Elephant tourism: An analysis and recommendations for public health, safety, and animal welfare

Background: Elephants are exploited for public entertainment tourism throughout Asia and Africa. Areas of concern include public health and safety and animal welfare. Materials and Methods: We examined over 500 scientific publications with respect to our primary objectives, as well as non-peer-reviewed materials relating to other relevant subject matters (e.g., tourism promotional websites and YouTube films) for background purposes, although these additional materials were not included in this review. Results: We identified at least 12 confirmed or potential zoonotic and other transmissible infections relevant to the elephant tourism sector, and at least 13 areas of animal welfare concern. Conclusion: Infection and injury risks between humans and captive elephants cannot be safely controlled where close contact experiences are involved, arguably creating an unredeemable and indefensible public health and safety situation. Elephant welfare within some sectors of the close contact interactive tourism industry continues to involve significant mistreatment and abuse. To alleviate key One Health concerns outlined in this study, we recommend several types of regulation, monitoring, and control regarding interactions at the human-captive elephant interface. These include legal bans on the promotion and performance of close contact experiences, combined with strong enforcement protocols; new policies toward discouraging elephant tourism; 24/7 surveillance of captive elephants; and the adoption of independent scientific positive list systems for tourism promoters or providers regarding public observation of free-ranging elephants within national parks and protected areas

Guidelines for Inspection of Companion and Commercial Animal Establishments

Various establishments exist in which animals are held for a variety of reasons. Historically, the management and inspection of animals in commerce and in private keeping have involved a considerable degree of arbitrary evaluation based on the personal experience of the vendor, keeper, advisor, or inspector. Accordingly, relevant protocols and standards are subject to considerable variation. Relatedly, diversity of traded and privately kept species generates significant challenges for those responsible for facility management and inspection alike. Animal welfare and public health and safety are constant and major concerns that require objective methodologies to monitor and control. This report focuses on establishments concerned with the boarding, breeding, storage, vending or handover of animals intended for human “companions” or “pets”, and aims to provide universal objective information for essential husbandry, inspection protocols and an allied inspection assessment tool for scoring establishments

Dropping the Ball? The Welfare of Ball Pythons Traded in the EU and North America.

Ball pythons (family Pythonidae) remain a commonly exploited species, readily available for purchase in North America and Europe. We assessed the housing conditions of more than 5000 Ball pythons across six exotic pet expositions and 113 YouTube videos. We scored provisions for hygiene, mobility, shelter, substrate and water provision, based on the Royal Society for the Protection of Animals (RSPCA) minimum guidelines. We found most entities involved in this commercial enterprise are not providing housing conditions that meet the minimum welfare recommendations for Ball pythons, either publicly or privately. We found that breeders and vendors typically utilised small and highly restrictive enclosures, with dimensions that prevented occupants from extending their bodies to full and unrestricted natural length. Our study also highlights that most vendors are not providing adequate written husbandry guidance to potential consumers, either at exotic pet expositions, on their commercial website, or on associated social media pages. Furthermore, our study also indicates that most potential consumers may themselves be unable to recognise unsuitable housing conditions that do not meet minimum animal welfare standards for Ball pythons. We suggest that more consistent guidance, adherence to agree principles and more potent operating models that are formally incorporated into relevant legislation would greatly aid existing and future efforts to safeguard animal welfare in this regard

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe