Exploring local knowledge and perceptions on zoonoses among pastoralists in northern and eastern Tanzania

Background: Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania. Methodology and principal findings: This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk. Conclusions: These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide effective and locally relevant interventions. Such studies should consider in their approaches the pastoralists' wider social, cultural and economic set up

Research options for controlling Zoonotic disease in India, 2010-2015

BACKGROUND: Zoonotic infections pose a significant public health challenge for low- and middle-income countries and have traditionally been a neglected area of research. The Roadmap to Combat Zoonoses in India (RCZI) initiative conducted an exercise to systematically identify and prioritize research options needed to control zoonoses in India. METHODS AND FINDINGS: Priority setting methods developed by the Child Health and Nutrition Research Initiative were adapted for the diversity of sectors, disciplines, diseases and populations relevant for zoonoses in India. A multidisciplinary group of experts identified priority zoonotic diseases and knowledge gaps and proposed research options to address key knowledge gaps within the next five years. Each option was scored using predefined criteria by another group of experts. The scores were weighted using relative ranks among the criteria based upon the feedback of a larger reference group. We categorized each research option by type of research, disease targeted, factorials, and level of collaboration required. We analysed the research options by tabulating them along these categories. Seventeen experts generated four universal research themes and 103 specific research options, the majority of which required a high to medium level of collaboration across sectors. Research options designated as pertaining to 'social, political and economic' factorials predominated and scored higher than options focussing on ecological, genetic and biological, or environmental factors. Research options related to 'health policy and systems' scored highest while those related to 'research for development of new interventions' scored the lowest. CONCLUSIONS: We methodically identified research themes and specific research options incorporating perspectives of a diverse group of stakeholders. These outputs reflect the diverse nature of challenges posed by zoonoses and should be acceptable across diseases, disciplines, and sectors. The identified research options capture the need for 'actionable research' for advancing the prevention and control of zoonoses in India

Invisible and ignored: lifting the lid on the problems of endemic zoonosez

No abstract available

Methods for prioritization: Toward quantitative approach to prioritize zoonoses in South East Asia

Resources for research, surveillance, control and others public health activities are limited and it is difficult to compare the importance of diseases, which vary in terms of occurrence, impacts, etc. So, in this context of scarce resources and multiple competing priorities, it is necessary to allocate rationally human and financial resources on relevant health priorities. Prioritization is an objective tool to make the best use of limited human and financial resources for funders of research and for organizations in charge of diseases' surveillance and implementation of disease control. In order to develop an efficient method for prioritization of zoonotic diseases in South East Asia, we performed a literature review on the different methods already developed to rank diseases. Several priority setting procedures have been used and described by various organizations (national, regional or international) and technical institutions with different models and goals. Mainly, qualitative and semi-quantitative approaches are used, in which experts are asked to score some criteria against which diseases are prioritized. Few initiatives for quantitative models have been undergone yet, mainly in the field of the food-borne diseases. Whatever the approach used to perform the prioritization exercise, some limitations to the current developed models arise from the analysis of scientific articles and organization reports. Following the identification of weak points in the methods already applied, we discuss about the potential means that can be used to improve current models or to develop innovative tools for prioritization of zoonoses in the specific context of South East Asia. (Résumé d'auteur

Adjustment and Completion of BASNEF Model to Provide a New Model for Educating Large Populations in Relation to Cutaneous Leishmaniasis

Background: Educational models that have been created for educating small populations do not have enough efficacy for educating large populations, so based on this premise and also high prevalence of Cutaneous Leishmaniasis (CL) in the Islamic Republic of Iran and lack of efficient methods for CL control, this study was designed and done with the aim of applying BASNEF model to provide a new model for educating large populations in relation to Cutaneous Leishmaniasis. Methods: In a quasi-experimental study, 60 Volunteer Health Workers (VHWS) and 120 households that were resident in endemic areas of CL in Yazd were selected through census and multi-stage sampling method, respectively. Then, educational intervention was designed and implemented on the basis of BASNEF model. After educating VHWS based on BASNEF model, they were asked to educate households on the basis of BASNEF model. Before and after 3 months of VHWS training activities, data were collected in intervention and control groups via valid and reliable questionnaires and were analyzed with the SPSS software. Results: The mean score of knowledge, attitude, behavioral intention, enabling factors, behaviors and influence of subjective norms after educational intervention in households in experimental were significantly increased (P<0.05) while the changes in control group were not significant. Conclusions: This educational program led to empowering of VHWS and a change in their educational behavior which in turn led to preventive measures in households under study region. It can be concluded that the new educational model presented in this research, formed based on the BASNEF model, is able to educate a large population. Keywords: BASNEF Model, Volunteer Health Workers, Health Education, Cutaneous Leishmaniasi

Prediction and prevention of the next pandemic zoonosis.

Most pandemics--eg, HIV/AIDS, severe acute respiratory syndrome, pandemic influenza--originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial effects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new efforts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption

Epidemiology, impact and control of rabies in Nepal : a systematic review

Background: Rabies is a vaccine-preventable viral zoonosis belonging to the group of neglected tropical diseases. Exposure to a rabid animal may result in a fatal acute encephalitis if effective post-exposure prophylaxis is not provided. Rabies occurs worldwide, but its burden is disproportionately high in developing countries, including Nepal. We aimed to summarize current knowledge on the epidemiology, impact and control of rabies in Nepal. Methods: We performed a systematic review of international and national scientific literature and searched grey literature through the World Health Organization Digital Library and the library of the National Zoonoses and Food Hygiene Research Centre, Nepal, and through searching Google and Google Scholar. Further data on animal and human rabies were obtained from the relevant Nepalese government agencies. Finally, we surveyed the archives of a Nepalese daily to obtain qualitative information on rabies in Nepal. Findings: So far, only little original research has been conducted on the epidemiology and impact of rabies in Nepal. Per year, rabies is reported to kill about 100 livestock and 10–100 humans, while about 1,000 livestock and 35,000 humans are reported to receive rabies post-exposure prophylaxis. However, these estimates are very likely to be serious underestimations of the true rabies burden. Significant progress has been made in the production of cell culture-based anti-rabies vaccine and rabies immunoglobulin, but availability and supply remain a matter of concern, especially in remote areas. Different state and non-state actors have initiated rabies control activities over the years, but efforts typically remained focalized, of short duration and not harmonized. Communication and coordination between veterinary and human health authorities is limited at present, further complicating rabies control in Nepal. Important research gaps include the reporting biases for both human and animal rabies, the ecology of stray dog populations and the true contribution of the sylvatic cycle. Interpretation: Better data are needed to unravel the true burden of animal and human rabies. More collaboration, both within the country and within the region, is needed to control rabies. To achieve these goals, high level political commitment is essential. We therefore propose to make rabies the model zoonosis for successful control in Nepal

Epidemiology, impact and control of bovine cysticercosis in Europe : a systematic review

Background: Bovine cysticercosis in Europe has been known for centuries but the data showing the occurrence of this zoonosis are scarce. The aim of this paper is to review and present the current knowledge on bovine cysticercosis in Europe. Methods: We conducted a systematic review of studies published between 1990 and November 2014. Qualitative and quantitative data on prevalence, risk factors, burden and interventions were extracted and analysed. Results: Reports on prevalence were available for 23 European countries, mostly from western and central Europe; for a few of these only data before 1990 were available. Prevalence based on meat inspection was generally low (below 6.2 % in 95 % of the records) and varied between and within countries. Serology and detailed meat inspection provided a higher prevalence range (0.41–14 %). Only few studies analysing risk factors were identified. Reported factors related to access to pastures and risky waters, dairy production and uncontrolled human defecation in the proximity of the farm among others. Only one estimate of the economic impact of the disease could be identified. Recommended interventions were focused on increasing diagnostic tests sensitivity or the application of risk based surveillance strategies. Conclusions: There is a lack of complete and updated data on most countries, especially in eastern Europe. Further risk factor studies might be needed together with estimates on the burden of the disease in all European countries. Risk-based interventions are being encouraged but current data are limited to guide this approach