Knowledge, Attitudes and Practices Towards Spotted Fever Group Rickettsioses and Q Fever in Laikipia and Maasai Mara, Kenya

Knowledge, Attitudes, and Practices of Pastoralists Towards Tick Bites, and Tick Control in Plateau State, Nigeria

PURPOSE

Pastoralists regularly come in contact with ticks as they herd their animals and are exposed to pathogens that cause zoonotic diseases. No study has been conducted in Nigeria to evaluate the knowledge, attitudes, and practices (KAP) of these Pastoralists towards ticks, tick bite, and tick control, and thus this research.

METHODS

A KAP survey of pastoralists (n = 119) was conducted in Plateau State, Nigeria. Data generated were analysed using Statistical Package for Social Sciences (SPSS).

RESULTS

The majority of the pastoralists (99.2%) had knowledge of ticks, with 79% of them being aware that ticks attach and bite humans, whereas only 30.3% believed that ticks transmit diseases to humans. Eighty-four per cent of the pastoralists do not wear protective clothing while herding their animals and 81.5% indicated to having been bitten by ticks, whereas hospital visit after tick bite was low (7.6%). Statistically significant variables were observed when knowledge of the respondents were compared in relation to the ability of ticks to cause diseases (Χ² = 9.980, P = 0.007); hospital visit after a bite (Χ² = 11.453, P = 0.003); and the use of protective clothing for herding (Χ² = 22.596, P = 0). The main tick control measure was hand picking (58.8%).

CONCLUSIONS

The pastoralists were unaware of the ability of ticks to transmit zoonotic pathogens. Preventive practices were insufficient to reduce tick bites, and thus were constantly exposed to tick-borne diseases. This study hopes to provide important insights for the development of educational awareness programmes for the pastoralists and serve as a guide for the health workers in designing future preventive programmes against tick-borne zoonoses in Nigeria.

Knowledge, Attitudes, Practices and Zoonotic Risk Perception of Bovine Q Fever (Coxiella burnetii) among Cattle Farmers and Veterinary Personnel in Northern Regions of Cameroon

A cross-sectional survey was conducted to investigate the knowledge, attitudes, practices and zoonotic risk perception of Q fever among 484 selected cattle farmers (438) and veterinary personnel (46) in three northern regions of Cameroon. Data collection was conducted using questionnaires and responses were recoded into binary scale. An ANOVA test was used to assess significant differences in mean knowledge, attitude, practice and zoonotic risk perception (KAPP) scores between regions, while Linear regression was done to explore the relationship between demographic characteristic and KAPP. Overall, surveyed had low mean scores for knowledge (0.02 ± 0.11), desirable attitude (0.30 ± 0.16), appropriate practice (0.43 ± 0.13) and negative perception of zoonotic risks (0.05 ± 0.11). The means knowledge, attitude, practice and risks perception scores of cattle farmers were lower than those of veterinary personnel. The nature of respondent was negatively associated to knowledge and risks perception, while regions were negatively correlated to attitude and practice. These results revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. To improve awareness, control programs are needed to update knowledge on medical personnel and to prevent animal-to-human transmission.

One hundred years of zoonoses research in the Horn of Africa: A scoping review

BACKGROUND

One Health is particularly relevant to the Horn of Africa where many people's livelihoods are highly dependent on livestock and their shared environment. In this context, zoonoses may have a dramatic impact on both human and animal health, but also on country economies. This scoping review aimed to characterise and evaluate the nature of zoonotic disease research in the Horn region. Specifically, it addressed the following questions: (i) what specific zoonotic diseases have been prioritised for research, (ii) what data have been reported (human, animal or environment), (iii) what methods have been applied, and (iv) who has been doing the research?

METHODOLOGY/PRINCIPAL FINDINGS

We used keyword combinations to search online databases for peer-reviewed papers and theses. Screening and data extraction (disease, country, domain and method) was performed using DistillerSR. A total of 2055 studies focusing on seven countries and over 60 zoonoses were included. Brucellosis attracted the highest attention in terms of research while anthrax, Q fever and leptospirosis have been comparatively under-studied. Research efforts did not always align with zoonoses priorities identified at national levels. Despite zoonoses being a clear target for 'One Health' research, a very limited proportion of studies report data on the three domains of human, animal and environment. Descriptive and observational epidemiological studies were dominant and only a low proportion of publications were multidisciplinary. Finally, we found that a minority of international collaborations were between Global South countries with a high proportion of authors having affiliations from outside the Horn of Africa.

CONCLUSIONS/SIGNIFICANCE

There is a growing interest in zoonoses research in the Horn of Africa. Recommendations arising from this scoping review include: (i) ensuring zoonoses research aligns with national and global research agendas; (ii) encouraging researchers to adopt a holistic, transdisciplinary One Health approach following high quality reporting standards (COHERE, PRISMA, etc.); and (iii) empowering local researchers supported by regional and international partnerships to engage in zoonoses research.

Knowledge, attitudes and practices on African tick bite fever of rural livestock communities living in a livestock-wildlife interface area in the Eastern Cape Province of South Africa

BACKGROUND

African tick bite fever (ATBF) caused by Rickettsia africae and transmitted by Amblyomma spp. ticks is one of the zoonotic tick-borne fevers from the spotted fever group (SFG) of rickettsiae, which is an emerging global health concern. There is paucity of information regarding the occurrence and awareness of the disease in endemic rural livestock farming communities living in livestock-wildlife interface areas in South Africa.

METHODS

The purpose of the study was to assess the level of knowledge, attitudes and practices on ticks and ATBF infection from a community living in livestock-wildlife interface areas in South Africa. A focus group discussion (FGD) was carried out followed by verbal administration of a standardized semi-structured questionnaire a month later to 38 rural livestock farmers (23 from Caquba area and 15 from Lucingweni area where A. hebraeum was absent). An FGD was conducted in Caquba (situated at the livestock-wildlife interface where Amblyomma hebraeum was prevalent on cattle and infected with Rickettsia africae) in the O.R. Tambo district of the Eastern Cape province of South Africa.

RESULTS

Results from the FGD and questionnaire survey showed that participants from the two rural communities were not aware of ATBF and were not aware that ticks are vectors of the disease. Respondents from Caquba reported of having frequent exposure to tick bites (91.3%, 21/23) specifically from the anthropophilic A. hebrauem which they were able to identify as Qwelagqibe in IsiXhosa (their vernacular). Thirteen out of 15 (86.7%) of respondents from Lucingweni reported that they had never been bitten by ticks, which corresponded with the absence of A. hebraeum from their locality as evidenced from results of a concurrent study on prevalence of ticks on livestock in the area. Both communities confirmed to being "very concerned" of tick bites and we presume this was more related to the localized wounds from the bites than to the diseases transmitted by the ticks.

CONCLUSIONS

We recommend future studies encompassing seroprevalence of ATBF in Caquba and other communities at risk in South Africa including establishing surveillance systems to monitor the seasonal infection rates in ticks, cattle and humans.

Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature

The estimated 50 million nomadic pastoralists in Africa are among the most "hard-to-reach" populations for health-service delivery. While data are limited, some studies have identified these communities as potential disease reservoirs relevant to neglected tropical disease programs, particularly those slated for elimination and eradication. Although previous literature has emphasized the role of these populations' mobility, the full range of factors influencing health service utilization has not been examined systematically. We systematically reviewed empirical literature on health services uptake among African nomadic pastoralists from seven online journal databases. Papers meeting inclusion criteria were reviewed using STROBE- and PRISMA-derived guidelines. Study characteristics were summarized quantitatively, and 10 key themes were identified through inductive qualitative coding. One-hundred two papers published between 1974-2019 presenting data from 16 African countries met our inclusion criteria. Among the indicators of study-reporting quality, limitations (37%) and data analysis were most frequently omitted (18%). We identified supply- and demand-side influences on health services uptake that related to geographic access (79%); service quality (90%); disease-specific knowledge and awareness of health services (59%); patient costs (35%); contextual tailoring of interventions (75%); social structure and gender (50%); subjects' beliefs, behaviors, and attitudes (43%); political will (14%); social, political, and armed conflict (30%); and community agency (10%). A range of context-specific factors beyond distance to facilities or population mobility affects health service uptake. Approaches tailored to the nomadic pastoralist lifeway, e.g., that integrated human and veterinary health service delivery (a.k.a., "One Health") and initiatives that engaged communities in program design to address social structures were especially promising. Better causal theorization, transdisciplinary and participatory research methods, clearer operational definitions and improved measurement of nomadic pastoralism, and key factors influencing uptake, will improve our understanding of how to increase accessibility, acceptability, quality and equity of health services to nomadic pastoralist populations.

Is a One Health Approach Utilized for Q Fever Control? A Comprehensive Literature Review

Q fever, a zoonotic disease transmitted from animals to humans, is a significant public health problem with a potential for outbreaks to occur. Q fever prevention strategies should incorporate human, animal, and environmental domains. A One Health approach, which engages cross-sectoral collaboration among multiple stakeholders, may be an appropriate framework and has the underlying principles to control Q fever holistically. To assess whether components of One Health for Q fever prevention and control have been applied, a comprehensive literature review was undertaken. We found 16 studies that had practiced or recommended a One Health approach. Seven emerging themes were identified: Human risk assessment, human and animal serology, integrated human⁻animal surveillance, vaccination for at-risk groups, environmental management, multi-sectoral collaboration, and education and training. Within the multi-sectoral theme, we identified five subthemes: Policy and practice guidelines, information sharing and intelligence exchange, risk communication, joint intervention, and evaluation. One Health practices varied between studies possibly due to differences in intercountry policy, practice, and feasibility. However, the key issue of the need for multi-sectoral collaboration was highlighted across most of the studies. Further research is warranted to explore the barriers and opportunities of adopting a One Health approach in Q fever prevention and control.