated animals have roughly a 69.3% lower chance of FMDV infection compared to unvaccinated animals, as indicated by the pooled results from the random-effects model, which showed a risk ratio (RR) of 0.3073. There was a statistically significant heterogeneity (p < 0.05) across all of the included articles.

Conclusion

Overall findings suggest that if properly planned and implemented, FMDV vaccination programs and strategies in Africa could help control the spread of the disease throughout the continent and beyond.

A review of foot-and-mouth disease in Ethiopia: epidemiological aspects, economic implications, and control strategies

Foot-and-mouth disease (FMD) is a contagious viral disease that affects the livelihoods and productivity of livestock farmers in endemic regions. It can infect various domestic and wild animals with cloven hooves and is caused by a virus belonging to the genus Aphthovirus and family Picornaviridae, which has seven different serotypes: A, O, C, SAT1, SAT2, SAT3, and Asia-1. This paper aims to provide a comprehensive overview of the molecular epidemiology, economic impact, diagnosis, and control measures of FMD in Ethiopia in comparison with the global situation. The genetic and antigenic diversity of FMD viruses requires a thorough understanding for developing and applying effective control strategies in endemic areas. FMD has direct and indirect economic consequences on animal production. In Ethiopia, FMD outbreaks have led to millions of USD losses due to the restriction or rejection of livestock products in the international market. Therefore, in endemic areas, disease control depends on vaccinations to prevent animals from developing clinical disease. However, in Ethiopia, due to the presence of diverse antigenic serotypes of FMD viruses, regular and extensive molecular investigation of new field isolates is necessary to perform vaccine-matching studies to evaluate the protective potential of the vaccine strain in the country.

Outbreak investigation of foot-and-mouth disease in cattle in Tigray region, Northern Ethiopia

An investigation of a foot-and-mouth disease (FMD) outbreak was conducted between late October and mid-December 2019 in Tigray region. The outbreak investigation team collected epidemiological data from the six villages of Kafta Humera and Seharti Samre districts, including morbidity proportions, mortality proportions, and clinical signs, and cattle management and vaccination history were collected via participatory methods, including interviews and group discussions with local experts and farmers in Kafta Humera and reports from the district veterinarians in Seharti Samre. Twenty-two tissue samples were collected for laboratory confirmation. Overall, 4,299/9,811 (43.8%) and 13,654/16,921 (80.6%) cattle showed clinical signs for FMD in Kafta Humera and Seharti Samre, respectively. In Kafta Humera, the highest morbidity proportion was found in adult cows and heifers (48.1%), followed by 27.8% in oxen and 15.9% in calves. In Seharti Samre, the morbidity proportion was similar in all age groups at ~81%. No death of FMD-suspected cattle was reported throughout the outbreak. The serotype of foot-and-mouth disease virus (FMDV) identified by laboratory analysis differed between the two districts (serotype O in Kafta Humera and serotype A in Seharti Samre). We, therefore, suggest that the outbreaks in the two districts occurred independently from each other. Experts and farmers were interviewed and believed that the outbreak in Kafta Humera was most likely caused by interaction between cattle and wildlife from the surrounding Kafta Sheraro National Park, which share common grazing land. This outbreak investigation showed that FMD can cause devastating cattle morbidity. A regular vaccination program against the identified circulating FMDV serotypes with sufficient coverage is required to avoid future outbreaks.

Molecular evolution, diversity, and adaptation of foot-and-mouth disease virus serotype O in Asia

Foot-and-mouth disease (FMD) is highly contagious and affects the economy of many countries worldwide. Serotype O is the most prevalent and is present in many regions of Asia. Lineages O/SEA/Mya-98, O/Middle East-South Asia (ME-SA)/PanAsia, O/Cathay and O/ME-SA/Ind-2001 have been circulating in Asian countries. Low antigenic matching between O/Cathay strains and current vaccine strains makes the disease difficult to control, therefore, analyzing the molecular evolution, diversity, and host tropisms of FMDV Serotype O in Asia may be helpful. Our results indicate that Cathay, ME-SA, and SEA are the predominant topotypes of FMDV serotype O circulating in Asia in recent years. Cathay topotype FMDV evolves at a higher rate compared with ME-SA and SEA topotypes. From 2011 onwards, the genetic diversity of the Cathay topotype has increased substantially, while large reductions were found in the genetic diversity of both ME-SA and SEA topotypes, suggesting a trend that infections sustained by the Cathay topotype were becoming a more severe epidemic in recent years. Analyzing the distributions of host species through time in the dataset, we found that the O/Cathay topotype was characterized by a highly swine-adapted tropism in contrast with a distinct host preference for O/ME-SA. The O/SEA topotype strains identified in Asia were isolated mainly from cattle until 2010. It is worth noting that there may be a fine-tuned tropism of the SEA topotype viruses for host species. To further explore the potential molecular mechanism of host tropism divergence, we analyzed the distribution of structure variations on the whole genome. Our findings suggest that deletions in the PK region may reflect a common pattern of altering the host range of serotype O FMDVs. In addition, the divergence of host tropism may be due to accumulated structural variations across the viral genome, rather than a single indel mutation.

Seroepidemiology of selected transboundary animal diseases in goats in Zambia

Transboundary pathogens of goats present significant constraints to the livelihoods of millions of farmers in countries such as Zambia. Consequently, this study aimed to investigate the seroprevalence of Mycoplasma capricolum subsp. capripneumoniae (Mccp), foot and mouth disease virus (FMDV), Brucella spp., Crimean Congo haemorrhagic fever virus (CCHFV), and Rift Valley fever virus (RVFV) in Zambian goats. Another aim was to identify associations between seroprevalence and different predictor variables, such as trade and border proximity. From September to October 2019, 962 serum samples were collected from goats in seven Zambian districts, four of which have an international border while the remaining three do not. A questionnaire survey was conducted with each household, focusing on trade routines, management strategies and herd disease history. Animal-level seroprevalence adjusted for herd-level clustering was 8.2 % (95 % confidence interval [CI] 7.5-9.0) for Mccp, 12.9% (95% CI 12.0-13.7) for FMDV, 13.0 % (95% CI 12.1-13.9) for Brucella spp., 3.3 % (95% CI 2.8-3.7) for CCHFV, and 0.4 % (95 % CI 0.3-0.7) for RVFV. The association between herd-level seroprevalence and border proximity and trade appeared negligible, with the exception of selling goats at least twice a year which was identified as a potential risk factor for Brucella spp. (OR 4.1, 95 % CI 1.1-16.0, p = 0.040). In addition, a positive association between herd-level seroprevalence of FMDV and a herd size of 21 goats or more (OR 3.3, 95 % CI 1.0-11.1, p = 0.049) was detected. Also, positive associations between animal-level seroprevalence of Brucella spp. and increasing age (OR 7.7, 95 % CI 1.5-40.7, p = 0.016), and CCHFV and keeping pigs in the household (OR 2.7, 95 % CI 1.0-7.1, p = 0.044), were found. For FMDV (OR 3.8, 95 % CI 1.4-10.9, p = 0.011) and Brucella spp. (OR 4.5, 95 % CI 1.2-17.3, p = 0.031) on the other hand, animal-level seroprevalence was significantly higher in households without pigs. To the best of the authors' knowledge, this is the first study to describe the presence of antibodies for CCPP and CCHF in the Zambian goat population. While the association between seroprevalence and trade and border proximity generally appeared negligible, it is recommended that their influence is further evaluated in future studies, preferably through in-depth longitudinal studies incorporating impacts of different biosecurity measures and trade variations, linked to for example seasonality and trade peaks.

A Five-Year Retrospective Study of Foot-and-Mouth Disease Outbreaks in Southern Africa, 2014 to 2018

Foot-and-mouth disease (FMD) virus (FMDv), like other ribonucleic acid (RNA) genome viruses, has a tendency to mutate rapidly. As such, available vaccines may not confer enough cross-protection against incursion of new lineages and sublineages. This paper is a retrospective study to determine the topotypes/lineages that caused previous FMD outbreaks in 6 southern African countries and the efficacy of the current vaccines to protect cattle against them. A total of 453 bovine epithelial tissue samples from 33 FMD outbreaks that occurred in these countries from 2014 to 2018 were investigated for the presence of FMDv. The genetic diversity of the identified Southern African Type (SAT)-FMD viruses was determined by comparing sequences from outbreaks and historical prototype sequences. Of the 453 samples investigated, 176 were positive for four FMDv serotypes. Out of the 176 FMD positive cases there were 105 SAT2 samples, 32 SAT1 samples, 21 SAT3 samples, and 18 serotype O samples. Phylogenetic analysis grouped the SATs VP1 gene sequences into previously observed topotypes in southern Africa. SAT1 viruses were from topotypes I and III, SAT2 viruses belonged to topotypes I, II, III, and IV, and SAT3 viruses were of topotypes I and II. Vaccine matching studies on the field FMDv isolates produced r 1-values greater than or equal to 0.3 for the three SAT serotypes. This suggests that there is no significant antigenic difference between current SAT FMD vaccine strains and the circulating SAT serotypes. Therefore, the vaccines are still fit-purpose for the control FMD in the region. The study did not identify incursion of any new lineages/topotypes of FMD into the sampled southern African countries.

Characterization of Foot-and-Mouth Disease Viruses in Zambia-Implications for the Epidemiology of the Disease in Southern Africa

The livestock industry supports livelihood and nutritional security of at least 42% of people in the Southern African Development Community region. However, presence of animal diseases such as foot-and-mouth disease poses a major threat to the development of this industry. Samples collected from FMD outbreaks in Zambia during 2015–2020, comprising epithelial tissues samples (n = 47) and sera (n = 120), were analysed. FMD virus was serotyped in 26 samples, while 92 sera samples tested positive on NSP-ELISA. Phylogenetic analysis revealed notable changes in the epidemiology of FMD in Zambia, which included: (i) introduction of a novel FMDV SAT-3 (topotype II) causing FMD cases in cattle in Western Province; (ii) emergence of FMDV serotype O (topotype O/EA-2) in Central, Southern, Copperbelt, Western, Lusaka Provinces; and (iii) new outbreaks due to SAT -2 (topotypes I) in Eastern Zambia. Together, these data describe eight different epizootics that occurred in Zambia, four of which were outside the known FMD high-risk areas. This study highlights the complex epidemiology of FMD in Zambia, where the country represents an interface between East Africa (Pool 4) and Southern Africa (Pool 6). These changing viral dynamics have direct impacts on FMD vaccine selection in the SADC region.

Seroprevalence of Bovine Brucellosis in Selected Districts of Zambia

Brucellosis is an infectious zoonosis that has huge economic and public health implications globally. The disease is prevalent in humans, livestock and wildlife in Sub-Saharan Africa. A cross-sectional study was conducted between 6 May 2017 and 31 July 2020 during which 1712 sera from 175 cattle herds in five districts from Southern, Western and Eastern Provinces of Zambia were collected and screened against brucellosis. The Rose Bengal Test (RBT) and competitive Enzyme-linked Immuno Assay (c-ELISA) were used in serial testing for the detection of antibodies against Brucella species. A total of 127 animals from 37 herds tested positive, giving overall individual animal and herd-level seroprevalences of 7.53% (95% CI: 6.28–8.78%) and 21.14% (95% CI: 15.0–27.2%), respectively. Namwala district had the highest herd seroprevalence (33.9%, 95% CI: 21.6–46.1%), while Lundazi did not record any seropositivity. Comparably, Southern Province had the highest individual animal (8.97%, 95% CI: 7–11%) and herd-level (28.5%, 95% CI: 20.3–36.7%) seroprevalences, although this was not statistically significant. Within Southern Province, higher seropositivity was observed in Namwala district (OR: 8.55; CI: 2.66–27.44), among female animals (OR: 2.48; CI: 1.38–4.46) and in those aged 11 years and above (OR: 2.67; CI: 1.34–5.34) as well as in gravid cows (OR: 4.34; CI: 2.08–8.92). Seropositivity was also observed among some animals with hygromas (OR: 6.5; CI: 0.45–94.08) and those with a history of abortion (OR: 1.13; CI: 0.18–7.28) although the findings were not statistically significant. Brucella seroprevalence among traditional cattle in Zambia remains high. Control programs against bovine brucellosis must be introduced to reduce its impact on human health and animal production.

Endemic foot and mouth disease: pastoral in-herd disease dynamics in sub-Saharan Africa

Foot and mouth disease (FMD) burden disproportionally affects Africa where it is considered endemic. Smallholder livestock keepers experience significant losses due to disease, but the dynamics and mechanisms underlying persistence at the herd-level and beyond remain poorly understood. We address this knowledge gap using stochastic, compartmental modelling to explore FMD virus (FMDV) persistence, outbreak dynamics and disease burden in individual cattle herds within an endemic setting. Our analysis suggests repeated introduction of virus from outside the herd is required for long-term viral persistence, irrespective of carrier presence. Risk of new disease exposures resulting in significant secondary outbreaks is reduced by the presence of immune individuals giving rise to a period of reduced risk, the predicted duration of which suggests that multiple strains of FMDV are responsible for observed yearly herd-level outbreaks. Our analysis suggests management of population turnover could potentially reduce disease burden and deliberate infection of cattle, practiced by local livestock keepers in parts of Africa, has little effect on the duration of the reduced risk period but increases disease burden. This work suggests that FMD control should be implemented beyond individual herds but, in the interim, herd management may be used to reduced FMD impact to livestock keepers.

The Development and Validation of a Novel Nanobody-Based Competitive ELISA for the Detection of Foot and Mouth Disease 3ABC Antibodies in Cattle

Effective management of foot and mouth disease (FMD) requires diagnostic tests to distinguish between infected and vaccinated animals (DIVA). To address this need, several enzyme-linked immunosorbent assay (ELISA) platforms have been developed, however, these tests vary in their sensitivity and specificity and are very expensive for developing countries. Camelid-derived single-domain antibodies fragments so-called Nanobodies, have demonstrated great efficacy for the development of serological diagnostics. This study describes the development of a novel Nanobody-based FMD 3ABC competitive ELISA, for the serological detection of antibodies against FMD Non-Structural Proteins (NSP) in Uganda cattle herds. This in-house ELISA was validated using more than 600 sera from different Uganda districts, and virus serotype specificities. The evaluation of the performance of the assay demonstrated high diagnostic sensitivity and specificity of 94 % (95 % CI: 88.9-97.2), and 97.67 % (95 % CI: 94.15-99.36) respectively, as well as the capability to detect NSP-specific antibodies against multiple FMD serotype infections. In comparison with the commercial PrioCHECK FMDV NSP-FMD test, there was a strong concordance and high correlation and agreement in the performance of the two tests. This new developed Nanobody based FMD 3ABC competitive ELISA could clearly benefit routine disease diagnosis, the establishment of disease-free zones, and the improvement of FMD management and control in endemically complex environments, such as those found in Africa.

Spatial and temporal distribution of foot-and-mouth disease in four districts situated along the Uganda-Tanzania border: Implications for cross-border efforts in disease control

Foot-and-mouth disease (FMD) is one of the major trans-boundary animal diseases in East Africa causing economic loss to farmers and other stakeholders in the livestock industry. Foot-and-mouth disease occurs widely in both Uganda and Tanzania with annual outbreaks recorded. With the recent introduction of the Progressive Control Pathway for FMD control (PCP-FMD) in eastern Africa, knowledge of the spatial and temporal distribution of FMD at the border area between Uganda and Tanzania is helpful in framing engagement with the initial stages of the PCP. Retrospective data collected between 2011 and 2016 from four districts located along the border areas of Uganda and Tanzania, recorded 23 and 59 FMD outbreaks, respectively, for the entire study period. Analysis showed that 46% of the 82 recorded outbreaks occurred in 20% of sub-counties and wards immediately neighbouring the Uganda–Tanzania border and 69.5% of the outbreaks occurred during the dry months. While the serotypes of the FMD virus responsible for most outbreaks reported in this region were not known, previous research reported South African Territory (SAT) 1, SAT 2 and O to be the serotypes in circulation. The results from this study provide evidence of the endemic status of FMD on the Uganda–Tanzania border and emphasise that the border area should be given due consideration during FMD control drives and that cross-border coordination should be prioritised. With the limited data on circulating serotypes in this area, there is a need for more vigilance on FMD case detection, laboratory diagnostic confirmation and provision of more complete documentation of outbreaks. This work further recommends more studies on cross-border livestock movement coupled with phylogenetics in order to understand the spread of the FMD in the border area.

Seasonality and pathogen transmission in pastoral cattle contact networks

Capturing heterogeneity in contact patterns in animal populations is essential for understanding the spread of infectious diseases. In contrast to other regions of the world in which livestock movement networks are integral to pathogen prevention and control policies, contact networks are understudied in pastoral regions of Africa due to the challenge of measuring contact among mobile herds of cattle whose movements are driven by access to resources. Furthermore, the extent to which seasonal changes in the distribution of water and resources impacts the structure of contact networks in cattle is uncertain. Contact networks may be more conducive to pathogen spread in the dry season due to congregation at limited water sources. Alternatively, less abundant forage may result in decreased pathogen transmission due to competitive avoidance among herds, as measured by reduced contact rates. Here, we use GPS technology to concurrently track 49 free-roaming cattle herds within a semi-arid region of Kenya, and use these data to characterize seasonal contact networks and model the spread of a highly infectious pathogen. This work provides the first empirical data on the local contact network structure of mobile herds based on quantifiable contact events. The contact network demonstrated high levels of interconnectivity. An increase in contacts near to water resources in the dry season resulted in networks with both higher contact rates and higher potential for pathogen spread than in the wet season. Simulated disease outbreaks were also larger in the dry season. Results support the hypothesis that limited water resources enhance connectivity and transmission within contact networks, as opposed to reducing connectivity as a result of competitive avoidance. These results cast light on the impact of seasonal heterogeneity in resource availability on predicting pathogen transmission dynamics, which has implications for other free-ranging wild and domestic populations.

Foot-and-Mouth Disease Impact on Smallholders - What Do We Know, What Don't We Know and How Can We Find Out More?

Foot‐and‐mouth disease (FMD) endemic regions contain three‐quarters of the world's FMD susceptible livestock and most of the world's poor livestock keepers. Yet FMD impact on smallholders in these regions is poorly understood. Diseases of low mortality can exert a large impact if incidence is high. Modelling and field studies commonly find high FMD incidence in endemic countries. Sero‐surveys typically find a third of young cattle are sero‐positive, however, the proportion of sero‐positive animals that developed disease, and resulting impact, are unknown. The few smallholder FMD impact studies that have been performed assessed different aspects of impact, using different approaches. They find that FMD impact can be high (>10% of annual household income). However, impact is highly variable, being a function of FMD incidence and dependency on activities affected by FMD. FMD restricts investment in productive but less FMD‐resilient farming methods, however, other barriers to efficient production may exist, reducing the benefits of FMD control. Applying control measures is costly and can have wide‐reaching negative impacts; veterinary‐cordon‐fences may damage wildlife populations, and livestock movement restrictions and trade bans damage farmer profits and the wider economy. When control measures are ineffective, farmers, society and wildlife may experience the burden of control without reducing disease burden. Foot‐and‐mouth disease control has benefitted smallholders in South America and elsewhere. Success takes decades of regional cooperation with effective veterinary services and widespread farmer participation. However, both the likelihood of success and the full cost of control measures must be considered. Controlling FMD in smallholder systems is challenging, particularly when movement restrictions are hard to enforce. In parts of Africa this is compounded by endemically infected wildlife and limited vaccine performance. This paper reviews FMD impact on smallholders in endemic countries. Significant evidence gaps exist and guidance on the design of FMD impact studies is provided.

Relations between Household Livestock Ownership, Livestock Disease, and Young Child Growth

BACKGROUND

In resource-limited settings in which child malnutrition is prevalent, humans live in close proximity to household livestock. However, the relation between household livestock and child nutrition represents a considerable knowledge gap.

OBJECTIVE

We assessed whether household livestock ownership or livestock disease episodes were associated with growth in young children in western Kenya.

METHODS

We incorporated monthly anthropometric measurements for children <5 y of age into an ongoing linked human and animal surveillance cohort in rural western Kenya. Using linear mixed models adjusted for age, sex, and household wealth, we tested whether baseline household livestock ownership was related to baseline child height for age or prospective growth rate. We also evaluated whether livestock disease episodes were associated with child growth rate over 11 mo of follow-up.

RESULTS

We collected data on 925 children over the course of follow-up. Greater household livestock ownership at baseline was not related to baseline child height-for-age z score (adjusted β: 0.01 SD; 95% CI: -0.02, 0.04 SD) or child growth rate (adjusted β: 0.02 cm/y; 95% CI: -0.03, 0.07 cm/y). Livestock disease episodes were not significantly associated with child growth across the entire cohort (adjusted β: -0.007 cm/mo; 95% CI: -0.02, 0.006 cm/mo). However, children in households with livestock digestive disease between June and November gained less height than did children in households that did not report livestock disease (β: -0.063 cm/mo; 95% CI: -0.112, -0.016 cm/mo). Children <2 y of age in households with livestock digestive disease gained less weight than did those who did not report disease (β: -0.033 kg/mo; 95% CI: -0.063, -0.003 kg/mo).

CONCLUSION

In this cohort of young children in western Kenya, we did not find an association between ownership of livestock and child growth status. However, disease episodes in household livestock may be related to a lower child growth rate in some groups.

Serological Survey of Foot-and-Mouth Disease Virus in Buffaloes (Syncerus caffer) in Zambia

A study was conducted to determine the serotypes of foot-and-mouth disease viruses (FMDV) circulating in African buffaloes (Syncerus caffer) from selected areas in Zambia. Sera and probang samples were collected between 2011 and 2012 and analysed for presence of antibodies against FMDV while probang samples were used to isolate the FMDV by observing cytopathic effect (CPE). Samples with CPE were further analysed using antigen ELISA. High FMD seroprevalence was observed and antibodies to all the three Southern African Territories (SAT) serotypes were detected in four study areas represented as follows: SAT2 was 72.7 percent; SAT1 was 62.6 percent; and SAT3 was 26.2 percent. Mixed infections accounted for 68.6 percent of those that were tested positive. For probang samples, CPE were observed in three of the samples, while the antigen ELISA results showed positivity and for SAT1 (n = 1) and SAT2 (n = 2). It is concluded that FMDV is highly prevalent in Zambian buffaloes which could play an important role in the epidemiology of the disease. Therefore livestock reared at interface with the game parks should be included in all routine FMDV vaccination programmes.