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An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléAn integrated Approach ...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléRISK ANALYSISINTRODUCTI...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENTH...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENT(...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENT(...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléDECISION TOOL FOR BRUCE...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléDECISION TOOL FOR BRUCE...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléMICROBIOLOGICAL RISKASS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN INFECTION RISKASS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATIONRISK...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RIS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RIS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RIS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RIS...
An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléCONCLUSIONRisk analysis...
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Brucellosis risk assessment

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Presented by Anani Adeniran Bankole at a Workshop: An Integrated Approach to Controlling Brucellosis in Africa, Addis Ababa, 29-31 January 2013

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Transcript of "Brucellosis risk assessment"

  1. 1. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléAn integrated Approach to ControllingBrucellosis in AfricaBrucellosisrisk assessment1Anani Adeniran Bankole, DVM & PhDDLS - TOGOWorkshop: An Integrated Approach to Controlling Brucellosis in Africa,Addis Ababa, 29-31 January 2013
  2. 2. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléRISK ANALYSISINTRODUCTIONTool to provide decision makers with anobjective repeatable and documentedassessment of the risk posed by a particularcourse of action« Hazard identification »What can go wrong?« Risk assessment »How likely is it to go wrong?What would be the consequences of it going wrong?« Risk management »What can be done to reduce the consequences?For Brucellosis . Import Risk. Brucellosis surveillance. Microbiological risk assessment. 2
  3. 3. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENTHazardidentificationImportedCommodity• Semen• Embryotransfer• Milk products(humancontamination)• BreedingfemaleOIE Handbook Volume 1, 20103
  4. 4. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENT(2)Entry assessmentRelease of Brucellosis viaimported potentiallyinfected cattleRisk assessmentExposure assessmentExposure of cattle to Brucellosis via imported potentiallyinfected cattleExample of importation of Brucellosis via breeding cattle4
  5. 5. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléIMPORT RISK ASSESSMENT(3)Risk assessment (2)Consequence assessmentSeveral different outcomes possible: No sufficient quantities to result in an infection with no infectionor disease established infection outbreak (within the herd, between herds)Risk estimationQualitative or quantitativeCombination of preceding probabilitiesQuantitative results1. Annual probability of importing brucellosis2. Expected number of infected imports5Acceptable risk
  6. 6. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléDECISION TOOL FOR BRUCELLOSISSURVEILLANCEEXAMPLE: A quantitative risk assessment for the importation of brucellosis-infected breeding cattle into Great Britain from selected European countries(Jones et al., 2004)6• GB (OFB since 1991) import breeding cattle from OFBherds in Northern Ireland and Republic of Ireland (NonOFB)• Results of the risk assessmentPrediction to import brucellosis from• Northern Ireland every 2.63 years• Republic of Ireland every 3.23 yearsRisk managementIntroduction of post-calving testing for all importedanimals apart from the routine testing
  7. 7. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléDECISION TOOL FOR BRUCELLOSISSURVEILLANCEEXAMPLE: A simulation model of brucellosis spread in British cattle underseveral testing regimes (England et al., 2004)7• High costs associated with Brucella routine testing in GB• Issue of reducing the level of testing raisedFollowing predictions, Policy-makers decided: Abortions notification very important No testing level reduction
  8. 8. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléMICROBIOLOGICAL RISKASSESSMENT• 2 examples or studies8 Historical reputation of safety of Fermented foods Many outbreaks reported due to fermented foodconsumption (Memish and Balkhy, 2004) Quantitativemicrobiological riskassessment (QMRA):scientific bases forthe control andmanagement of food-borne diseases
  9. 9. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN INFECTION RISKASSESSMENTRisk assessment of human brucellosis infection fromconsumption of raw cow milk sold by vendors in TheGambia• Hazard identification• Brucellosis present in Gambia and Brucella isolation (HF)• Isolation from milk reported by many authors (Hamdy andAmin, 2002; Ocholi et al., 2004)• Associated with disease in humans (Jennings et al., 2007)• Hazard characterization• 10-100 Brucella = dose by aerosol through inhalationsufficient to initiate infection (Bossi et al., 2004).• Oral route: no definite knowledge, 1 CFU/g or ml in foodsmight might initiate infection (Kuplulu and Sarimehmetoglu,2004). 15 to 30 % survive after ingestion (Pappas et al., 2005)9
  10. 10. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATIONRISK ASSESSMENT (MILK)Exposure assessmentProbabilities at ≠ levelsDose-response assessmentConcentration of Brucellain 1 serving (50-100ml)Concentration at ≠ levelsVariation in Brucella concT and pH Growth modelDose-response Model fromBinomial distribution (notreshold)10
  11. 11. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RISKASSESSMENT (3)Probabilities of infection when exposed to contaminated serving and unknownstatus serving(More time)fermented byfermented by11Risk characterization
  12. 12. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RISKASSESSMENT (4)Raw milk after Overnight fermentation contains, moreBrucella than fresh milk (Plommet, 1988)Sensitivity analysis: if 50% reduction of theprobability of Brucella shedding in milk:30% reduction of the probability of infection by contaminatedservingControl optionsAction to be undertaken apart from boiling the milkand reducing the prevalence (control measures):Reduction of Brucella shedding (farmers’ practices inGambia)12
  13. 13. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RISKASSESSMENT (5)How Human Brucellosis Incidence in Urban Kampala Can Be Reduced MostEfficiently? A Stochastic Risk Assessment of Informally-Marketed Milk (Makita et al.,2010)Design stochastic risk models to• assess the risk of human brucellosis infectionthrough consumption of informally marketed rawmilk potentially infected with Brucella abortus inKampala• Identify the best control optionsResults• 12.6% of informally marketed milk in urban Kampalacontaminated at purchase• annual incidence rate estimate: 5.8 per 10,000 people13
  14. 14. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléHUMAN CONTAMINATION RISKASSESSMENT (6)Recommendations from the control optionsassessmentAssessment of control options by simulations assuming 90% of enforcement wasachieved14Risk reductionAnnually avoided incidence
  15. 15. An integrated Approach to Controlling Brucellosis in Africa - Addis Ababa, 29-31 Jan 2013Dr BankoléCONCLUSIONRisk analysis• Important tool in all decision-making in theface of uncertainty– Animal and animal products import– Surveillance programs (choice between differentoptions)– Food borne brucellosis control options• Need of good risk communication andcommitment of policy and decision makers15
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