New global migration mapping to help fight against infectious diseases

New global migration mapping to help fight against infectious diseases

by | Aug 23, 2016 | Infectious Diseases

New global migration mapping to help fight against infectious diseases

newglobalmigGeographers at the University of Southampton have completed a large scale data and mapping project to track the flow of internal human migration in low and middle income countries.

Researchers from the WorldPop project at the University have, for the first time, mapped estimated in across three continents; Africa, Asia and Latin America and the Caribbean.

Professor Andy Tatem, Director of WorldPop, comments: “Understanding how people are moving around within countries is vital in combating infectious diseases like malaria. The parasite which causes the disease can be quickly reintroduced to a malaria free area by highly mobile populations.

“Having an accurate overview of how different regions of countries are connected by human movement aids effective disease control planning and helps target resources, such as treated bed nets or community health workers, in the right places. Having data for all low and across three continents will greatly aid disease control and elimination planning on global and regional scales.”

Working with colleagues at the Flowminder Foundation and supported by the Bill and Melinda Gates Foundation, the researchers have used census micro-data (anonymised census information at the individual level) to model estimates of flows within countries and then produced a series of maps to visually represent the data. The research paper ‘Mapping internal connectivity through human migration in malaria endemic countries’ published in Scientific Data details the methods they employed, and presents the freely available data.

Lead author Dr Alessandro Sorichetta from the University of Southampton says: “We sourced the census data from around 40 different countries and have produced detailed population migration maps on a scale not seen before. They show webs of connectivity within countries – indicating high and low flows of people moving between different locations.”

Figures from the International Organization for Migration and The World Bank show that, without accounting for seasonal and temporary migrants, more than one billion people live outside their place of origin – 740 million as ‘internal migrants’. Human mobility is expected to continue to rise, creating a range of impacts, such as invasive species, drug resistance spread and disease pandemics.

Dr Sorichetta comments: “It’s crucial we understand human mobility, so we can quantify the effect it has on our societies and the environment and provide strong evidence to support the development of policies to address issues, such as public health problems.”

The researchers are now integrating the migration estimates with data on malaria prevalence – helping to inform regional elimination and global eradication plans for the disease. Equally, they believe the data could be used to support regional control and elimination strategies for other , for example, Schistosomiasis, River Blindness, HIV, dengue and Yellow Fever. Furthermore, the datasets could help inform decisions in the fields of trade, demography, transportation and economics.

More information: Alessandro Sorichetta et al. Mapping internal connectivity through human migration in malaria endemic countries, Scientific Data (2016). DOI: 10.1038/sdata.2016.66

This post originally appeared at: http://medicalxpress.com/news/2016-08-global-migration-infectious-diseases.html

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Do wildlife have a role in the dissemination of antimicrobial resistance?

Do wildlife have a role in the dissemination of antimicrobial resistance?

by | Aug 19, 2016 | Antimicrobial resistance, My Write Ups

Do wildlife have a role in the dissemination of antimicrobial resistance?

MomanyiNK (150)A recent (16 August 2016) publication by Arnold et al. tries to dymistify “the possible role of wildlife in the dissemination of AMR, specifically how wildlife might acquire and transport AMR and the potential for them to transmit AMR to humans and livestock.”

The authors note that “little is known about the flow and fate of AMR in the natural environment”, I believe the ongoing research on wildlife in Nairobi may address some the research gaps presented in the paper.

Read the paper here: http://dx.doi.org/10.1098/rsbl.2016.0137

A simple question am left wondering are wildlife the “threat” or are they the “victims of a threat of our own making”?

Have a nice read. Drop your comments below.

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Making decisions

Making decisions

by | Jul 30, 2016 | Empowerment

Making decisions

This post is a transcript of the Youtube video by Julian Kyula. 

“I have been asking myself how do we make decisions. I have found out that decisions are mental functions that lead to a particular action. Every one of us is here as a result of a decision that you have made. Blame the world all you want, blame your teacher all you want. Ultimately, we make decisions.

Screenshot 2016-07-29 15.13.41

I wanna deal with decisions today and I hope that you can make some clear decisions about what happens after this.

Five levels of knowledge

So I found out that when they do research they have five levels of knowledge. They have the lowest level of knowledge that’s called “assumption” or “personal opinion“, they have another level after that called “hypothesis” then they have the next third level called “thesis“, fourth level that is called “law” and the fifth level is called “truth” or “fact“.

Screenshot 2016-07-29 15.10.10

From which level are you getting advice?

So when people come and try to influence my decisions I always ask myself a very fundamental question. From which level of knowledge are you giving me this advice. Is it from a personal opinion perspective or from a truth and fact perspective. So analyzing self is a very important piece of being a very good leader, or being a great father, being a great person or mother. And what we have to do is to make sure you are not over judging yourself in something that you are not supposed to be.

Screenshot 2016-07-29 15.11.54

90% of us make decisions based on other person’s personal opinions

But when people come and give you personal opinions, I’ve found through some research, that 90% of us make decisions based on other person’s personal opinions. What does that mean? You are actually making decisions based on the fact that people came to speak to you on the lowest level of knowledge. Ooops!

Screenshot 2016-07-29 15.12.41

So how do you make the right decisions?

You need to make decisions to relate. Make decisions to honour. The weight of negatives against positives is the direction of a decision. Weigh it carefully, ask yourself:  What do I want to do? Where do I want to be? How do I want to react to this? And sometimes there is only one thing that people cannot mis-quote, is called silence. You don’t have to answer everything.

Take some time before making a decision

Next time people want you to make a quick decision, take some time. Go make some serious deliberation. Make some notes around it. Take your decisions seriously. Make sure every decision you make from now is a decision that is true you may have do it when afraid; but at the same time make an educated decision. Make a decision based on the truth, don’t make a decision based on a personal opinion.”

Reference

Julian Kyula (): Decisions. Category: People & Blogs. Licence: Standard YouTube Licence. Available at: https://www.youtube.com/channel/UCQPT4_JywtyjxiXIo83kZ1g

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Accelerating Progress beyond the MDG-era through addressing endemic zoonoses in the East African Community Member States

Accelerating Progress beyond the MDG-era through addressing endemic zoonoses in the East African Community Member States

by | Jul 29, 2016 | My Write Ups, Zoonoses

Accelerating Progress beyond the MDG-era through addressing endemic zoonoses in the East African Community Member States

1.1 Introductory statement

This blog post will initially provide an overview of the achievements and “pending issues” of the Millennium Development Goals (MDGs) and the opportunities that the Sustainable Development Goals (SDGs) present to the East African Community (EAC) Member States so as to accelerate progress beyond the MDGs. Secondly, it will propose priority zoonotic diseases to be targeted (that will act as a model of controlling the other zoonotic diseases) and lastly, provide recommendations on adequate measures to improve their surveillance, prevention and control.

1.2 Overview

1.2.1 Transition from Millennium Development Goals to Sustainable Development Goals

The eight MDGs[4] adopted on 18th September 2000 have guided development efforts for fifteen years (2000 to 2015), with a clear focus on poverty and on developing nations. The EAC Member States comprise of Kenya, Uganda, Tanzania, Burundi and Rwanda[1] (Figure 1), all of which are classified as developing countries and lower income economies, except Kenya which was recently re-classified as a lower-middle income economy[5]. Three of the 8 MDGs focused directly on health (MDG-4, MDG-5 and MDG-6), with the goal of reducing child mortality, improving maternal health, and combating HIV/AIDS, malaria and other diseases, respectively. The MDG Report 2015: “Assessing Progress in Africa toward the Millennium Development Goals”[6] highlights important success stories from the MDGs in Africa.

Figure 1: EAC Member States

Figure 1: EAC Member States

Contrary to the success stories, there are “pending issues” that cannot be overlooked especially with respect to the EAC Member States. The MDGs were compartmentalized to specific health goals which drove resources to specific types of programmes. This is very evident from the MDG country progress reports from the EAC Member States i.e. Kenya[7], Uganda[8], Tanzania[9], Burundi[10], and Rwanda[11], all of which provide elaborate documentation on the progress made and statistics on TB, Malaria and HIV/AIDS forgetting the “other neglected and endemic diseases”. Therefore a  key lesson from the MDGs for the EAC Member States is that endemic zoonotic diseases are a great burden to human and animal health[12] characterized by lack of reliable data which undermines the ability to set goals, optimize investments, decisions, and measure progress[13].

The 17 Sustainable Development Goals (SDGs)[14], originally conceptualized as “The Future We Want” on September 2012[15] were adopted on September 2015[14] after a series of inclusive and consultative meetings (Figure 2).

Figure 2: The origin and evolution of SDGs [2]

Figure 2: The origin and evolution of SDGs [2]

In contrast to the 3 MDGs focused on health, only 1 out of the 17 proposed SDGs focus on health framed broadly as: to ensure healthy lives and promote well-being for all at all ages. Based on the ‘Alma Ata Declaration’[16] defining health as, “A state of complete physical, mental and social well-being”, it therefore means that health priorities may also be sustained through several of the other SDGs, namely: Goal 8, Goal 11, Goal 16 and Goal 10. The SDGs therefore spur transformative change towards sustainable development, addressing systemic barriers to social, economic and environmental progress[17] at the global, regional and national level and between different sectors. They thus form the basis of a more comprehensive and integrated development agenda and requiring far-reaching change in domestic policy and action [2, 18].

1.1 Zoonoses as a platform of addressing the SDG goal 3, target 3.3 & 3.d

1.1.1 Burden of zoonotic diseases in the EAC Member States

Outbreaks of endemic zoonotic diseases in the EAC Member States, such as anthrax and rabies have considerable impact on the health care systems at the local level and adversely affect livelihoods. The burden of zoonotic diseases in this region remains poorly defined[13], in part, because of weak surveillance and health information systems and also because endemic zoonoses are not considered of high priority within both the human and animal health sectors[3].

The increasing burden of zoonotic diseases in the EAC Member States can be attributed to several factors[3, 12]. The intensification of farming, for example, leads to closer relationships between individual animals, generating opportunities for more rapid mutations as organisms move from host to host, while also providing a structured way for those pathogens to enter highly ordered food chains that branch out and reach very large numbers of people[19]. At the same time development of antimicrobial resistance poses an increasing burden in the treatment of some of the zoonotic diseases in the region[20].

1.1.2 Suggested priority diseases to target

In the EAC Member States, several zoonotic diseases of neglected populations conspire to hinder the health of people and the animals they depend on for their livelihoods which are transmitted in many ways.  For the scope of this report let us focus on four:

  • Brucellosis is an important source of morbidity in all EAC Member States. It causes a chronic debilitating disease in humans and often misdiagnosed thus wrongly treated[21]. Misdiagnosis is expensive; individuals incur significant expenses in failing to acquire diagnosis and treatment, and fail to conduct their daily activities by being unwell. Across the EAC Member States, brucellosis is still a very common but often neglected disease, and constitutes a major under-reported problem[22]. Geographical distribution depends upon local food habits, milk processing methods, animal husbandry types and standards of personal and environmental hygiene. Cattle, sheep and goats harbour this bacterium, which they transmit to each other and humans through milk or through contaminated aborted materials[19].
  • Rabies is a well-known, but nonetheless, neglected zoonotic infection, caused by the rabies virus and a public health problem in the region. For example in Kenya it is estimated that 2000 human deaths occur annually due to rabies[23]. It is transmitted and maintained mostly in domestic dog populations (though in areas with a wildlife interface, the epidemiology may get more complex), which transmit the infection to humans through bites. It is best controlled by vaccinating the dog reservoir to prevent disease from developing if infection occurs, but a human vaccine is available both as a pre- and post-exposure course, and effective and timely delivery of the vaccine will minimize mortality (but the human vaccine is very costly). Lack of cooperation between the health and veterinary sectors often impedes progress in the control of rabies. Limited accessibility to modern rabies vaccine, lack of public awareness and insufficient political commitment are the major problems in EAC Members States[23].
  • Cysticercosis is a disease caused by the tapeworm Taenia solium. It has a relatively complex lifecycle, involving pigs eating Taenia egg-carrying human faeces that contaminates the environment, humans eating undercooked pork meat, and environmental contamination with eggs that can encyst in humans. The greatest problem with solium is that it may cause a neurological disease called neurocysticercosis in people who are infected with tapeworm eggs; in the EAC Member States, it is the single largest cause of acquired epilepsy in humans[24, 25].
  • Anthrax is a disease caused by the spore-forming bacteria Bacillus anthracis, that is classified as a category ‘A’ agent by the CDC [26]. Anthrax is a very serious zoonotic disease of livestock and wild animals because it can potentially cause the rapid loss of a large number of animals in a very short time. It is estimated that 1 livestock case equals 10 human cutaneous and enteric cases [27]. A recent (July 2015) outbreak of the disease in Nakuru County in Kenya killed over one hundred buffaloes and 2 rhinos.

1.2 Conclusion and recommendations

Many factors involved in prevention and control of zoonotic infections in the EAC Member States cannot be addressed by the livestock or health sector alone.  To effectively address the proposed priority zoonoses (to act as a model to control other zoonoses and infections) it will entail focusing transmission control, prevention and burden reduction in animals so as to accrue the benefits of control and prevention  in humans as documented by other studies in Chad[28] and Mongolia[29]. This, in turn, requires a One Health approach, involving joint surveillance, control and policy management by veterinary, medical and other sectors[30]. The outstanding opportunity that is at hand is there is already a working model of a One Health office in Kenya[3], this model offers a “success story” that can be adopted to suit the needs of the other EAC Member States in addressing the priority zoonotic diseases and others as well. The good thing is that, the model will utilize the existing medical and veterinary workforce within the respective countries (Figure 3).

Figure 3: Potential One Health Coordination model among EAC Member States (modified from ZDU[3])

Figure 3: Potential One Health Coordination model among EAC Member States (modified from ZDU[3])

For these suggested priority diseases many aspects of their basic biology are well understood, and the transmission of the pathogens has been controlled in many countries. The outstanding issues that the EAC Member States need to address to effectively deploy intervention efforts, are:

  • High-level commitment and the ability of national programmes to mobilize the necessary resources and to strengthen collaboration with the pre-existing funding agencies and organisations from the MDG era e.g. the World Health Organization[31] among others to scale up intervention strategies in order to cope with the common challenges in the control of zoonoses.
  • Create multisectoral committees responsible for surveillance and control of zoonoses. These committees should be empowered to coordinate zoonosis control activities at national level and be provided with adequate budget. The committees should comprise members from all sectors and the community involved in zoonoses surveillance and control, particularly public health and veterinary services.
  • Develop national integrated surveillance systems with an open policy of cross sharing information among the EAC Member States on occurrence, distribution and disease burden. These integrated surveillance systems to be linked to the National statistics system to complement monitoring the SDGs[32].
  • Update veterinary and health professions educational curricula according to current knowledge and practical needs for control of zoonotic diseases, with emphasis on multisectoral and community led approaches
  • Diagnostic facility strengthening by deploying, and in some cases developing, new and better tools to diagnose the infections in humans and animals esp. for brucellosis, and cysticercosis (because accurate and efficient detection is key to both delivering cure and also to gathering good surveillance data)
  • Finally and most importantly, develop key indicators (reflecting each country socio-economic context and political priorities[18]) so as to measure progress in the work of controlling the four priority zoonotic diseases.

References

  1. EAC. The East African Community. 2015; Available from: http://www.eac.int/.
  2. Weitz, N., et al., Sustainable Development Goals for Sweden: Insights on Setting a national Agenda in Working Paper 2015-10. 2015, Stockholm Environmental Institute: Sweden.
  3. ZDU, Zoonotic Disease Unit: National One Health Strategic Plan 2012-2017, Ministry of Health and L.a.F. Ministry of Agriculture, Editors. 2012, The Zoonotic Diseases Unit Nairobi. p. 1-46.
  4. UN, Resolution adopted by the General Assembly-United Nations Millennium Declaration, G. Assembly, Editor. 2000, United Nations: Geneva.
  5. Bank, W., Country and Lending Groups. 2015.
  6. UNDP, MDG Report 2015: Lessons learned in implementing the MDGS, in Assessing progress in Africa toward the Millennium Development Goals. 2015, United Nations Economic Commission for Africa, African Union, African Development Bank and United Nations Development Programme.
  7. UNDP, Millennium Development Goals: Status Report for Kenya 2013, in Country MDG Progress Reports. 2014, Ministry of Devolution and Planning: Nairobi. p. 1-56.
  8. UNDP, Millennium Development Goals: Report for Uganda 2013, in Country MDG Progress Reports. 2014.
  9. UNDP, Millennium Development Goals 2014-Tanzania, in Country MDG Progress Reports. 2014.
  10. UNDP, Système des Nations Unies au Burundi et Gouvernement du Burundi 2012, in Country MDG Progress Reports. 2012, United Nations Development Programme: Burindi. p. 1-131.
  11. UNDP, Millennium Development Goals: Final Progress Report, Rwanda 2013, in Country MDG Progress Reports. 2014: Rwanda p. 1-117.
  12. Delia, G., Mapping of poverty and likely zoonoses hotspots. 2012, Department for International Development, UK: Nairobi, Kenya. p. 1-119.
  13. Hotez, P.J. and A. Kamath, Neglected tropical diseases in sub-saharan Africa: review of their prevalence, distribution, and disease burden. PLoS Negl Trop Dis, 2009. 3(8): p. e412.
  14. UN, Resolutions adopted by General Assembly on 25 September 2015, G. Assembly, Editor. 2015, United Nations. p. 1-35.
  15. UN General Assembly, The Future We Want, G. Assembly, Editor. 2012, United Nations: Rio de Janeiro.
  16. ICPHC, Declaration of Alma-Ata, A.-A. International Conference on Primary Health Care, USSR, 6-12 September 1978, Editor. 1978.
  17. Kumar, G., et al., A Transformative Post-2015 Development Agenda. 2014, Independent Research Forum (IRF2015): London.
  18. Porsch, L., T. Kafyeke, and J. Yuan, How to measure the Sustainable Development Goals in central Europe?, NETGREEN, Editor. 2015. p. 1-25.
  19. Microbiology Society, Comment: Zoonoses in Africa. Microbiology Society’s online magazine-Microbiology Today, 2015(November 2015).
  20. Kimang’a Andrew, N., A situational analysis of antimicrobial drug resistance in Africa: Are we losing the battle. Ethiop J Health Sci, 2012. 22(2): p. 1-9.
  21. McDermott, J.J. and S.M. Arimi, Brucellosis in sub-Saharan Africa: epidemiology, control and impact. Vet Microbiol 2002. 90: p. 111–34.
  22. Welburn, S.C., et al., The Neglected Zoonoses – The Case for Integrated Control and Advocacy. Clinical Microbiology And Infection: The Official Publication Of The European Society Of Clinical Microbiology And Infectious Diseases, 2015.
  23. ZDU, Kenya Strategic Plan for the Elimination of Human Rabies in kenya 2014-2030, Ministry of Health and L.a.F. Ministry of Agriculture, Editors. 2014, Zoonotic Diseases unit.
  24. Phiri, I.K., et al., The emergence of Taenia solium cysticercosis in Eastern and Southern Africa as a serious agricultural problem and public health risk. Acta Tropica, 2003. 87(1): p. 13-23.
  25. Ngowi, H.A., et al., Taenia Solium Cyticercosis in eastern and Southern Africa: An Emerging Problem in Agriculture and Public Health. 2004. 35(1): p. 266-270.
  26. CDC. Bioterrorism Agents/Diseases. Emergency Preparedness and Response 2015 [cited 2015 23 Nov 2015]; Available from: http://emergence\y.cdc.gov/agent/agentlist.asp.
  27. ZDU. Anthrax Outbreak Response, Nakuru COunty-February 2014. Outbreaks 2015 [cited 2015 23 Nov 2015]; Available from: http://zdukenya.org/outbreaks/.
  28. Zinsstag, J., et al., Potential of cooperation between human and animal health to strengthen health systems. The Lancet, 2005. 366(9503): p. 2142-2145.
  29. Batsukh, Z., et al., One Health in Mongolia. Current Topics In Microbiology And Immunology, 2013. 366: p. 123-37.
  30. Zinsstag, J., et al., One Health: The Theory and Practice of Integrated Health Approaches. 2015: CAB International.
  31. WHO, Neglected tropical diseases, in Closer intersectoral collaboration using existing tools can defeat zoonoses affecting humans. 2015, World Health Organisation Online.
  32. SDSN, Data for development: An Action Plan to Finance the Data Revolution for Sustainable Development. 2015, Sustainable Development Solutions Network, Open Data Watch.

 

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The role of wildlife in transboundary animal diseases in Kenya

The role of wildlife in transboundary animal diseases in Kenya

by | Jul 28, 2016 | My Write Ups, Transboundary diseases

The role of wildlife in transboundary animal diseases in Kenya

SUMMARY OF RECENT HISTORY (SINCE 2000) OF SELECTED TRANSBOUNDARY DISEASES IN KENYA

Avian influenza A (H7N9 & H1N1)

The 2009 Pandemic influenza A (H1N1) was first characterized in Kenya on 29th June, 2009 (Matheka et al., 2013). Thereafter sentinel data from ten sites in Kenya have identified both influenza type A and B circulating in Kenya (Muthoka, 2012). The distribution of these influenza types between 2006 to 2011 was as follows: Type A pandemic (H1N1) 2009 (28%), Type A (H1N1) seasonal (10%), Type A (H3N3) seasonal (24%), Type B (31%) and uncharacterized (7%) (Muthoka, 2012). In 2012 the predominant strain in Kenya was H3N2 with a seasonal occurrence (Achilla et al., 2009, Muthoka, 2012).

Foot and Mouth Disease

The Foot and Mouth disease outbreaks (see Figure 1 and 4) that have occurred in Kenya during the period 2004-2006 have involved serotypes: O, A, C, SAT1 and SAT2 (Sangula, 2006, CDC, 2007). The outbreak serotype distribution over the years has been as follows: 1 outbreak of SAT 1 and 19 of SAT2 reported in 2004; 3 of SAT1 and 10 of SAT2 reported in 2005; and 7 of SAT 1 and 4 of SAT 2 reported in 2006 (Sangula, 2006).

Figure 1: Map of Kenya showing reported FMD Outbreaks per province: 2004-2006 (Sangula, 2006)

Rift Valley Fever

The most recent outbreak of Rift Valley Fever in Kenya occurred between November 2006 to January 2007 (see Figure 4) that affected 6 provinces and 29 administrative districts (see Figure 2 & 3) out of the total 8 provinces and 69 administrative districts, respectively (Munyua et al., 2010) as a result of extraordinarily heavy rainfall during October-December 2006 (CDC, 2007). Following the El-nino development advisory that was issued by Kenya Meteorological Department on 22nd September, 2015 (Kenya, 2015a), as of 19th February, 2016 (time of writing this assignment) there has not been any confirmed RVF case in Kenya preceding the late-2015 El-Nino rains.

Figure 2: Districts in Kenya with confirmed RVF cases in humans and animals during 2006/07 outbreak (Munyua et al., 2010)

 

Figure 3: Number and percentage of reported RVF cases by district in Kenya Nov 2006-January 25th 2007 (CDC, 2007)

Figure 3: Number and percentage of reported RVF cases by district in Kenya Nov 2006-January 25th 2007 (CDC, 2007)

 The last known outbreak of Rinderpest in Kenya was of cattle reported in Meru National Park in 2001 (Omiti and Irungu, 2010) and a buffalo (AVMA, 2011). Since then Kenya has been free of Rinderpest (see Figure 4)

Figure 4: OIE-WAHIS Disease timelines for FMD, RVF and Rinderpest in Kenya between 2005-2015 (OIE, 2016b)

RISK OF WILDLIFE IN THE EPIDEMIOLOGY OF FMD IN KENYA

Records at the Kenya national Foot-and-Mouth Disease Laboratory show that previous studies on FMD in Kenya have mainly focused on cattle and rarely on other susceptible domestic species (Wekesa et al., 2014) and only to a minor extent on wildlife. However, in 1979, a field survey isolated SAT1 and SAT2 FMDVs from buffalo populations in the southern part of Kenya (Anderson et al., 1979).

(Bronsvoort et al., 2008) demonstrated a high and increasing seroprevalence of Foot and Mouth Disease Virus (FMDV) between the years 1994-2002 among the African buffalo (Syncerus caffer) in Eastern Africa (Kenya inclusive) with a high sero-conversation early in life (1-2 years). The study also found that the dominant serotypes were SAT2, SAT1 and then SAT3 in that order, although the buffalo seemed to be more associated to maintain the SAT2 as compared to the other serotypes.

FMDV has also been shown to infect several wild species that are found in Laikipia, with the African elephant proposed to play a potential transmission role (Aftosa, 2014). This potential transmission is further purported by (Benka, 2012) where 92.2% of the respondents in Laikipia-Kenya noted an increased contact time and population of wildlife in the recent past, especially the elephants and the buffaloes. The OIE WAHIS database also shows existence of FMD outbreaks in Kenya among wildlife (refer to Figure 4), with suspected cases in 2009 and confirmed cases between 2010-2011 that were limited to one or more zones (OIE, 2016b).

A study by (Wekesa et al., 2015) found that the Buffalo harbored SAT1 and SAT2 serotypes (see Figure 5). Wildlife have been implicated, through molecular epidemiology, as a possible culprit for the upsurge of the SAT1 and SAT2 epidemics in Kenya because of the intimate interaction of livestock and wildlife in the pastoral ecosystem (Sangula, 2006, CDC, 2007). This makes it imperative to undertake antigenic comparison to determine if the current vaccines confer protection against these co-shared serotypes at the livestock-wildlife interface.

The cross-border movement of wildlife from Kenya to Tanzania (see Figure 6) could be facilitating the complex and trans-boundary nature of this disease and further complicating its epidemiology. This could mean that control measures need to be collaborative between the governments of Kenya and Tanzania, employing a One Health concept.

Figure 5: Cross-border movement of wildlife between Kenya and Tanzania (Rovi film, 2013)

Figure 6: Circles with numbers indicate geographic origins of the 15 SAT 1 and SAT 2 foot-and-mouth disease viruses (FMDVs) isolated from buffalo and cattle (Wekesa et al., 2015)

Figure 6: Circles with numbers indicate geographic origins of the 15 SAT 1 and SAT 2 foot-and-mouth disease viruses (FMDVs) isolated from buffalo and cattle (Wekesa et al., 2015)

BIOLOGIC, SOCIOLOGIC, AND ECONOMIC FACTORS IMPORTANT IN THE CONTROL AND/OR ELIMINATION OF FMD IN KENYA

BIOLOGIC FACTORS

Wide array of serotypes: There are several serotypes for the FMDV with antigenic variations within each serotype making it impossible for one serotype to confer immunity against another serotype (OIE, 2012), and therefore in practice vaccine matching becomes necessary with the field strains  (Chepkwony, 2011).

FMDV is highly contagious: Transmission can be facilitated through contact with infected animals, their excretions, secretions, or contaminated fomites and products (OIE, 2012, USDA, 2013). It has also been shown that humans can possibly transmit the FMDV to susceptible animals during FMD outbreaks (USDA, 2013) and therefore responders should uphold biosecurity measures.

Wide range of susceptible hosts: Many of the cloven-hoofed wildlife and domestic species at the wildlife-livestock interface in Kenya, including: cattle, goats, sheep, and pigs are susceptible to FMDV, and this presents a possible spillover of infection into livestock or sympatric cloven-hoofed wildlife (OIE, 2012 1512).

Carrier state: Cattle, sheep, and goats can become carriers or persistently infected even after successful vaccination (Chhetri et al., 2010). The carrier state is a complication which should be considered during outbreak situations (Grubman and Baxt, 2004).

FMDV is moderately stable in the environment: Under certain conditions the FMDV can maintain infectivity in the environment for extended periods of time (USDA, 2013). It is essential for livestock owners and producers to maintain sound biosecurity practices as outlined by (OIE, 2016a) to prevent introduction/spread of the virus during outbreaks.

Illegal movement routes: Illegal stock routes for trade as a result of drought, forced cattle movement due to cattle rustling and across the borders are some of the main causes of FMDV spread in Kenya (Chepkwony, 2011). Therefore there should be coordinated livestock movement control at borders and stop cattle rustling.

Pastoralism: Pastoral long distance movement of animals, and high stocking densities facilitates the widespread of viral particles (OIE and FAO, 2012) within and across borders.

Several differential diagnosis: FMD cannot be differentiated clinically from other similar diseases and therefore an suspected case is best confirmed through laboratory diagnosis (OIE, 2012).

SOCIAL FACTORS

The social factors to be considered are:

  • Effective, timely and accurate communications with the affected premises, stakeholders, farmers and animal keepers, the public and the media so as to reduce the impact and spread of disease and to provide accurate and timely updates on latest situation
  • Timely risk communication to the public, region and international community during an outbreak or incident to ensure effective representation of Kenya disease control activities.
  • Background knowledge on the structure of livestock production systems to understand epidemiology and control options suitable at the local setting
  • Public health implications since FMD can cause mild disease in humans and accompanied by floods during the rains
  • Assurance to the public and international community of safe commodities for trade
  • Public acceptance especially when it comes to: culling of animals and animal welfare perspectives
  • Provision of support services e.g. psychological support during mass death
  • How to counter misinformation and misconceptions especially through media
  • Supporting legal framework in Kenya: The animal diseases Act Chapter 364; Public Health act cap 242; Meat Control Act cap 356; Procurement and audit act

ECONOMIC FACTORS

Some of the economic factors to consider are (OIE, 2014):

  • Costs and benefits of intervention
  • Availability of resources
  • Logistics and ease of implementation
  • Stakeholder engagement especially the public-private partnerships
  • Environmental impact
  • Political will
  • Incentives and compensation
  • Budget and financial resources planning

IMPORTANT STAKEHOLDERS TO BE INVOLVED IN THE CONTROL

Ministry of Agriculture, Livestock and Fisheries: Kenya’s economy is dominated by the agricultural sector and FMD poses a great threat to it both as production losses and indirect losses.

Ministry of Health: FMD has public health implications e.g. flooding & zoonotic.

Ministry of Tourism and other local & international travel organisations: The African wildlife are a major tourist attraction and if there is a risk of infection from wildlife this may impact negatively on the tourism industry

Devolved local government administration: have the responsibility to enforce disease control measures, offer administrative and information technology resources such as administered movement licensing, provide advice and support to affected sectors.

Central Veterinary Laboratory: has the capacity to provide and interpret diagnostic and surveillance data and provide disease-specific expert knowledge in terms of the epidemiology and control measures of FMD.

Regional or Local NGOs, CBOs, FBOs, youth groups, churches etc.:  These groups will help inform local decision making as appropriate and will assist with ensuring that developments in local operations are communicated to all relevant parties, including those who are not engaged with industry groups and sector councils, and can be a challenge to reach.

Ministry of Defence and Police:  They will play the role of organization and logistical arrangements especially when it comes to intensifying biosecurity patrols and protecting the public order with individual roles such as: enforcement of movement controls with local authorities, policing of control zones, coordination of legal entry to premises etc.

Global facilitation/technical assistance bodies: such as GARC (Global Alliance for Rabies Control) who can act as a liaison body between national governments, community stakeholders and the international FAO-OIE-WHO tripartite.

Regional banks and stakeholders: they have contributed and still contribute significantly to FMD control efforts in Africa.

Ministry of Environment and Natural Resources: Will contributed to development of carcass transport arrangements and advice on planning, air and environment quality issues relating to disposal of carcasses and cleanup.

Foot and Mouth Disease champion: Having an FMD champion from a country that has successfully eradicated FMD so as to provide ‘good practices’ that can locally be adopted in the prevention and control of FMD

Kenya Veterinary Vaccines Production Institute (KEVEVAPI): Since they produce the FMD vaccine they will play a valuable contribution in its control through vaccine provision

Local community: They have and are already suffering because of the production losses as a result of FMD and therefore will be a direct beneficiary and implementer of prevention/control strategies proposed.

The media:  They will disseminate key messages on the prevention and control of FMD to the public

CONCLUSIONS AND RECOMMENDATIONS

It is clear that wildlife have a potential role in the epidemiology of Foot and Mouth Disease in Kenya and the neighboring regions, although the existing information is still limited. Hence, Foot and Mouth Disease control in Kenya should principally target on reducing the high burden of disease among livestock and consequently limit the livestock-wildlife interaction through collaborative efforts with stakeholders and between countries that share a border with Kenya that facilitate cross-border movement of livestock and wildlife. This can be achieved through a number of ways:

  • Strengthen surveillance systems: Build the capacity of local laboratories and promote regional integrated surveillance systems so as to facilitate early detection and rapid response to any FMD outbreak. At the same time develop multivalent vaccines targeting the shared serotypes between livestock and wildlife.
  • Disease prevention and infection control: with the aim of slowing the spread of FMD and end the outbreak so as to prevent new cases from arising. This can be at the:
    • Human level through: public health education; behavior change communication especially targeting the pastoralists to avoid risky practices that propagate transmission between communities and across borders
    • Animal level through: strategic livestock vaccination in specific hot spots; imposition of quarantines in affected areas and slaughter bans.
  • Cross-border mitigation: The cross-border movement of livestock and wildlife necessitates that control measures need to be collaborative between the governments employing a One Health concept.
  • Support services: Contingency plans to be in place to provide support in regard to floods that can result to partial/full harm to humans which may require provision of temporary support facilities and relief aid to both humans and animals
  • Targeted and coordinated communication: The aim is to provide accurate, timely and easy to understand information through coordinated communication among all relevant stakeholders to ensure consistent messages to the general public and at the same time address the circulating rumours, misinformation and conflicting information.
  • Standard Operating Procedures and protocols: Should be available before the outbreak and address: simulation and training, quarantine measures, handling of samples, vaccination of livestock, surveillance, rapid response teams, biosecurity and biosafety, communication protocol, and allocation of responsibilities.

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