Zoonoses in Livestock in Kenya – The Beginnings of Surveillance

Jul 13, 2017 | A4NH, Blog, FSZ, Latest news, ZooLink project, Zoonotic Diseases

Zoonoses in Livestock in Kenya – The Beginnings of Surveillance

By Steven Kemp, PhD student, University of Liverpool

After a period of intense lab work at both KEMRI and the UK, investigating the patterns of antimicrobial resistance in faecal bacteria isolated from slaughterhouse workers in Busia County and the surrounding areas, I have returned to Kenya to begin the next phase of my PhD project.

ZooLinK is a cyclical programme which aims to set up surveillance systems of both human and animal health sectors over a long period of time. Surveillance of disease is particularly important, as the more information we have, the better we can treat diseases in both human and animal sectors. Recent research by colleagues indicates that the incidence of several zoonotic diseases, including E. coli, Salmonella sp. and others are vastly underestimated.

In recent times, we often hear about how we should now look to conform to the ‘One Health’ approach; this is where, in order to combat issues surrounding antimicrobial resistance and associated issues effectively, intersectoral approaches which share the cost and responsibility evenly between environmental, human & veterinary health professionals is required. In theory, this would be a perfect way to help educate and better promote antimicrobial stewardship.

Currently, I have large amounts of data on access to, use of, and perceptions of antimicrobials from a variety of parties, including animal healthcare workers, district veterinary offices, farmers and agrovet shops. Over the last three months, I have added to this repository by investigating the amounts of antibiotic resistance found in E. coli, which have been isolated from the faeces of workers in 142 slaughterhouses which were selected in western Kenya. These included slaughterhouses in Busia County and the surrounding Kakamega and Bungoma counties.

For the next portion of this study, I am attempting to collect four different sets of samples – to complete the ‘picture’. I will attempt to collect both human and animal faecal samples, from farmers and farm animals, water samples (to determine if there are patterns of resistance in animals which share common grazing grounds) and environmental samples (from the inside of homesteads, where animals are allowed to roam). By covering all of these bases, we will be able to eventually determine not only if there is transfer of antimicrobial resistance between animals and humans and the environment, but also which direction it is going in.

Typical small-holder farm in Funyula, Busia. Most farmers manage between 5-25 cattle.

Example of environment which may also be a good idea to sample in the future. If antimicrobial resistance can be found in the envi-ronment, then why not in wild animals such as these Zebra?

Challenges associated with tracking the movements of people and their livestock

Apr 25, 2017 | A4NH, Blog, Epidemiology, Latest news, OneHealth, ZooLink project

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

Non-typhoidal Salmonella (NTS) in pigs in Busia, Nairobi and Malawi

Feb 20, 2017 | ABS, Blog, Food Safety, Latest news, ZooLink project, Zoonotic Diseases

Non-typhoidal Salmonella (NTS) in pigs in Busia, Nairobi and Malawi

This blog post was authored by Catherine Wilson an MRES Student from the University of Liverpool attached under our #ZooLink project

I am investigating the prevalence of Non-typhoidal Salmonella (NTS) in pigs in both Kenya and Malawi in extensive, low input production systems. The aim is to determine whether invasive NTS are present in the pig population of three study areas; one rural and one urban area in Kenya and one rural region of Malawi. In sub-Saharan Africa, NTS is a leading cause of human mortality, particularly in the very young, old, malnourished, or those suffering from co-morbidities such as HIV or malaria.

Pig slaughter slab in Bumala

An invasive NTS serovar has been found to be able to cause severe disease in chickens; suspicion is therefore arising that transmission between humans is not the sole route of spread of NTS, and that zoonotic transmission, especially from pigs, may have a role to play in the epidemiology of the disease. Should this invasive strain of bacteria be found in pigs, we will assess whether the same serovar clinically affects humans in the same geographical location, using data already gathered from human hospitals. A correlation between the two would indicate that zoonotic transmission may be occurring.

The final part of this study will assess the presence of drug resistance in the strains of NTS isolated from pigs, and whether this bears any correlation to a similar antimicrobial resistance pattern of NTS to that previously detected in humans in the same area. Should antimicrobial resistance be detected, other management techniques for the swine, such alterations in husbandry and hygiene, may be trialed. In the longer-term vaccination development may be a possibility as an important method of preventing zoonotic disease transmission in the study areas, for which research is currently in the very early stages.

For sampling, both faecal and mesenteric lymph nodes samples were collected post mortem from 256 pigs in Busia and 304 pigs in Nairobi. The location in which the pigs were reared, as well as details of signalment, any previous antibiotic treatment if known and the method of transport of the pig to the slaughterhouse, were recorded for each individual pig.

Samples were processed at the Busia Field Lab and ILRI laboratories respectively. Culture and serotyping was carried out to confirm the presence of Salmonella followed by antimicrobial susceptibility testing to a range of antibiotics. Positive isolates have then been stored for transport to the UK, where whole genome sequencing will be undertaken to identify the presence of any antimicrobial resistance genes. Once the results have returned, analysis is planned compare antimicrobial resistance profiles of the pig samples to those of humans in the same geographical location, to assess whether zoonotic transmission may be occurring.

Dengue and Chikungunya infections among febrile children in Busia County Referral Hospital

Nov 25, 2016 | ABS, Blog, Latest news, ZooLink project

Dengue and Chikungunya infections among febrile children in Busia County Referral Hospital

Recruitment and venous blood sampling of children in the study

Infections leading to fever are the largest causes of child morbidity and mortality in Africa. Dengue and Chikungunya infections are among viral diseases that cause fever even in traditionally malaria endemic areas. We set out to determine the prevalence and risk factors of Dengue and Chikungunya infections and estimate coinfection with malaria among children aged between 1 and 12 years presenting with fever at Busia County Referral Hospital in Western Kenya.

We sampled a cross section of children presenting with fever. We interviewed the parents/guardians of these children and collected blood samples and tested by microscopy for malaria and by conventional PCR for dengue and chikungunya. We found that chikungunya was prevalent among febrile children and infection was more likely among children presenting with vomiting and children with positive blood slide for malaria. None of the children screened was found to have dengue.

Our results suggest that mainly chikungunya virus appears to be actively circulating in western Kenya even in the absence of a declared outbreak. We recommend the establishment of prevention measures and routine laboratory testing of febrile cases for chikungunya in western Kenya.

Article by Isaac Ngere– Resident, Kenya FELTP

Tracking the movements of people and their livestock

Nov 23, 2016 | A4NH, Animal Diseases, Blog, Epidemiology, ILRI, Latest news, ZooLink project, Zoonotic Diseases

Tracking the movements of people and their livestock

cattle-with-trackers As zoonotic diseases can be transported across landscapes by hosts, understanding the complexities of host-mediated pathogen movement is a priority for zoonotic disease research. For my research, I have been using surveys and GPS trackers to gather data on the movement patterns of people and their livestock. We will be looking at the differences in movement patterns between the wet and dry seasons: the first part of the study took place in July and we anticipate completion in November 2016.

At each selected household, we interview the adults present and ask them questions about places they regularly go to, how they get there and how long they stay. We also ask questions about places they go to less regularly and their activities involving livestock kept by the household. At the end of the interview, we ask the adult who spends the most time looking after the livestock (if they have any) to wear a GPS tracker on a lanyard around their neck for one week which stores their location once a minute. At the same time, if they keep cattle, goats or sheep then one of these animals (usually a cow) is fitted with an identical device attached to a collar. If the household does not keep any livestock, one person is still asked to wear a tracker, so that we can detect differences in movement patterns between people who do keep livestock and those who don’t. Once the week is up, we return to the household to collect the devices and download the data. The devices are set to record their location once a minute, and the batteries can last up to 10 days.

Nearly all of the people we interviewed have been willing to wear a tracker and all of the trackers given out have been returned without problems. We look forward to sharing some results from this study in the next newsletter!