A Pilot Study to Investigate the potential for developing syndromic surveillance system based on meat inspection records in Western Kenya

Training of meat inspectors on how to use hand held device for syndromic surveillance

Article by Joseph Ogola, ZooLinK Consultant

During our field visits in preparation for the ZooLink research project, we selected Kimilili and Webuye slaughterhouses in Bungoma County to participate in the syndromic surveillance pilot study. The two facilities within the study area were identified based on infrastructure and the willingness of the two meat inspectors to participate in the project. The rationale of this pilot project is to assess the feasibility of using slaughterhouse data to enhance the coverage and efficiency of the surveillance system in the study area alongside the routine laboratory based surveillance system. We developed a data collection form from the monthly reports from meat inspection records which

The rationale of this pilot project is to assess the feasibility of using slaughterhouse data to enhance the coverage and efficiency of the surveillance system in the study area alongside the routine laboratory based surveillance system. We developed a data collection form from the monthly reports from meat inspection records which

We developed a data collection form from the monthly reports from meat inspection records which were loaded onto a handheld device. The form captures information related to the carcass inspection together with animal location and movement data. The two meat inspectors after a short training session were then provided with two mobile phones to use daily to record data
(including any relevant photos) of animals slaughtered over a 6 month period. The data collected are sent directly to our data management platform.

We look forward to share the outcomes of this study in subsequent editions of the newsletter!

 

Challenges associated with tracking the movements of people and their livestock

Phase two of this study (detailed in the previous ZooLink newsletter) began in November. Over the last two months, we revisited 27 households that we collected GPS data from in phase one in order to track the movements of the same people and livestock as we did in July and August of this year. Briefly, this involves visiting randomly selected households in Busia County and asking the participant to wear a small GPS tracker on a lanyard around their neck or alternatively, to keep it in a pocket on their person for one week. During the same visits, we also attach an identical GPS unit on a collar to one of the livestock belonging to the household. After the week is over we return to the household to collect the trackers and to ask a few questions about the experience.

Cattle with trackers around their necks

Although most people have been keen to participate in the study for a second time, we often hear of challenges they encountered while wearing the trackers. These are nearly always due to other people’s perceptions of the purpose of the trackers and the research. For example, many participants reported that they were questioned by people from other households, which led to participants having to convince other people of the purpose and worth of the study. In the worst cases, participants reported that other people were convinced that the tracker was listening to their conversations, was a bomb or was doing “the work of the devil”. However, it was heartening to hear that in all cases the participant attempted to explain the study to other people, with varying results. Interestingly, the intensity of the questioning by outsiders seemed to be related to the participant’s age and gender: We tended to find that young women wearing the trackers were more likely to be subjected to questioning and (attempted) persuasion to discontinue their participation in the study than others. Nonetheless, participants invariably reported that while others might be doubtful, they themselves remained convinced of the purpose of the study and continued to wear the trackers.

Cattle outside a “boma” with trackers around their necks

Sometimes it was difficult to find our participants and collect the trackers when the week was up – we would drive to a sub-location up to two hours away from Busia town, only to find that the people we wanted to visit were out and we would have to track them down, mainly by asking the villagers where our participants might be. On the bright side, this also meant that our trackers were out collecting interesting data, and has led to us stumbling upon various events within the villages, including a funeral, a circumcision ceremony and a fishing trip.

Overall, this second phase of fieldwork has been largely successful!

This blog article was authored by Jessica Floyd, PhD student, University of Southampton and also appears in our Zoolink Newsletter Volume1 Issue 2

Do livestock have a role in the emergence of disease in urban cities?

One of the primary objectives of the Urban Zoo project is to quantify and understand microbial diversity in an urban setting and to try and link that to urban livestock keeping. In so doing we aim to elucidate the possible role of livestock as a risk factor in the emergence of disease in cities.

To give us a handle on microbial diversity we have chosen commensal Escherichia coli as an indicator species, which we have isolated from samples taken from a diversity of sources across the city of Nairobi. These comprise people and their living spaces, including the food they eat; their immediate environments, including water sources, waste and wildlife; and the livestock that they keep either for their own consumption or for sale. From these samples we isolate and culture E. coli, extract their DNA, and perform whole genome sequencing, enabling us to compare isolates from different compartments and to determine how closely related they are, and thus how microorganisms might pass from one to another.

The collection of these samples has been guided by a highly structured sampling frame, which I described in Urban Zoo newsletter number 7. Essentially, we have selected 33 sub-locations in Nairobi representing a range of social strata and, within each, have chosen 3 households to sample: one with no livestock; one with only monogastric species (pigs or chickens); and one with ruminant livestock (sheep, goats or cattle); You can view the spatial maps at our earlier post by clicking here .

The collection of such comprehensive data from these 99 households was an enormous undertaking and has been a considerable logistical feat of coordination between the field and the laboratory. The good news is that the sampling is now complete, thanks to the heroic efforts of the field team, led by Judy Bettridge and James Akoko, and of our colleagues in the laboratories.

Overall, 2,351 samples have been collected and we managed to culture E. coli from 80% of these (1,850). Once the last few have been done this will give us 1,809 whole genome sequences to analyse. 327 of these are from people; 58 from the places where they prepare food; 64 from animal source foods (milk meat and eggs); 644 from 12 different species of livestock; 239 from the environment around the home-stead including water sources; and 477 from a wide diversity of wildlife in the vicinity of the household.

But it is not over yet. We will very soon have finalised the sequencing and now comes the equally challenging task of deciphering all of this genetic data to unveil the pattern of microbial diversity across Nairobi. Over to you Melissa!

On that note, I would like once again to congratulate the field and laboratory teams, and to wish everyone a great year ahead, 2017.

This article was authored by Dr. Timothy Robinson who is a co-principal investigator in the Urban Zoo project and also a principal scientist with ILRI’s Livestock Systems and Environment research group.

Laboratory capacity to diagnose Mycobacterium bovis in East Africa

The full report can be accessed at this link: http://www.rr-africa.oie.int/docspdf/en/2016/CHEROTICH1.pdf

A report by Dr. Chepkwony submitted to the OIE- Regional Representation for Africa explores the diagnostic capacities at different scales for both human and animal national tuberculosis reference laboratories in Kenya, Uganda and Tanzania to diagnose Mycobacterium bovis. One recommendation put forward is that national governments should invest in new and more accurate diagnostic technologies for detecting zoonotic tuberculosis. Moreover, it is important to utilize regional and international partnerships and carefully determine how to link these new tests and incorporate them within a country’s national diagnostic algorithm.

One World-One Health at the RSTMH Biennial Meeting, autumn 2016

There are fears that Africa’s next major modern disease crisis will emerge from its cities. Like Ebola, it may well originate from animals”. So writes Eric Fèvre from Nairobi in his conversation “Urban Zoo”

womanandlivestockatdandoragarbagedump_cropped
This intimate association between human and animal health underpins what is known as the One Health agenda, recognised by both the WHO (World Health Organisation) and the OIE (World Animal Health Organisation). And it’s not only in Africa that urgency applies but throughout the world, particularly in developing regions where surveillance systems are at their weakest and pandemic spread is highly likely.

Against this backdrop, the RSTMH is showing great insight in focussing attention on the need to bring together medical and veterinary health delivery systems and expertise under the headline of “One World-One Health” (OW-OH). Lord Soulsby, the veterinary parasitologist and long-time proponent of OW-OH, celebrated his 90th birthday last year. Hence it was entirely fitting for the RSTMH, as part of its Biennial Meeting in autumn last year, to kick off an afternoon programme dedicated to OW-OH by hosting the inaugural Soulsby Lecture followed by a series of presentations by world authorities in their field.

Of great importance was the decision to focus the programme on the challenges and opportunities for human and animal health delivery systems to collaborate and take a more holistic systems-based approach. The message that “the collaborative whole is greater than the sum of the parts” was obvious throughout, from David Heymann’s opening message early in the conference (new challenges in the ‘last mile’ of disease elimination caused by animal reservoirs) to Sandy Trees’ illumination of how veterinary research into onchocerciasis in cattle has given new insight into river blindness in humans; from Sarah Cleaveland’s demonstration of how mass rabies vaccination of dogs is both feasible and cost-effective in eliminating the disease in people, to Eric Fèvre’s plea for disease surveillance systems to consider the human-animal interface in relation to the “Urban Zoo”.

I was particularly drawn to the case made by Bernadette Abela-Ridder that many rural communities in the least developed countries live in close proximity to their animals. This means that eliminating zoonotic diseases is critically important to their own health as well as the health of their animals. Furthermore the financial well-being of these communities is also dependent on the health and well-being of their animals. And Esther Schelling illustrated the importance of generating community engagement and trust to deliver such integrated programmes.

Many health delivery programmes reside in silos directed only towards human populations – either intentionally (“this funding is only for human health benefit”) or through lack of information (“we didn’t realise the relationship with animal health”). By pooling resources, significant cost savings can be made. And the benefits to each sector will be clearly demonstrable by attributing costs carefully.

So for me, there are two massively important take-home messages to be drawn from all this wisdom.

Firstly that eradication of human disease will often be frustrated by failing to appreciate the parallel situation in animal health.  This may be due to lack of awareness of animal reservoirs of infection or to failure to incorporate essential veterinary experience and resources. The  sooner veterinary and medical scientists and practitioners work more effectively together to  contribute to the challenges they all face, the better the world will be.

And secondly, and equally importantly, resources available to achieve disease elimination are necessarily limited and, to be effective, require local involvement. The sustainability of such local involvement may weaken just at the time when it is most needed – the ‘last mile’ when the big gains have already been achieved and the final small but essential gains require relentless and absolute commitment. At such a time, that same local involvement could be sustained by broadening their remit to include animal health matters; same skills – different patient. However the silos of project funding seem often to not support this happening.

By acting on these take-home messages, both human and animal welfare will benefit and opportunities for disease elimination in both populations will become more realistic.

This article originally appeared on the Royal Society of Tropical Medicine and Hygiene website available at (here). Authored by Judy MacArthur Clark

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