Estimation of the economic impact of a bluetongue serotype 4 outbreak in Tunisia

Introduction

Since 1999, Tunisia has experienced multiple occurrences of Bluetongue (BT) outbreaks, leading to numerous reported cases of infection and mortality in flocks. The re-emergence of the disease in 2020 caused substantial economic losses in cattle, attributed to the incursion of serotype BTV-4.

Methods

To evaluate the economic impact of the recent BT episode, we conducted a retrospective study on outbreaks that occurred in Tunisia between August and November 2020, focusing on the impact at the owner's level and its effects on both small ruminants and cattle. A total of 234 ruminant farms (sheep, cattle, and mixed) were randomly selected across Tunisian governorates and included in the study to estimate both the direct and indirect costs of these outbreaks.

Results

Total costs were calculated as the sum of losses and expenditures resulting from the BT outbreaks. At the animal level, total losses were estimated to range between 116.280 and 207.086 TND for one infected ewe (€33.721 and 60.055). For one lactating cow, costs varied between 2,590.724 and 3,171.107 TND (€751.310 and 919.621). In cattle, exposure to BTV led to a daily unit milk yield decrease of 12.50 to 14.66 L over an average period of 5 months. Diseased sheep experienced weight loss ranging between 4 and 10 kg during the BT outbreaks. The total mean cost of the 2020 BT outbreak in Tunisian investigated farms was estimated at 1,935 million TND (million €561.15) (range: 1,489 and 2,474 million TND; 431.81 and million €717.46). The most influential costs of the total BT outbreaks were the decrease in milk yield, mortality, and veterinary treatment.

Discussion

This study gives valuable insights on the economic impact of the incursion of a new serotype of BT in a naive population in Tunisia. Considering the substantial costs incurred, it is imperative that this disease receives increased attention from stakeholders, including animal owners, veterinary services, practitioners, and decision-makers.

L’indice ROX prédit-il précocement l’intubation chez les patients gravement atteints par la Covid-19 ?

Introduction

L’oxygénothérapie par canule nasale à haut débit (HFNC) s’est avérée utile dans le traitement des patients atteints du syndrome de détresse respiratoire aiguë (SDRA) éventuellement celle secondaire à la Covid-19. Elle peut retarder la décision et le moment d’intubation. Récemment un indice d’oxygénation (indice ROX) est proposé pour prédire le recours à une ventilation mécanique invasive (VMI).

Objectif

Évaluer la capacité de l’indice ROX pour prédire la nécessite d’une VMI.

Méthodes

Étude rétrospective observationnelle qui s’est déroulée au service de réanimation de l’hôpital régional de Zaghouan entre le 1^er janvier 2021 et le 31 juin 2021. Ont été inclus tous les patients confirmés positifs au COVID-19 avec une durée de séjour supérieure à 48 h et qui ont été mis sous HFNC au cours de l’hospitalisation. L’index de ROX était calculé à H4 après l’admission. Deux groupes ont été identifié : G1 ceux qui n’ont pas eu une VMI et G2 ceux qui ont eu une VMI.

Résultats

Durant les 6 mois de l’étude, 124 patients répondaient aux critères d’inclusion : 78 dans G1 et 46 dans G2. L’âge moyen était de 56 ± 11 ans avec un sex-ratio de 1,2. En comparant les deux groupes, les caractéristiques démographiques, les scores de gravité : IGS II et APPACHE II, l’aspect et l’étendue des lésions scanographiques étaient similaires. Le rapport P/F était significativement plus élevé dans G1 que dans G2 (151 ± 55 versus 109 ± 60 ; p < 0,05). L’incidence du SDRA sévère dans G2 était plus fréquente (57 % versus 43 %, p = 0,006). Le décubitus ventral était plus toléré chez les patients du G1(60 % versus 20 %, p < 0,05). La tolérance à la HFNC était meilleure chez les patients de G1. L’indice Rox moyen à l’admission était de 5 ± 2, avec une différence significative entre G1 et G2 (6,28 ± 2,45 vs 3,15 ± 0,9 ; p < 0,05). Un indice Rox inférieur à 4,3 était un facteur prédictif de l’intubation (sensibilité 75 %, spécificité 87 %), air sous la courbe ROC à 0,91 (0,86–0,96 avec p < 0,05). La durée de séjour était plus longue dans G2 (11,5 ± 5 versus 6,7 ± 3,7 ; p < 0,05) avec une mortalité intra-hospitalière plus élevée (p < 0,05). Dans l’analyse multivariée, un indice ROX inférieur à 4,3 (OR = 2,5 (1,3–4,8) p < 0,05), Un rapport PaO₂/FiO₂ inférieur à 100 (OR = 0,96 (0,94–0,99), p = 0,012) ainsi qu’une mauvaise tolérance à la HNFC à l’admission (OR = 4,5 (2–6,3), p = 0,003) étaient corrélés au recours la VMI (OR = 9,9 (0,94–0,99), p = 0,012).

Conclusion

Un indice Rox inférieur à 4,3 parait être prédictif d’une évolution vers l’intubation des patients Covid-19 en milieu de réanimation.

Owned and free-roaming dogs in the North West of Tunisia: estimation, characteristics and application for the control of dog rabies

Understanding the structure of dog population and the evaluation of the accessibility of dogs to vaccination is essential to succeed in the fight against dog rabies and to adapt the strategy of its control. We studied the characteristics of the unowned and owned dogs using the beck method during a rabies vaccination campaign in randomly selected sectors (urban and rural sites) in the North West of Tunisia. During a door-to-door investigation of households, data on owned dogs were collected to describe the owned population dog. A photographic-recapture method was used to characterize and estimate the size of the unowned dogs. A total of 1432 households accounting for 5403 inhabitants were interviewed during the survey (1298 (90.6%) in the urban site and 134 (9.3%) in the rural site). The dog-owning households were significantly higher in the rural site (76.1% (102/134)) compared to the urban site (17.8% (231/1298)) (P < 0.000000). Of the 17.8% dog-owning households in urban site, 58.4% owned one dog and 9% between 4 and 8 dogs. While, of the 76.1% dog-owning households in rural site, 24.5% owned one dog and 32.3% owned between 4 and 10 dogs. The dog: human ratio was 1:11 in the urban site and 1:1.6 in the rural site. The dog population density was estimated at 16 dogs/km2 and 4 dogs/km2 in the urban and rural sites, respectively. The confinement practices varied significantly among the urban and rural sites (P < 0.000000). The percentage of free-roaming owned dogs was 51.1% in the rural site and 31.4% in the urban site. More than 60.0% of the owned dogs in the urban site were confined. The majority of dogs in the rural site were born in the house, although, a high percentage (56.7%) of owned dogs in the urban site was adopted from neighbours, others sectors, or countries. The vaccination coverage findings indicated that 77.8% and 84.2% of the owned dog were vaccinated in the urban and rural sites, respectively. The estimated size of the free-roaming dogs was 72 dogs in the urban site (Kalaat Senan) and 16 dogs in the rural site (Sod el Khir).