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Kaburi BB, Harries M, Hauri AM, Kenu E, Wyss K, Silenou BC, Klett-Tammen CJ, Ressing C, Awolin J, Lange B, Krause G. Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review. BMC Public Health 2024; 24:1731. [PMID: 38943132 PMCID: PMC11214246 DOI: 10.1186/s12889-024-19205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.
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Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- PhD Programme "Epidemiology" Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bernard Chawo Silenou
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Cordula Ressing
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Jannis Awolin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
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Kahariri S, Thumbi SM, Bett B, Mureithi MW, Nyaga N, Ogendo A, Muturi M, Thomas LF. The evolution of Kenya's animal health surveillance system and its potential for efficient detection of zoonoses. Front Vet Sci 2024; 11:1379907. [PMID: 38966562 PMCID: PMC11223174 DOI: 10.3389/fvets.2024.1379907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/22/2024] [Indexed: 07/06/2024] Open
Abstract
Introduction Animal health surveillance systems in Kenya have undergone significant changes and faced various challenges throughout the years. Methods In this article, we present a comprehensive overview of the Kenya animal health surveillance system (1944 to 2024), based on a review of archived documents, a scoping literature review, and an examination of past surveillance assessments and evaluation reports. Results The review of archived documents revealed key historical events that have shaped the surveillance system. These include the establishment of the Directorate of Veterinary Services in 1895, advancements in livestock farming, the implementation of mandatory disease control interventions in 1944, the growth of veterinary services from a section to a ministry in 1954, the disruption caused by the Mau Mau insurrection from 1952 to 1954, which led to the temporary halt of agriculture in certain regions until 1955, the transition of veterinary clinical services from public to private, and the progressive privatization plan for veterinary services starting in 1976. Additionally, we highlight the development of electronic surveillance from 2003 to 2024. The scoping literature review, assessments and evaluation reports uncovered several strengths and weaknesses of the surveillance system. Among the strengths are a robust legislative framework, the adoption of technology in surveillance practices, the existence of a formal intersectoral coordination platform, the implementation of syndromic, sentinel, and community-based surveillance methods, and the presence of a feedback mechanism. On the other hand, the system's weaknesses include the inadequate implementation of strategies and enforcement of laws, the lack of standard case definitions for priority diseases, underutilization of laboratory services, the absence of formal mechanisms for data sharing across sectors, insufficient resources for surveillance and response, limited integration of surveillance and laboratory systems, inadequate involvement of private actors and communities in disease surveillance, and the absence of a direct supervisory role between the national and county veterinary services. Discussion and recommendations To establish an effective early warning system, we propose the integration of surveillance systems and the establishment of formal data sharing mechanisms. Furthermore, we recommend enhancing technological advancements and adopting artificial intelligence in surveillance practices, as well as implementing risk-based surveillance to optimize the allocation of surveillance resources.
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Affiliation(s)
- Samuel Kahariri
- Directorate of Veterinary Services, Nairobi, Kenya
- International Livestock Research Institute, Nairobi, Kenya
- Department of Medical Microbiology and Immunology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
- Centre for Epidemiological Modelling and Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - S. M. Thumbi
- Centre for Epidemiological Modelling and Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | - Marianne W. Mureithi
- Department of Medical Microbiology and Immunology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Nazaria Nyaga
- County Directorate of Veterinary Services, Kajiado, Kenya
| | - Allan Ogendo
- County Directorate of Veterinary Services, Busia, Kenya
| | - Mathew Muturi
- Directorate of Veterinary Services, Nairobi, Kenya
- International Livestock Research Institute, Nairobi, Kenya
- Centre for Epidemiological Modelling and Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Lian Francesca Thomas
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
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Penrith ML, van Emmenes J, Hakizimana JN, Heath L, Kabuuka T, Misinzo G, Odoom T, Wade A, Zerbo HL, Luka PD. African Swine Fever Diagnosis in Africa: Challenges and Opportunities. Pathogens 2024; 13:296. [PMID: 38668251 PMCID: PMC11054189 DOI: 10.3390/pathogens13040296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 04/29/2024] Open
Abstract
The global spread of African swine fever (ASF) in recent decades has led to the need for technological advances in sampling and diagnostic techniques. The impetus for these has been the need to enable sampling by lay persons and to obtain at least a preliminary diagnosis in the field for early control measures to be put in place before final laboratory confirmation. In rural Africa, rapid diagnosis is hampered by challenges that include lack of infrastructure as well as human and financial resources. Lack of animal health personnel, access to affordable means to transport field samples to a laboratory, and lack of laboratories with the capacity to make the diagnosis result in severe under-reporting of ASF, especially in endemic areas. This review summarizes the challenges identified in gap analyses relevant to low- and middle-income countries, with a focus on Africa, and explore the opportunities provided by recent research to improve field diagnosis and quality of diagnostic samples used. Sampling techniques include invasive sampling techniques requiring trained personnel and non-invasive sampling requiring minimal training, sampling of decomposed carcass material, and preservation of samples in situations where cold chain maintenance cannot be guaranteed. Availability and efficacy of point-of-care (POC) tests for ASF has improved considerably in recent years and their application, as well as advantages and limitations, are discussed. The adequacy of existing laboratory diagnostic capacity is evaluated and opportunities for networking amongst reference and other laboratories offering diagnostic services are discussed. Maintaining laboratory diagnostic efficiency in the absence of samples during periods of quiescence is another issue that requires attention, and the role of improved laboratory networking is emphasized. Early diagnosis of ASF is key to managing the disease spread. Therefore, the establishment of the Africa Chapter of the Global African Swine Fever Research Alliance (GARA) increases opportunities for collaboration and networking among the veterinary diagnostic laboratories in the region.
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Affiliation(s)
- Mary-Louise Penrith
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria 0110, South Africa
| | - Juanita van Emmenes
- Transboundary Animal Diseases, Onderstepoort Veterinary Institute, Agricultural Research Council, Pretoria 0110, South Africa; (J.v.E.); (L.H.)
| | - Jean N. Hakizimana
- SACIDS Africa Centre of Excellence for Infectious Diseases, SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania; (J.N.H.); (G.M.)
| | - Livio Heath
- Transboundary Animal Diseases, Onderstepoort Veterinary Institute, Agricultural Research Council, Pretoria 0110, South Africa; (J.v.E.); (L.H.)
| | - Tonny Kabuuka
- National Livestock Resources Research Institute, National Agricultural Research Organization, Entebbe P.O. Box 295, Uganda;
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases, SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania; (J.N.H.); (G.M.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania
| | - Theophilus Odoom
- Veterinary Services Directorate, Accra Veterinary Laboratory, Accra P.O. Box M161, Ghana;
| | - Abel Wade
- National Veterinary Laboratory (LANAVET), Garoua P.O. Box 503, Cameroon;
| | - Habibata L. Zerbo
- Ministry of Agriculture, Animal and Fisheries Resources, Ouagadougou 03 BP 907, Burkina Faso;
| | - Pam D. Luka
- Biotechnology Centre, National Veterinary Research Institute, PMB 1, Vom 930103, Nigeria
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Innovative Research Offers New Hope for Managing African Swine Fever Better in Resource-Limited Smallholder Farming Settings: A Timely Update. Pathogens 2023; 12:pathogens12020355. [PMID: 36839627 PMCID: PMC9963711 DOI: 10.3390/pathogens12020355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023] Open
Abstract
African swine fever (ASF) in domestic pigs has, since its discovery in Africa more than a century ago, been associated with subsistence pig keeping with low levels of biosecurity. Likewise, smallholder and backyard pig farming in resource-limited settings have been notably affected during the ongoing epidemic in Eastern Europe, Asia, the Pacific, and Caribbean regions. Many challenges to managing ASF in such settings have been identified in the ongoing as well as previous epidemics. Consistent implementation of biosecurity at all nodes in the value chain remains most important for controlling and preventing ASF. Recent research from Asia, Africa, and Europe has provided science-based information that can be of value in overcoming some of the hurdles faced for implementing biosecurity in resource-limited contexts. In this narrative review we examine a selection of these studies elucidating innovative solutions such as shorter boiling times for inactivating ASF virus in swill, participatory planning of interventions for risk mitigation for ASF, better understanding of smallholder pig-keeper perceptions and constraints, modified culling, and safe alternatives for disposal of carcasses of pigs that have died of ASF. The aim of the review is to increase acceptance and implementation of science-based approaches that increase the feasibility of managing, and the possibility to prevent, ASF in resource-limited settings. This could contribute to protecting hundreds of thousands of livelihoods that depend upon pigs and enable small-scale pig production to reach its full potential for poverty alleviation and food security.
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Ngere I, Hunsperger EA, Tong S, Oyugi J, Jaoko W, Harcourt JL, Thornburg NJ, Oyas H, Muturi M, Osoro EM, Gachohi J, Ombok C, Dawa J, Tao Y, Zhang J, Mwasi L, Ochieng C, Mwatondo A, Bodha B, Langat D, Herman-Roloff A, Njenga MK, Widdowson MA, Munyua PM. Outbreak of Middle East Respiratory Syndrome Coronavirus in Camels and Probable Spillover Infection to Humans in Kenya. Viruses 2022; 14:1743. [PMID: 36016365 PMCID: PMC9413448 DOI: 10.3390/v14081743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 12/03/2022] Open
Abstract
The majority of Kenya’s > 3 million camels have antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV), although human infection in Africa is rare. We enrolled 243 camels aged 0−24 months from 33 homesteads in Northern Kenya and followed them between April 2018 to March 2020. We collected and tested camel nasal swabs for MERS-CoV RNA by RT-PCR followed by virus isolation and whole genome sequencing of positive samples. We also documented illnesses (respiratory or other) among the camels. Human camel handlers were also swabbed, screened for respiratory signs, and samples were tested for MERS-CoV by RT-PCR. We recorded 68 illnesses among 58 camels, of which 76.5% (52/68) were respiratory signs and the majority of illnesses (73.5% or 50/68) were recorded in 2019. Overall, 124/4692 (2.6%) camel swabs collected from 83 (34.2%) calves in 15 (45.5%) homesteads between April−September 2019 screened positive, while 22 calves (26.5%) recorded reinfections (second positive swab following ≥ 2 consecutive negative tests). Sequencing revealed a distinct Clade C2 virus that lacked the signature ORF4b deletions of other Clade C viruses. Three previously reported human PCR positive cases clustered with the camel infections in time and place, strongly suggesting sporadic transmission to humans during intense camel outbreaks in Northern Kenya.
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Affiliation(s)
- Isaac Ngere
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Elizabeth A. Hunsperger
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Julius Oyugi
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Walter Jaoko
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Jennifer L. Harcourt
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Natalie J. Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Harry Oyas
- Kenya Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi P.O. Box 30028 00100, Kenya
| | - Mathew Muturi
- Kenya Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi P.O. Box 30028 00100, Kenya
- Dahlem Research School, Freie Universität Berlin, Kaiserswerther Str. 16-18, 14195 Berlin, Germany
| | - Eric M. Osoro
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - John Gachohi
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi P.O. Box 62000 00200, Kenya
| | - Cynthia Ombok
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Jeanette Dawa
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Ying Tao
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jing Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Lydia Mwasi
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi P.O. Box 54840 00200, Kenya
| | - Caroline Ochieng
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi P.O. Box 54840 00200, Kenya
| | - Athman Mwatondo
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
- Kenya Ministry of Health, Nairobi P.O. Box 30016 00100, Kenya
| | - Boku Bodha
- Department of Veterinary and Livestock, County Government of Marsabit, Marsabit 60500, Kenya
| | - Daniel Langat
- Kenya Ministry of Health, Nairobi P.O. Box 30016 00100, Kenya
| | - Amy Herman-Roloff
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - M. Kariuki Njenga
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Marc-Alain Widdowson
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - Peninah M. Munyua
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
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Wainaina M, Lindahl JF, Dohoo I, Mayer-Scholl A, Roesel K, Mbotha D, Roesler U, Grace D, Bett B, Al Dahouk S. Longitudinal Study of Selected Bacterial Zoonoses in Small Ruminants in Tana River County, Kenya. Microorganisms 2022; 10:microorganisms10081546. [PMID: 36013964 PMCID: PMC9414833 DOI: 10.3390/microorganisms10081546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
Brucellosis, Q fever, and leptospirosis are priority zoonoses worldwide, yet their epidemiology is understudied, and studies investigating multiple pathogens are scarce. Therefore, we selected 316 small ruminants in irrigated, pastoral, and riverine settings in Tana River County and conducted repeated sampling for animals that were initially seronegative between September 2014 and June 2015. We carried out serological and polymerase chain reaction tests and determined risk factors for exposure. The survey-weighted serological incidence rates were 1.8 (95% confidence intervals [CI]: 1.3–2.5) and 1.3 (95% CI: 0.7–2.3) cases per 100 animal-months at risk for Leptospira spp. and C. burnetii, respectively. We observed no seroconversions for Brucella spp. Animals from the irrigated setting had 6.83 (95% CI: 2.58–18.06, p-value = 0.01) higher odds of seropositivity to C. burnetii than those from riverine settings. Considerable co-exposure of animals to more than one zoonosis was also observed, with animals exposed to one zoonosis generally having 2.5 times higher odds of exposure to a second zoonosis. The higher incidence of C. burnetii and Leptospira spp. infections, which are understudied zoonoses in Kenya compared to Brucella spp., demonstrate the need for systematic prioritization of animal diseases to enable the appropriate allocation of resources.
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Affiliation(s)
- Martin Wainaina
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277 Berlin, Germany; (A.M.-S.); (S.A.D.)
- Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany; (K.R.); (D.M.)
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
- Correspondence:
| | - Johanna F. Lindahl
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, 75237 Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, 75007 Uppsala, Sweden
| | - Ian Dohoo
- Centre for Veterinary Epidemiologic Research, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada;
| | - Anne Mayer-Scholl
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277 Berlin, Germany; (A.M.-S.); (S.A.D.)
| | - Kristina Roesel
- Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany; (K.R.); (D.M.)
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
| | - Deborah Mbotha
- Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany; (K.R.); (D.M.)
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
| | - Uwe Roesler
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, 14163 Berlin, Germany;
| | - Delia Grace
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
- Natural Resources Institute, University of Greenwich, Kent ME4 4TB, UK
| | - Bernard Bett
- Animal & Human Health Program, International Livestock Research Institute, Nairobi 00100, Kenya; (J.F.L.); (D.G.); (B.B.)
| | - Sascha Al Dahouk
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277 Berlin, Germany; (A.M.-S.); (S.A.D.)
- Department of Internal Medicine, RWTH Aachen University Hospital, 52074 Aachen, Germany
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Worsley-Tonks KEL, Bender JB, Deem SL, Ferguson AW, Fèvre EM, Martins DJ, Muloi DM, Murray S, Mutinda M, Ogada D, Omondi GP, Prasad S, Wild H, Zimmerman DM, Hassell JM. Strengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries. Lancet Glob Health 2022; 10:e579-e584. [PMID: 35303467 PMCID: PMC8923676 DOI: 10.1016/s2214-109x(22)00031-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 01/19/2023]
Abstract
The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world. In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritise urban and adjacent rural communities. Communities in remote rural areas have had far less support despite having routine exposure to zoonotic diseases due to frequent contact with domestic and wild animals, and restricted access to health care. Limited disease surveillance in remote rural areas is a crucial gap in global health security. Although this point has been made in the past, practical solutions on how to implement surveillance efficiently in these resource-limited and logistically challenging settings have yet to be discussed. We highlight why investing in disease surveillance in remote rural areas of low-income and middle-income countries will benefit the global community and review current approaches. Using semi-arid regions in Kenya as a case study, we provide a practical approach by which surveillance in remote rural areas can be strengthened and integrated into existing systems. This Viewpoint represents a transition from simply highlighting the need for a more holistic approach to disease surveillance to a solid plan for how this outcome might be achieved.
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Affiliation(s)
| | - Jeff B Bender
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Sharon L Deem
- Institute for Conservation Medicine, Saint Louis Zoo, Saint Louis, MO, USA
| | - Adam W Ferguson
- Gantz Family Collection Center, Field Museum of Natural History, Chicago, IL, USA
| | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Dino J Martins
- Mpala Research Centre, Nanyuki, Kenya; Department of Ecology and Evolution, Princeton University, Princeton, NJ, USA
| | - Dishon M Muloi
- International Livestock Research Institute, Nairobi, Kenya; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Suzan Murray
- Global Health Program, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
| | - Mathew Mutinda
- Veterinary Services Department, Kenya Wildlife Service, Nairobi, Kenya
| | - Darcy Ogada
- The Peregrine Fund, Boise, ID, USA; National Museums of Kenya, Nairobi, Kenya
| | - George P Omondi
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA; Ahadi Veterinary Resource Center, Nairobi, Kenya
| | - Shailendra Prasad
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
| | - Hannah Wild
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Dawn M Zimmerman
- Department of Clinical Studies, University of Nairobi, Nairobi, Kenya; Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, USA
| | - James M Hassell
- Global Health Program, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA; Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, USA
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Falzon LC, Ogola JG, Odinga CO, Naboyshchikov L, Fèvre EM, Berezowski J. Electronic data collection to enhance disease surveillance at the slaughterhouse in a smallholder production system. Sci Rep 2021; 11:19447. [PMID: 34593856 PMCID: PMC8484591 DOI: 10.1038/s41598-021-98495-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/09/2021] [Indexed: 11/09/2022] Open
Abstract
Globally, meat inspection provides data for animal health surveillance. However, paper-based recording of data is often not reported through to higher authorities in sufficient detail. We trialled the use of an electronic meat inspection form in Kenyan slaughterhouses, in lieu of the currently used paper-based format. Meat inspectors in two ruminant slaughterhouses completed and submitted an electronic report for each animal slaughtered at their facility. The reports, which captured information on the animal demographics and any eventual condemnations, were stored in a central database and available in real-time. A stakeholder meeting was held towards the end of the study. Over the 2.75 year study period, 16,386 reports were submitted; a downward linear trend in the monthly submissions was noted. There was a week effect, whereby more reports were submitted on the market day. Of the slaughtered animals, 23% had at least a partial condemnation. The most frequently condemned organs were the liver, lungs and intestines; the primary reasons for condemnations were parasitic conditions. Lack of feedback and difficulty capturing animal origin information were the primary challenges highlighted. The study demonstrated that electronic data capture is feasible in such challenging environments, thereby improving the timeliness and resolution of the data collected.
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Affiliation(s)
- Laura C Falzon
- Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK. .,International Livestock Research Institute, Nairobi, Kenya.
| | - Joseph G Ogola
- International Livestock Research Institute, Nairobi, Kenya.,Veterinary Department, Bungoma County Government, Bungoma, Kenya
| | | | | | - Eric M Fèvre
- Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK. .,International Livestock Research Institute, Nairobi, Kenya.
| | - John Berezowski
- Veterinary Public Health Institute, University of Bern, Bern, Switzerland
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