Antimicrobial resistance interventions in the animal sector: scoping review

Animals are considered key contributors to the development and spread of antimicrobial resistance (AMR). However, little is known about the existing AMR interventions in the animal sector. This scoping review examines the existing evidence on AMR interventions aimed at livestock, animal health professionals (AHPs), and farmers, while reviewing their impact, limitations, gaps, and lessons for future use. The scoping review was conducted following guidelines from the PRISMA-ScR checklist. The databases, Web of Science, Scopus, PubMed, and international organisations’ websites (WHO, FAO, WOAH) were searched for articles reporting interventions targeting livestock, farmers, and AHPs. Interventions were categorised based on seven pre-defined primary measures including: change in antimicrobial use (AMU) practices; change in the uptake of antimicrobial stewardship (AMS); change in development of AMR; change in knowledge of appropriate AMU practices, AMR, and AMS; change in attitudes and perceptions concerning AMU, AMR, and AMS; and surveillance strategies. In total, ninety three sources were included: 66 studies, 20 reports, and 7 webpages. The reviewed interventions focused mostly on AMU practices (22/90), AMS uptake (8/90), and reduction of bacterial or resistant strains (30/90). Changes in knowledge (14/90) and attitude (1/90) were less frequently assessed and were often implicit. Most interventions were conducted within a select country (83/90) and 7/90 were at a global level. Only 19% (16/83) of interventions were implemented in low- and middle-income countries (LMICs) and most were at herd level with many self-reporting changes. Most of the interventions that focused on surveillance strategies (30/83) were implemented in high-income countries (62/83). Only one study investigated the financial implications of the intervention. The study findings provide an overview of existing AMR interventions and insights into the gaps which can be addressed to guide future interventions and research. A focus on developing, implementing and evaluating interventions in LMICs coupled with the use of objective outcome measures (e.g., measurable outcomes vs. self-reporting) will improve our understanding of the impact of interventions in these settings. Finally, assessing the financial benefits of interventions is necessary to inform feasibility and to encourage uptake of interventions aimed at reducing AMR in the animal health sector

One Health proof of concept: Bringing a transdisciplinary approach to surveillance for zoonotic viruses at the human-wild animal interface.

As the world continues to react and respond inefficiently to emerging infectious diseases, such as Middle Eastern Respiratory Syndrome and the Ebola and Zika viruses, a growing transdisciplinary community has called for a more proactive and holistic approach to prevention and preparedness - One Health. Such an approach presents important opportunities to reduce the impact of disease emergence events and also to mitigate future emergence through improved cross-sectoral coordination. In an attempt to provide proof of concept of the utility of the One Health approach, the US Agency for International Development's PREDICT project consortium designed and implemented a targeted, risk-based surveillance strategy based not on humans as sentinels of disease but on detecting viruses early, at their source, where intervention strategies can be implemented before there is opportunity for spillover and spread in people or food animals. Here, we share One Health approaches used by consortium members to illustrate the potential for successful One Health outcomes that can be achieved through collaborative, transdisciplinary partnerships. PREDICT's collaboration with partners around the world on strengthening local capacity to detect hundreds of viruses in wild animals, coupled with a series of cutting-edge virological and analytical activities, have significantly improved our baseline knowledge on the zoonotic pool of viruses and the risk of exposure to people. Further testament to the success of the project's One Health approach and the work of its team of dedicated One Health professionals are the resulting 90 peer-reviewed, scientific publications in under 5 years that improve our understanding of zoonoses and the factors influencing their emergence. The findings are assisting in global health improvements, including surveillance science, diagnostic technologies, understanding of viral evolution, and ecological driver identification. Through its One Health leadership and multi-disciplinary partnerships, PREDICT has forged new networks of professionals from the human, animal, and environmental health sectors to promote global health, improving our understanding of viral disease spillover from wildlife and implementing strategies for preventing and controlling emerging disease threats

Utility of the Rose Bengal Test as a Point-of-Care Test for Human Brucellosis in Endemic African Settings: A Systematic Review.

In endemic African areas, such as Tanzania, Brucella spp. cause human febrile illnesses, which often go unrecognized and misdiagnosed, resulting in delayed diagnosis, underdiagnosis, and underreporting. Although rapid and affordable point-of-care tests, such as the Rose Bengal test (RBT), are available, acceptance and adoption of these tests at the national level are hindered by a lack of local diagnostic performance data. To address this need, evidence on the diagnostic performance of RBT as a human brucellosis point-of-care test was reviewed. The review was initially focused on studies conducted in Tanzania but was later extended to worldwide because few relevant studies from Tanzania were identified. Databases including Web of Science, Embase, MEDLINE, and World Health Organization Global Index Medicus were searched for studies assessing the diagnostic performance of RBT (sensitivity and specificity) for detection of human brucellosis, in comparison to the reference standard culture. Sixteen eligible studies were identified and reviewed following screening. The diagnostic sensitivity (DSe) and specificity (DSp) of RBT compared to culture as the gold standard were 87.5% and 100%, respectively, in studies that used suitable "true positive" and "true negative" patient comparison groups and were considered to be of high scientific quality. Diagnostic DSe and DSp of RBT compared to culture in studies that also used suitable "true positive" and "true negative" patient comparison groups but were considered to be of moderate scientific quality varied from 92.5% to 100% and 94.3 to 99.9%, respectively. The good diagnostic performance of RBT combined with its simplicity, quickness, and affordability makes RBT an ideal (or close to) stand-alone point-of-care test for early clinical diagnosis and management of human brucellosis and nonmalarial fevers in small and understaffed health facilities and laboratories in endemic areas in Africa and elsewhere

Utility of the Rose Bengal Test as a Point-of-Care Test for Human Brucellosis in Endemic African Settings: A Systematic Review.

In endemic African areas, such as Tanzania, Brucella spp. cause human febrile illnesses, which often go unrecognized and misdiagnosed, resulting in delayed diagnosis, underdiagnosis, and underreporting. Although rapid and affordable point-of-care tests, such as the Rose Bengal test (RBT), are available, acceptance and adoption of these tests at the national level are hindered by a lack of local diagnostic performance data. To address this need, evidence on the diagnostic performance of RBT as a human brucellosis point-of-care test was reviewed. The review was initially focused on studies conducted in Tanzania but was later extended to worldwide because few relevant studies from Tanzania were identified. Databases including Web of Science, Embase, MEDLINE, and World Health Organization Global Index Medicus were searched for studies assessing the diagnostic performance of RBT (sensitivity and specificity) for detection of human brucellosis, in comparison to the reference standard culture. Sixteen eligible studies were identified and reviewed following screening. The diagnostic sensitivity (DSe) and specificity (DSp) of RBT compared to culture as the gold standard were 87.5% and 100%, respectively, in studies that used suitable "true positive" and "true negative" patient comparison groups and were considered to be of high scientific quality. Diagnostic DSe and DSp of RBT compared to culture in studies that also used suitable "true positive" and "true negative" patient comparison groups but were considered to be of moderate scientific quality varied from 92.5% to 100% and 94.3 to 99.9%, respectively. The good diagnostic performance of RBT combined with its simplicity, quickness, and affordability makes RBT an ideal (or close to) stand-alone point-of-care test for early clinical diagnosis and management of human brucellosis and nonmalarial fevers in small and understaffed health facilities and laboratories in endemic areas in Africa and elsewhere

Continuing Education of Animal Health Professionals in Uganda: A Training Needs Assessment

In Uganda, delivery of veterinary services is vital to animal health and productivity, and is heavily dependent on well-trained and skilled animal health professionals. The purpose of this study was to identify and prioritize areas for refresher training and continuous professional development of animal health professionals (veterinarians and veterinary paraprofessionals), with the overarching aim of improving veterinary service delivery in Uganda. A survey was administered electronically to 311 animal health professionals during the period November 14–30, 2019. Data were collected on relevant parameters including demographics, knowledge on preventive medicine, diagnostics, disease control and treatment, epidemiology, and One Health, as well as participants’ opinions on training priorities, challenges faced, and constraints to veterinary service delivery. Most respondents were veterinarians 26–35 years old, were male, and worked in clinical practice. Lowest perceived knowledge was reported on subjects relating to laboratory diagnostics, antimicrobial resistance (AMR), and nutrition. Training topics considered to be of most benefit to respondents included laboratory diagnostics, treatment of common livestock diseases, AMR, and practical clinical skills in reproductive and preventive medicine. Participants preferred to receive training in the form of practical workshops, in-practice training, and external training. This study highlights the need to prioritize training in practical clinical skills, laboratory diagnostics, and AMR. Wet labs and hands-on practical clinical and laboratory skills should be incorporated to enhance training. Provision of targeted and successful trainings will be dependent on the allocation of adequate resources and support by relevant public and private stakeholders across the veterinary sector

Baseline Assessment of Poultry Production, Pharmaceutical Product Use, and Related Challenges on Commercial Poultry Flocks in Kano and Oyo States of Nigeria

Poultry production is a major component of the livestock sector in Nigeria and continues to expand rapidly; however, it is still constrained by low productivity. A farm survey was conducted to provide a baseline assessment of poultry production (products generated, farm costs, and revenue), pharmaceutical use, and related challenges faced by farmers on 44 commercial poultry farms in Oyo and Kano states of Nigeria. Live spent layers, eggs, and used beddings were the most frequently sold products for revenue. Antibiotic products were widely used, the most reported were Doxygen, Tylosin, and Conflox. Overall, 40% of farms used feed additives (including toxin binders, minerals, and vitamins) and 12% used coccidiostats. Access to pharmaceutical products was a key challenge and appeared to disproportionally affect farmers in the northern part (Kano) of Nigeria. Other challenges included perceived antibiotic ineffectiveness, high cost of drugs, and long distances to pharmaceutical suppliers. Challenges related to vaccine use were unavailability, distance to the supplier, and health issues interfering with the vaccination schedule. Study findings highlight the need for improved access to veterinary pharmaceuticals, particularly in the northern states. Further investigations into the causes of antibiotic ineffectiveness and strategies for distribution of high-quality, effective pharmaceuticals are also necessary

Fruit bats in flight: a look into the movements of the ecologically important Eidolon helvum in Tanzania.

BackgroundMany ecologically important plants are pollinated or have their seeds dispersed by fruit bats, including the widely distributed African straw-colored fruit bats (Eidolon helvum). Their ability to fly long distances makes them essential for connecting plant populations across fragmented landscapes. While bats have been implicated as a reservoir of infectious diseases, their role in disease transmission to humans is not well understood. In this pilot study, we tracked E. helvum to shed light on their movement patterns in Tanzania and possible contact with other species.MethodsTracking devices were deployed on 25 bats captured in the Morogoro Municipal and Kilombero District area near the Udzungwa Mountains of Tanzania. Nightly flight patterns, areas corresponding to foraging bouts and feeding roosts, and new day roosts were determined from bat movement data and characterized according to their proximity to urban built-up and protected areas. Sites for additional environmental surveillance using camera traps were identified via tracking data to determine species coming in contact with fruits discarded by bats.ResultsTracking data revealed variability between individual bat movements and a fidelity to foraging areas. Bats were tracked from one to six nights, with a mean cumulative nightly flight distance of 26.14 km (min: 0.33, max: 97.57) based on data from high-resolution GPS tags. While the majority of their foraging locations were in or near urban areas, bats also foraged in protected areas, of which the Udzungwa Mountains National Park was the most frequented. Camera traps in fruit orchards frequented by tracked bats showed the presence of multiple species of wildlife, with vervet monkeys (Chlorocebus pygerythrus) observed as directly handling and eating fruit discarded by bats.ConclusionsBecause we observed multiple interactions of animals with fruits discarded by bats, specifically with vervet monkeys, the possibility of disease spillover risk exists via this indirect pathway. With flight distances of up to 97 km, however, the role of E. helvum in the seed dispersal of plants across both protected and urban built-up areas in Tanzania may be even more important, especially by helping connect increasingly fragmented landscapes during this Anthropocene epoch

Fruit bats in flight: a look into the movements of the ecologically important Eidolon helvum in Tanzania.

BackgroundMany ecologically important plants are pollinated or have their seeds dispersed by fruit bats, including the widely distributed African straw-colored fruit bats (Eidolon helvum). Their ability to fly long distances makes them essential for connecting plant populations across fragmented landscapes. While bats have been implicated as a reservoir of infectious diseases, their role in disease transmission to humans is not well understood. In this pilot study, we tracked E. helvum to shed light on their movement patterns in Tanzania and possible contact with other species.MethodsTracking devices were deployed on 25 bats captured in the Morogoro Municipal and Kilombero District area near the Udzungwa Mountains of Tanzania. Nightly flight patterns, areas corresponding to foraging bouts and feeding roosts, and new day roosts were determined from bat movement data and characterized according to their proximity to urban built-up and protected areas. Sites for additional environmental surveillance using camera traps were identified via tracking data to determine species coming in contact with fruits discarded by bats.ResultsTracking data revealed variability between individual bat movements and a fidelity to foraging areas. Bats were tracked from one to six nights, with a mean cumulative nightly flight distance of 26.14 km (min: 0.33, max: 97.57) based on data from high-resolution GPS tags. While the majority of their foraging locations were in or near urban areas, bats also foraged in protected areas, of which the Udzungwa Mountains National Park was the most frequented. Camera traps in fruit orchards frequented by tracked bats showed the presence of multiple species of wildlife, with vervet monkeys (Chlorocebus pygerythrus) observed as directly handling and eating fruit discarded by bats.ConclusionsBecause we observed multiple interactions of animals with fruits discarded by bats, specifically with vervet monkeys, the possibility of disease spillover risk exists via this indirect pathway. With flight distances of up to 97 km, however, the role of E. helvum in the seed dispersal of plants across both protected and urban built-up areas in Tanzania may be even more important, especially by helping connect increasingly fragmented landscapes during this Anthropocene epoch