A focused ethnographic study of Sri Lankan government field veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance

Knowledge, attitude, and practices of veterinarians towards canine vector-borne pathogens in Sri Lanka

Canine vector-borne pathogens (CVBP) have a worldwide distribution and show a high prevalence in tropical countries such as Sri Lanka. Some CVBP are zoonotic, with dogs identified as reservoir hosts for human subcutaneous dirofilariasis and potentially for spotted fever rickettsioses and re-emergent brugian filariasis in Sri Lanka, making these pathogens emerging public health issues in the country. Veterinarians are crucial in monitoring, preventing, and controlling these pathogens in dogs. Therefore, it is imperative to understand veterinarians' knowledge, attitude, and practices (KAP) regarding CVBP to mitigate their impact. A survey was designed and administered electronically to veterinarians residing and practising in Sri Lanka. Responses were evaluated using descriptive, univariable, and multivariable analyses to investigate associations between demographic factors, knowledge, attitude, and practices related to CVBP. Out of the 170 participating veterinarians, nearly 70% had moderate or high knowledge. However, the awareness of zoonotic pathogens, Brugia spp. (16%) and Rickettsia conorii (18%), was low, and a considerable number of veterinarians were unaware of the zoonotic nature of Dirofilaria repens. Based on multivariable analysis adjusting for experience and self-rated knowledge, new graduates had higher odds of knowledge compared to experienced veterinarians (OR 5.7, 95% CI 1.7-23, p = 0.028). Questions assessing the attitude towards CVBP indicated that most participating veterinarians comprehend and agree with their importance. Nearly all participants agreed that ectoparasite control is the best option to prevent CVBP infections (91%, 153/167) and that for effective treatment of CVBP, a definitive diagnosis is required (81%, 135/167). However, veterinarians recommended suboptimal treatments for some CVBP, like Babesia gibsoni. Better practices were associated with being a companion animal practitioner (OR 2.4, 95% CI 1.1-5.7, p = 0.032) and having a low to moderate canine caseload (OR 3.6, 95% CI 1.3-10.4, p = 0.038). Limited knowledge of zoonotic CVBP among veterinarians, along with suboptimal treatment, might contribute to dogs acting as reservoirs and high prevalence of these pathogens in Sri Lanka. Therefore, continued veterinary education is recommended to improve knowledge and practices, which in turn will help to improve the diagnosis, treatment, and control of these infections in Sri Lanka to ensure the well-being of dogs and humans.

A systematic review of social research data collection methods used to investigate voluntary animal disease reporting behaviour

Voluntary detection of emerging disease outbreaks is considered essential for limiting their potential impacts on livestock industries. However, many of the strategies employed by animal health authorities to capture data on potential emerging disease threats rely on farmers and veterinarians identifying situations of concern and then voluntarily taking appropriate actions to notify animal health authorities. To improve the performance of these systems, it is important to understand the range of socio-cultural factors influencing the willingness of individuals to engage with disease reporting such as trust in government, perceived economic impacts, social stigma and perceptions of 'good farming'. The objectives of this systematic review were to assess how different social research methodologies have been employed to understand the role these socio-cultural dimensions play in voluntary disease reporting and to discuss limitations to address in future research. The review uncovered 39 relevant publications that employed a range of quantitative and qualitative methodologies including surveys, interviews, focus groups, scenarios, observations, mixed-methods, interventions and secondary data analysis. While these studies provided valuable insights, one significant challenge remains eliciting accurate statements of behaviour and intentions rather than those that reflect desirable social norms. There is scope to develop methodological innovations to study the decision to report animal disease to help overcome the gap between what people say they do and their observable behaviour. A notable absence is studies exploring specific interventions designed to encourage disease reporting. Greater clarity in specifying the disease contexts, behavioural mechanisms and outcomes and the relationships between them would provide a more theoretically informed and policy relevant understanding of how disease reporting works, for which farmers, and in which disease contexts.

Surveillance Opportunities and the Need for Intersectoral Collaboration on Rabies in Sri Lanka

Sri Lanka is progressing towards its goal of eliminating human rabies. This goal rests on programs designed to limit canine rabies, which in turn requires a combination of targeted dog rabies control and a better understanding of the movement of the virus between domestic animals, people, and wildlife. Coordinated and integrated surveillance of the disease between human and animal health sectors underpins successful rabies elimination. Our objective was to review surveillance data from 2005 to 2014 to assemble the first multispecies synthesis of rabies information in Sri Lanka and, in doing so, assess needs and opportunities for a One Health approach to rabies surveillance in the country. Our descriptive epidemiological findings were consistent with other studies showing a decline in human cases, endemic and unchanging numbers of dog cases, a relationship between human density and the occurrence of human and animal cases, and significant gaps in understanding trends in rabies incidences in livestock and wildlife. Assessing the trends in the data from the three government organizations responsible for rabies surveillance was difficult due to lack of information on animal population sizes, unquantified sampling biases due to inequities in access to diagnostic capacities, regulatory and administrative barriers, and a continued reliance on clinical means to establish a diagnosis. The information required for a comprehensive rabies control programme was not standardized or consistent, was not in one place, showed significant gaps in completeness, and was not amenable to routine and rapid analysis. Achieving rabies elimination in Sri Lanka would benefit from harmonization of diagnostic and information management standards across animal and human health sectors as well as equitable access to diagnostic capacity for all regions and species.

The use of animals as a surveillance tool for monitoring environmental health hazards, human health hazards and bioterrorism

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It discusses the use of animal sentinels for surveillance.

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It discusses the use of animals as a surveillance tool for monitoring environmental health hazards.

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It discusses the use of animals as a surveillance tool for monitoring human health hazards.

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It discusses the use of animals as a surveillance tool for monitoring bioterrorism.

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It discusses the One Health approach.

This review discusses the utilization of wild or domestic animals as surveillance tools for monitoring naturally occurring environmental and human health hazards. Besides providing early warning to natural hazards, animals can also provide early warning to societal hazards like bioterrorism. Animals are ideal surveillance tools to humans because they share the same environment as humans and spend more time outdoors than humans, increasing their exposure risk. Furthermore, the biologically compressed lifespans of some animals may allow them to develop clinical signs more rapidly after exposure to specific pathogens. Animals are an excellent channel for monitoring novel and known pathogens with outbreak potential given that more than 60 % of emerging infectious diseases in humans originate as zoonoses. This review attempts to highlight animal illnesses, deaths, biomarkers or sentinel events, to remind human and veterinary public health programs that animal health can be used to discover, monitor or predict environmental health hazards, human health hazards, or bioterrorism. Lastly, we hope that this review will encourage the implementation of animals as a surveillance tool by clinicians, veterinarians, ecosystem health professionals, researchers and governments.

One Health and its practical implications for surveillance of endemic zoonotic diseases in resource limited settings

Surveillance of zoonotic disease requires special attention because the animal and human health sectors are involved. A proliferation of scholarly literature and technical guidelines exist for early detection of exotic and re-emerging diseases and to demonstrate freedom from disease as part of international trade agreements. In contrast, literature focussing on surveillance of endemic zoonotic diseases is relatively rare. In this article, we describe and discuss the main aspects to consider when planning a surveillance system for endemic zoonotic diseases in a resource-limited country. We describe advantages and disadvantages of different active and passive surveillance systems and explore how risk-based sampling might improve efficiency and reduce costs, and which tools are available to identify high-risk populations.

A retrospective epidemiological analysis of risk factors for a primary necropsy diagnosis of bovine respiratory disease

Bovine respiratory disease (BRD) is a multifactorial disease and the primary cause of both bovine morbidity and mortality in Ireland. The risk factors associated with a primary necropsy diagnosis of BRD among cattle in the traditional (non-feedlot) husbandry systems prevalent in Ireland have not been investigated previously. The aim of this case-control study was to investigate those risk factors among cattle of all ages over an 8 year period. A total of 3,090 BRD cases and 5,236 controls were matched by submitting veterinary practitioner. Univariable and multivariable analyses were performed to examine the association of selected animallevel, herd-level and environmental risk factors with case or control status using a conditional logistical regression model. Male cattle aged more than 31 days were significantly more likely to record a primary necropsy diagnosis of BRD than female cattle. Older cattle of both sexes were at increased odds of a BRD necropsy diagnosis than younger calves with the exception of female cattle aged greater than 165 days. The risk of a primary necropsy diagnosis of BRD increased with increasing herd size and decreased with increasing time in days since the last animal movement into the submitting herd. There were significantly reduced odds of a primary necropsy diagnosis of BRD in the summer (June to August) when compared with the autumn (September to November). These findings identify significant risk factors for a necropsy diagnosis of BRD under non-feedlot-type husbandry conditions.

Experiences with a voluntary surveillance system for early detection of equine diseases in Switzerland

Clinical observations made by practitioners and reported using web- and mobile-based technologies may benefit disease surveillance by improving the timeliness of outbreak detection. Equinella is a voluntary electronic reporting and information system established for the early detection of infectious equine diseases in Switzerland. Sentinel veterinary practitioners have been able to report cases of non-notifiable diseases and clinical symptoms to an internet-based platform since November 2013. Telephone interviews were carried out during the first year to understand the motivating and constraining factors affecting voluntary reporting and the use of mobile devices in a sentinel network. We found that non-monetary incentives attract sentinel practitioners; however, insufficient understanding of the reporting system and of its relevance, as well as concerns over the electronic dissemination of health data were identified as potential challenges to sustainable reporting. Many practitioners are not yet aware of the advantages of mobile-based surveillance and may require some time to become accustomed to novel reporting methods. Finally, our study highlights the need for continued information feedback loops within voluntary sentinel networks.

Finding a Place for Systems-Based, Collaborative Research in Emerging Disease Research in Asia

The need to adequately predict, prevent and respond to infectious diseases emerging unexpectedly from human-animal-environmental systems has driven interest in multisectoral, socio-economic, systems-based, collaborative (MSC) research approaches such as EcoHealth and One Health. Our goals were to document how MSC research has been used to address EIDs in Asia, and to explore how MSC approaches align with current priorities for EID research in Asia. We gathered priorities for EID research from the peer-reviewed and grey literature, documented organizational descriptions of MCS research approaches, and analysed a series of EID MSC projects. We found that priority areas for EID research in Asia included (1) understanding host-pathogen-environment interactions; (2) improving tools and technologies; (3) changing people's behaviour; and (4) evaluating the effectiveness of interventions. We found that the unifying characteristics of MSC research were that it was action-oriented and sought to inspire change under real-world conditions at the complex interface of human and natural systems. We suggest that MSC research can be considered a type of 'pragmatic research' and might be most useful in describing change in complex human-animal-environmental systems, accelerating research-to-action, and evaluating effectiveness of interventions in 'real world' settings.

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam

Economic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non-monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non-monetary benefit) which was mainly obtained from other private actors and media.

Integrating novel data streams to support biosurveillance in commercial livestock production systems in developed countries: challenges and opportunities

Reducing the burden of emerging and endemic infectious diseases on commercial livestock production systems will require the development of innovative technology platforms that enable information from diverse animal health resources to be collected, analyzed, and communicated in near real-time. In this paper, we review recent initiatives to leverage data routinely observed by farmers, production managers, veterinary practitioners, diagnostic laboratories, regulatory officials, and slaughterhouse inspectors for disease surveillance purposes. The most commonly identified challenges were (1) the lack of standardized systems for recording essential data elements within and between surveillance data streams, (2) the additional time required to collect data elements that are not routinely recorded by participants, (3) the concern over the sharing and use of business sensitive information with regulatory authorities and other data analysts, (4) the difficulty in developing sustainable incentives to maintain long-term program participation, and (5) the limitations in current methods for analyzing and reporting animal health information in a manner that facilitates actionable response. With the significant recent advances in information science, there are many opportunities to develop more sophisticated systems that meet national disease surveillance objectives, while still providing participants with valuable tools and feedback to manage routine animal health concerns.

A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs

The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.