Development and delivery of evidence-based messages to reduce the risk of zoonoses in Nairobi, Kenya

This paper describes a trans-disciplinary process of co-generating and disseminating evidence-based messages for reducing the risk from cryptosporidiosis and other zoonoses in an urban community in Nairobi. Research findings about disease prevalence, risk factors and observed risky and risk-mitigating practices were analysed by a team comprising researchers, community members and local policy- and decision-makers. Using participatory planning, multiple strategies were developed for disseminating key information. We identified five vulnerable groups at higher risk of exposure to cryptosporidiosis and other cattle zoonoses with similar transmission pathways (women, children, elderly people, immunosuppressed people and male farm workers). For each group, targeted messages were developed. Good practices already in use, as were also practices as practices to improve environmental conditions. These messages were disseminated through printed material, in a workshop, through community campaigners and also an edutainment soap opera episode broadcast on Kenyan television. In conclusion, a participatory and trans-disciplinary process can help transform the findings of research into messages that are targeted, attractive and understandable.     

A trans-disciplinary study on the health risks of cryptosporidiosis from dairy systems in Dagoretti,Nairobi, Kenya: study background and farming system characteristics

This paper characterises the dairy farming system in Dagoretti, Nairobi. Characterisation was part of a broader ecohealth project to estimate the prevalence and risk of cryptosporidiosis and develop risk mitigation strategies. In the project a trans-disciplinary team addressed epidemiological, socioeconomic, environmental and policy aspects of cryptosporidiosis, an emerging zoonosis. This paper also provides background and describes sampling methods for the wider project. Three hundred dairy households were probabilistically sampled from a sampling frame of all dairy households in five of the six locations of Dagoretti, one of the eight districts of Nairobi Province. Randomly selected households identified 100 non-dairy-keeping households who also took part in the study. A household questionnaire was developed, pre-tested and administered in the dry and wet seasons of 2006. An additional study on livelihood and economic benefits of dairying took place with 100 dairy farmers randomly selected from the 300 farms (as well as 40 non-dairy neighbours as a control group), and a risk-targeted survey of environmental contamination with Cryptosporidium was conducted with 20 farmers randomly selected from the 29 farmers in the wider survey who were considered at high risk because of farming system. We found that around 1 in 80 urban households kept dairy cattle with an average of three cattle per household. Cross-breeds of exotic and local cattle predominate. Heads of dairy-keeping households were significantly less educated than the heads of non-dairy neighbours, had lived in Dagoretti for significantly longer and had significantly larger households. There was a high turnover of 10 % of the cattle population in the 3-month period of the study. Cattle were zero grazed, but productivity parameters were sub-optimal as were hygiene and husbandry practices. In conclusion, dairy keeping is a minor activity in urban Nairobi but important to households involved and their community. Ecohealth approaches are well suited to tackling the complex problem of assessing and managing emerging zoonoses in urban settings.     

A trans-disciplinary study on the health risks of cryptosporidiosis from dairy systems in Dagoretti, Nairobi, Kenya: study background and farming system characteristics

This paper characterises the dairy farming system in Dagoretti, Nairobi. Characterisation was part of a broader ecohealth project to estimate the prevalence and risk of cryptosporidiosis and develop risk mitigation strategies. In the project a trans-disciplinary team addressed epidemiological, socioeconomic, environmental and policy aspects of cryptosporidiosis, an emerging zoonosis. This paper also provides background and describes sampling methods for the wider project. Three hundred dairy households were probabilistically sampled from a sampling frame of all dairy households in five of the six locations of Dagoretti, one of the eight districts of Nairobi Province. Randomly selected households identified 100 non-dairy-keeping households who also took part in the study. A household questionnaire was developed, pre-tested and administered in the dry and wet seasons of 2006. An additional study on livelihood and economic benefits of dairying took place with 100 dairy farmers randomly selected from the 300 farms (as well as 40 non-dairy neighbours as a control group), and a risk-targeted survey of environmental contamination with Cryptosporidium was conducted with 20 farmers randomly selected from the 29 farmers in the wider survey who were considered at high risk because of farming system. We found that around 1 in 80 urban households kept dairy cattle with an average of three cattle per household. Cross-breeds of exotic and local cattle predominate. Heads of dairy-keeping households were significantly less educated than the heads of non-dairy neighbours, had lived in Dagoretti for significantly longer and had significantly larger households. There was a high turnover of 10?% of the cattle population in the 3-month period of the study. Cattle were zero grazed, but productivity parameters were sub-optimal as were hygiene and husbandry practices. In conclusion, dairy keeping is a minor activity in urban Nairobi but important to households involved and their community. Ecohealth approaches are well suited to tackling the complex problem of assessing and managing emerging zoonoses in urban settings.     

猪隐孢子虫和隐孢子虫病的研究进展

隐孢子虫病是一种全球性的人兽共患病 ,猪隐孢子虫病世界各地均有报道 ,严重威胁着人类和动物的健康。本文对猪隐孢子虫病的病原分类、虫体形态和生活史、流行病学特点、诊断、防治等方面目前研究状况进行了综述 ,为猪隐孢子虫病的有效防制提供参考     

Participatory probabilistic assessment of the risk to human health associated with cryptosporidiosis from urban dairying in Dagoretti, Nairobi, Kenya

We carried out a participatory risk assessment to estimate the risk (negative consequences and their likelihood) from zoonotic Cryptosporidium originating in dairy farms in urban Dagoretti, Nairobi to dairy farm households and their neighbours. We selected 20 households at high risk for Cryptosporidium from a larger sample of 300 dairy households in Dagoretti based on risk factors present. We then conducted a participatory mapping of the flow of the hazard from its origin (cattle) to human potential victims. This showed three main exposure pathways (food and water borne, occupational and recreational). This was used to develop a fault tree model which we parameterised using information from the study and literature. A stochastic simulation was used to estimate the probability of exposure to zoonotic cryptosporidiosis originating from urban dairying. Around 6?% of environmental samples were positive for Cryptosporidium. Probability of exposure to Cryptosporidium from dairy cattle ranged from 0.0055 for people with clinical acquired immunodeficiency syndrome in non-dairy households to 0.0102 for children under 5?years from dairy households. Most of the estimated health burden was born by children. Although dairy cattle are the source of Cryptosporidium, the model suggests consumption of vegetables is a greater source of risk than consumption of milk. In conclusion, by combining participatory methods with quantitative microbial risk assessment, we were able to rapidly, and with appropriate 'imprecision', investigate health risk to communities from Cryptosporidium and identify the most vulnerable groups and the most risky practices.     

Milk producers’ awareness of milk-borne zoonoses in selected smallholder and commercial dairy farms of Zimbabwe

A cross-sectional questionnaire-based study was conducted to assess milk producers’ awareness of milk-borne zoonoses in selected smallholder and commercial dairy farms of Zimbabwe. The questionnaire was designed to obtain information on dairy breeds, milk production, dairy farmers’ knowledge and awareness of zoonoses with particular emphasis on milk-borne zoonoses and farmers’ behavioural practices that may lead to increased risk of milk-borne zoonoses transmission. A total of 119 dairy farmers were interviewed, and 41.5% were aware of milk-borne zoonoses with a significantly (P < 0.01) higher percentage of commercial dairy farmers (65.0%) being aware compared to smallholder dairy farmers (36.7%). The behavioural practices of dairy farmers observed to increase the risk of milk-borne zoonoses transmission were; consumption of raw milk (68.1%), sale of raw milk to the local public (25.2%), lack of cooling facilities by smallholder farmers (98%), and no routine testing (84.9%) and medical check-ups (89.1%) for milk-borne zoonoses. General hygienic and disease control practices need to be integrated in the milk production process particularly at the smallholder level. Awareness, teaching and training programmes for smallholder dairy farmers can improve disease control in animals and reduce the public health risk of milk-borne zoonoses.     

New aspects of parasitic zoonoses

Selected parasitic zoonoses are discussed with emphasis on epidemiological, diagnostic and some chemotherapeutic aspects. Pneumocystosis, toxoplasmosis, cryptosporidiosis and microsporidiosis are briefly reviewed as "AIDS-related zoonoses". Up to now 5 genera of Microsporidia have been identified as causative agents of human infections, including Encephalitozoon cuniculi, Enterocytozoon bieneusi and Pleistophora sp. which were found in AIDS patients. From the many "other parasitic zoonoses", giardiasis, echinococcosis and taeniosis/cysticercosis are discussed as examples. Significant advances in the understanding of transmission dynamics, in strain characterisation and diagnosis of the diseases have been achieved.     

Informal value chain actors’ knowledge and perceptions about zoonotic diseases and biosecurity in Kenya and the importance for food safety and public health

Zoonotic diseases, transmitted from animals to humans, are a public health challenge in developing countries. Livestock value chain actors have an important role to play as the first line of defence in safeguarding public health. However, although the livelihood and economic impacts of zoonoses are widely known, adoption of biosecurity measures aimed at preventing zoonoses is low, particularly among actors in informal livestock value chains in low and middle-income countries. The main objective of this study was to investigate knowledge of zoonoses and adoption of biosecurity measures by livestock and milk value chain actors in Bura, Tana River County, in Kenya, where cattle, camels, sheep and goats are the main livestock kept. The study utilised a mixed methods approach, with a questionnaire survey administered to 154 value chain actors. Additional information was elicited through key informant interviews and participatory methods with relevant stakeholders outside the value chain. Our results found low levels of knowledge of zoonoses and low levels of adherence to food safety standards, with only 37% of milk traders knowing about brucellosis, in spite of a sero-prevalence of 9% in the small ruminants tested in this study, and no slaughterhouse worker knew about Q fever. Actors had little formal education (between 0 and 10%) and lacked training in food safety and biosecurity measures. Adoption of biosecurity measures by value chain actors was very low or non-existent, with only 11% of butchers wearing gloves. There was a gendered dimension, evidenced by markedly different participation in value chains and lower adoption rates and knowledge levels among female actors. Finally, cultural and religious practices were shown to play an important role in exposure and transmission of diseases, influencing perceptions and attitudes to risks and adoption of biosecurity measures.     

Prevalence of cryptosporidiosis in dairy cattle, cattle-keeping families, their non-cattle-keeping neighbours and HIV-positive individuals in Dagoretti Division, Nairobi, Kenya

This paper reports a study estimating the prevalence of cryptosporidiosis, an emerging zoonosis, in people and cattle in Dagoretti, Nairobi. A repeated cross-sectional survey was carried out among randomly selected cattle keepers in Dagoretti, their dairy cattle and their non-cattle-keeping neighbours in the dry and wet seasons of 2006. A survey was also carried out among a group of people living with human immunodeficiency virus (HIV). Faecal samples were examined for Cryptosporidium oocysts using the modified Ziehl-Neelsen method; 16?% of the samples were also examined using immunofluorescence antibody (IFA) technique. Quality control consisted of blind reviews of slides, examining split samples and confirming slide results with IFA. We found that members of dairy households had a dry season cryptosporidiosis prevalence of 4?% and wet season prevalence of 0.3?%, and non-dairy households, a prevalence of 5 and 0?%, respectively. The cattle dry season prevalence was 15?%, and the wet season prevalence, 11?%. The prevalence in people living with HIV was 5?%. The laboratory quality control system showed some inconsistency within and between different tests, indicating challenges in obtaining consistent results under difficult field and working conditions. In conclusion, this is the first reported study to simultaneously survey livestock, livestock keepers and their neighbours for cryptosporidiosis. We failed to find evidence that zoonotic cryptosporidiosis is important overall in this community. This study also draws attention to the importance of quality control and its reporting in surveys in developing countries.     

An economic analysis of communal goat production

The economic impact of different extension messages used was calculated using enterprise budgeting (gross margin analysis). Input data were gleaned from the literature, from participatory appraisals, as well as a field study, spanning 12 months, of small-scale communal goat farming systems in Jericho in the Odi District of North West Province. The number of offspring weaned per annum, as a proportion of does owned, was selected as the desired output for analysis. This study has shown that small-scale communal goat farmers are not adopting or implementing extension messages to improve production capacity. In South Africa the majority of goats are slaughtered in the informal sector. If the informal sector is to be persuaded to market goats commercially through formal channels, then knowledge of the economics of goat farming on communal lands should be provided. The economic aspects of extension messages are probably an important factor in determining acceptance and sustainability yet appear to be seldom investigated. The probable reason for lack of adoption of standard extension messages, which promote improved nutrition, parasite control, vaccination and treatment of goats, was economic. In other words, the so-called 'poor management practices' used by communal farmers appeared to be economically more profitable than the 'good management practices' suggested to increase production. The price of communal goats was not related to their mass. A higher level of inputs would probably have resulted in a heavier kid, however it was established that this would not have influenced the price received as a majority of the goats were slaughtered for ritual purposes where age, colour and sex were more important to the purchaser than body mass. It is standard practice in commercial farming systems to evaluate the economic benefits of all management practices before they are implemented. Production animal veterinarians use veterinary economics to compare different scenarios to control diseases or select management practices in commercial herds. It is suggested that the inputs and outputs of small-scale farming systems should be carefully analysed and that veterinary economics should also be used to evaluate the probable impact of extension messages formulated by veterinarians and animal health technicians.     

Veterinary infection control in Australia: is there control?

There is little information relating to infection control procedures in Australian veterinary practices. This review summarises the findings of international studies in the area of zoonoses and infection control, and discusses potential reasons for the apparent complacency about these issues in veterinary practice. It is the authors’ opinion that legislative changes governing veterinary practice in Australia should be implemented. The curricula in veterinary schools should also emphasise infection control. These measures would significantly improve safety issues associated with the control of zoonoses in veterinary practice.     

Sheep management and cryptosporidiosis in central Mexico

To establish the association between sheep farm management practices and cryptosporidiosis in Central Mexico, 37 farms were invited and questionnaires answered by owners. Faeces samples were taken from lambs under 3 months old and ewes in the farms. Parasites were identified by modified Ziehl-Neelsen stain. Questionnaire included: general farm information, facilities characteristics, facilities cleaning measures, water use and farm and animal management practices. Farms were grouped in a low (￡3,37%), medium (3.38-49.9%) and high basis (³50%) according to prevalence. Associations (OR) were calculated according to positivity, compared by chi-square test. A general prevalence of 34,33% was found. Five variables showed statistical significance (p<0.05). Associations found were: use of bed, grazing place, and bottle cleaning. The only association found between management practices and cryptosporidiosis that could represent a risk was the grazing place. This report is the first one in the country regarding predisposing conditions for cryptosporidiosis.     

Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi, Kenya

A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change.     

Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi,Kenya

A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change.     

Emerging zoonoses

The food-borne zoonoses are the most important zoonoses in England and Wales measured in terms of human morbidity and mortality and they include the most important emerging infections. Over the past decade there were over 100,000 laboratory reported cases of salmonellosis, about 1–5 per cent with serious extra-intestinal complications with 427 registered deaths; there were nearly 90,000 Campylobacter infections. In salmonellosis the sources and modes of spread of infection are largely known, but veterinary and human public health measures have so far failed to control the disease. In Campylobacter enteritis however, the source and spread in most of the reported cases are unknown and control is not yet possible. Amongst the remaining less common food-borne zoonoses, listeriosis and yersiniosis are most prominent. Both are increasing with food-borne outbreaks of both infections having been reported, but the origin of infection of most cases recorded in England and Wales is not known. Of the new food-borne or water-borne diseases the most common are giardiasis and cryptosporidiosis but in neither is it clear whether the infections are predominantly of human or animal origin. The place of haemorrhagic colitis and of S. zooepidemicus infection is not yet apparent, both may emerge as important zoonoses. Streptobacillary fever, on the other hand, seems unlikely to recur with normal hygienic standards of water and milk supply. Of the occupational zoonoses Q fever and leptospirosis are the most important. Although only 1,330 cases of Q fever were reported in 10 years, it is a severe disease; 123 of them had endocarditis. Leptospirosis probably increased in incidence and emerged as a new disease of farmers and others working with cattle. S. suis type 2, a ‘new’ disease, remained a rarity. Zoonoses acquired from pets made up only a small proportion of human zoonotic infections and the only apparent change was an increase in psittacosis, the reason for which is unknown. Lastly, among the zoonoses acquired from wild and captive animals the viral haemorrhagic fevers have emerged as an important hazard in hospitals and laboratories.     

Modeling intentions to sanction among anglers in a catch-and-release recreational fishery for golden dorado (Salminus brasiliensis) in Salta,Argentina

Catch-and-release (C&R) angling is a powerful tool for reducing impacts on recreationally targeted fishes. Although C&R can be mandated in fisheries through regulation, voluntary adoption and informal management are often critical due to minimal enforcement opportunities. Anglers themselves may play a role in increasing C&R adoption through interpersonal sanctioning (i.e., self-policing). To date, little research has examined factors that predict the willingness of anglers to sanction others’ behavior. We present results from surveys (n = 49) with anglers in Argentina to explore their motivations to sanction other anglers within their stakeholder community. Anglers with the strongest intentions to sanction were younger and more open to adopting best practices, identified fishing as important to their lifestyle, and expressed high environmental concern relative to other anglers. Our findings highlight the role that recreational anglers can play in promoting best practices via interpersonal sanctioning and identify barriers that inhibit this type of action.     

Worms in smallholder livestock systems: technologies and practices that make a difference

Australian scientists, in partnership with Asian, African and Pacific nations have longstanding interests in applied research on helminth parasite control. Many technologies and practices have been successfully developed to control the parasite problems of smallholder and emerging farmers. This wide range extends from simple herbal remedies to complex, integrated use of chemicals, feeding and breeding. In many cases widespread adoption has been limited by lack of technical support, poor access to input markets and lack of incentives for poorer farmers to seek out and pay for innovations. A further new approach may be required that encompasses the wider production and market environment. The biological, social and economic context of each 'emerging farming system' is different and the matching of technologies to each system requires sound understanding of farmer needs and requirements. Thus, it is essential that farmers, extension workers, and scientists jointly decide what technologies to try, what results mean and, if successful, how to sustain their use. In one Asian example a range of technologies were considered for pig, large ruminant and goat production and parasite control through a participatory process which was also used to agree on what determines sustainability beyond testing. The criteria use to screen technologies and practices were (a) continued availability of inputs including dewormers, (b) dependence on related innovations (e.g. weaning or fencing) and (c) degree of community organisation required (e.g. control of breeding or communal grazing). On this basis deworming with chemicals, especially for Toxacara infection in cattle and buffalo calves following on from supplementary feeding with forages were the most feasible entry points. Further interventions were dependent on changes to the production system, including the introduction of weaning and controlled breeding. Further, the incentives for these production changes could not exist without improved market access and market signals for improved weight and condition. Examples such as this point to the need for stronger multidisciplinary and participatory approaches to parasite control.     

Use of Multicriteria Risk Ranking of Zoonotic Diseases in a Developing Country: Case Study of Mongolia

Many developing countries face significant health burdens associated with a high incidence of endemic zoonoses and difficulties in integrated control measures for both the human and animal populations. The objective of this study was to develop and apply a multicriteria ranking model for zoonoses in Mongolia, a country highly affected by zoonotic disease, to inform optimal resource allocation at the national level. Diseases were evaluated based on their impact on human health, livestock sector health and the wider society through affects on the economic value of livestock, as well as the feasibility of control in both the human and livestock population. Data on disease in Mongolia were collected from various government departments including the Mongolian State Central Laboratory, the Mongolian Department of Veterinary and Animal Breeding, the Mongolian Ministry of Health, Mongolian National Center for Communicable Diseases, the National Center for Zoonotic Disease and expert opinion from a workshop with a number of Mongolian Government officials and researchers. A combined score for both impact of the disease and feasibility of its control was calculated. Five zoonotic diseases were determined to be of high priority from this assessment (i.e. ovine brucellosis, echinococcosis (hydatids), rabies, anthrax and bovine brucellosis). The results supported some of the findings for high‐priority diseases (namely brucellosis, rabies and anthrax) from a previous priority setting exercise carried out in Mongolia in 2011, but also identified and ranked additional animal diseases of public health importance. While the process of model development was largely Mongolian specific, the experience of developing and parameterizing this multicriteria ranking model could be replicated by other countries where zoonoses have substantive impacts on both animal and human health.     

The Italian Information System on Zoonoses Data Collection

In the framework of the international obligations subscribed by the Italian government, the Italian Ministry of Health should provide the European Union (EU) (European Commission, European Food Safety Authority – EFSA) with a set of data and information related to the report and the spread of zoonoses and to the activities put in place for monitoring and control of zoonoses. In 2008, the Italian Ministry of Health commissioned the Istituto G. Caporale (ICT) to implement an information system able to provide information and data on the monitoring and control of zoonoses in the national territory, in accordance with the national and community legislation. The system is part of the e‐Government process that involves all public administrations of the EU and refers to the use of information and communication technologies for the digital processing of documents in order to obtain simplification and interoperability of administrative procedures through the Internet, as defined in the strategic lines published by the National Centre for Information Systems in Public Administration (DigitPA) in 2009–2011.