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A framework for understanding zoonoses at thelivestock-human interface in western KenyaDr Eric Fèvrewww.zoonotic-diseases....
AcknowledgementsFunded by:Wellcome Trust (UK)BBSRC (UK)MRC (UK)Thanks toLian Thomas (University of Edinburgh)William de Gl...
What research is needed? - WHOField epidemiological studies in humans and livestockthe number of cases and number of death...
People, Animals and their Zoonoses (PAZ)Integrated project that addresses this lack of data and these scientific aimsAims ...
Aims of studyAcquire basic field epidemiological data on zoonotic diseases in both humans andanimalsEnumerate co-infection...
Study siteField site is the Western Province ofKenya2000 km2zone (500,000 cattle,67,000 pigs, ~1 million people)Small-hold...
The project is focused on…
Cross sectional sample flow (field lab)
Slaughter house sample flow (field lab)
Livestock cross sectional surveyInfections with zoonotic diseases and other pathogens in cattle, pigs,goatsSampling 1100 c...
Pathogens and conditions considered (first pass)Organism/condition Test type Sample type Sample volumeState of health Clin...
Human cross sectional surveySame principle as livestock element, but in humans; 120 item questionnaireCollaboration with C...
Scientific data on epidemiologicalparameters in the study population anddesign of targeted interventionsMapping disease di...
FinThanks for your attention!Eric FèvreEmail: Eric.Fevre@ed.ac.ukWeb: www.zoonotic-diseases.orgtel: +44 (0)131 208 32 35te...
Good Practice in QuantitativeVeterinary Epidemiologyhttp://www.qve-goodpracticeguide.org.uk/Woolhouse, M.E.J., Fèvre, E.M....
Data managament
FacilitiesFull scale “district level” parasitology and microbiology diagnostic lab for human and animalsamplesPost-mortem ...
List of current equipment3x long wheelbase land cruisers forfieldworkLarge refrigerated centrifuges x237C incubators x3Wat...
Studies currently under wayLarge cross-sectional survey of 450 households investigating epidemiology ofendemic zoonoses an...
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
A framework for understanding zoonoses at the livestock-human interface in western Kenya
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A framework for understanding zoonoses at the livestock-human interface in western Kenya

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Presented by Eric Fèvre at a workshop on an integrated approach to controlling brucellosis in Africa, Addis Ababa, Ethiopia, 29-31 January 2013.

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A framework for understanding zoonoses at the livestock-human interface in western Kenya

  1. 1. A framework for understanding zoonoses at thelivestock-human interface in western KenyaDr Eric Fèvrewww.zoonotic-diseases.orgCentre for Immunity, Infection and Evolution, University of EdinburghandInternational Livestock Research Institute, NairobiIn collaboration with: KEMRI, Centre for Microbiology ResearchDepartment of Veterinary Services, KenyaWorkshop: An Integrated Approach to Controlling Brucellosis in Africa, AddisAbaba, 29-31 January 2013
  2. 2. AcknowledgementsFunded by:Wellcome Trust (UK)BBSRC (UK)MRC (UK)Thanks toLian Thomas (University of Edinburgh)William de Glanville (University ofEdinburgh)Annie Cook (University of Edinburgh)The 15-strong PAZ teamJames Akoko, Omoto Lazarus, LorrenAlumasa, Daniel Cheriyot, JenipherAmbaka, Fred Opinya, John Mwaniki,Hannah Kariuki, Gideon Mwali, GeorgeOmondi, Alice Kiyong’a, Lilian Abonyo,Maseno Cleophas, Fred Ambaka, VelmaKivaliPhil Toye (ILRI)Sam Kariuki (Kenya Medical ResearchInstitute, KEMRI)Njeri Wamae (Kenya Medical ResearchInstitute, KEMRI)Bernard “Risky” Agwanda (NMK)Mark Bronsvoort (Roslin Institute)Mark Woolhouse (University ofEdinburgh)Claire Okell (Royal Veterinary College)The DVOs, Western Province
  3. 3. What research is needed? - WHOField epidemiological studies in humans and livestockthe number of cases and number of deathsnumber of new infectionsage-and sex-specific disability weights for zoonosesEstimates/models of under-reportingMuch recent progress: rabies, sleeping sicknessCase studies to gather an evidence-baseMulti-disease studies – what is the overall burden of zoonosesas a group on communitiesPublic healthEconomicsField-level diagnosticsCost-effectiveness studies – dual medical/veterinary benefitsPathogen and host ecology
  4. 4. People, Animals and their Zoonoses (PAZ)Integrated project that addresses this lack of data and these scientific aimsAims to address both (veterinary) public health and ‘biological’ questionsEpidemiology – population scaleFramework that can be repeated elsewhere in different communities andecologiesFood chainDomestic animalsPeri-domesticwildlifeHumansEnvironment
  5. 5. Aims of studyAcquire basic field epidemiological data on zoonotic diseases in both humans andanimalsEnumerate co-infections/co-exposure with zoonoses amongst humans andlivestock (with 1+ zoonosis; with all pathogens)Quantify the human burden of zoonoses and other infections in the study areaInvestigate links between zoonoses and non-zoonotic infections – co-factors (eg –are sick animals better reservoirs?)Understand/model the extent to which co-factors predict exposure to zoonosesWhat is the impact of zoonoses on production losses in livestock?Understand the role of the wider ecosystem on disease transmissionInvestigate the potential of simple livestock-targeted interventions as a means ofimproving human public health
  6. 6. Study siteField site is the Western Province ofKenya2000 km2zone (500,000 cattle,67,000 pigs, ~1 million people)Small-holder crop-livestockproduction system in the Lake VictoriaCrescent (highest human andlivestock densities in East Africa)Intensively and comprehensivelysampled over 2.5 yearsCluster design (random household),organised by sub-location unitsAll sublocations in the study site to besampled, proportionally by cattlepopulation distribution
  7. 7. The project is focused on…
  8. 8. Cross sectional sample flow (field lab)
  9. 9. Slaughter house sample flow (field lab)
  10. 10. Livestock cross sectional surveyInfections with zoonotic diseases and other pathogens in cattle, pigs,goatsSampling 1100 cattle in ~ 450 householdsAll cattle, pigs, goats in each home sampledComprehensive individual level questionnaire covering a diversity of socio-economic, spatial and biological risk factors (c.100 item questionnaire)ProcessField examination/full clinical exam, collection of blood, serum, faecesParasitological screening, sample processing, some serologic diagnosticassays in field labELISA and PCR at central labBiobanking + material for livestock genetics
  11. 11. Pathogens and conditions considered (first pass)Organism/condition Test type Sample type Sample volumeState of health Clinical examinationBlood-borne parasites (Plasmodium,Rickettsia, Trypanosoma,microfilariaem, microfilariae,Theileria, Anaplasma, etc)Microscopy Thick and think blood smears;possibility of testing some rapidtests100µlVarious intestinal parasites (Ancylostoma,Trichuris, Strongologides, Ascaris,Necator, Hymenolepis, Taenia,Schistosoma, Coccidia, Crypto, Giardia,Fasiola, Entamoeba…)Kato-Katz concentration,formol-ether concentration,microscopyFresh faeces 10gHaemoglobin PCV and direct measurement Whole blood 10µlCoxiella burnetii (Q-fever) Serology Serum **Brucella spp. (Brucellosis) Serology Whole blood in anticoagulant **Mycobacterium bovis (Bovine TB) Serology (Gamma-interferon) Peripheral Blood Mononuclear Cellsfrom whole blood8mlsRift Valley Fever Serology Serum **Trypanosoma brucei rhodesiense(sleeping sickness)Microscopy and PCR Whole blood in anticoagulant **Taenia solium (pork tapeworm) Copro-PCR, serology andmicroscopyStool, serum **Faeces – 10gTaenia saginata (beef tapeworm) Microscopym serology andCopro-PCRStool 10gHIV Serology Whole blood in anticoagulant **Leptospirosis (?) Serology Serum and whole blood inanticoagulant**
  12. 12. Human cross sectional surveySame principle as livestock element, but in humans; 120 item questionnaireCollaboration with Centre for Microbiology Research, KEMRITwo strata - households that keep cattle and those that do not – target 2500patients sampledKEMRI ethical approvalProcessField examination and clinical exam, collection of blood, serum, faecesSample processing, parasitology, some serologic diagnostic assays in field labELISA tests and PCR at central labsBiobanking of serum and blood for further analysisReporting back and free treatment of parasites
  13. 13. Scientific data on epidemiologicalparameters in the study population anddesign of targeted interventionsMapping disease distributions and riskModelling transmission and the role of co-factors in zoonotic disease spreadCo-investigation of all humans and livestockin the sampling unit gives a uniquelycomprehensive understandingWill provide data to address gaps in NZDknowledge identified by WHOCountry- and regional- scale policy outputswith a wider regional relevance
  14. 14. FinThanks for your attention!Eric FèvreEmail: Eric.Fevre@ed.ac.ukWeb: www.zoonotic-diseases.orgtel: +44 (0)131 208 32 35tel: +254 (0) 722 545 345Centre for Infection, Immunity and EvolutionSchool of Biological SciencesUniversity of EdinburghAshworth LabsWest Mains RoadEdinburgh EH9 3JTUKInternational Livestock Research InstituteOld Naivasha RoadPo Box 30709-00100NairobiKenya
  15. 15. Good Practice in QuantitativeVeterinary Epidemiologyhttp://www.qve-goodpracticeguide.org.uk/Woolhouse, M.E.J., Fèvre, E.M., Handel, I., Heller, J., Tildesley, M.J.,Parkin, T., & Reid, S.W.J. (2011). Guide to Good Practice for QuantitativeVeterinary Epidemiology (http://www.qve-goodpracticeguide.org.uk/).VTRI0101, Universities of Edinburgh and Glasgow.
  16. 16. Data managament
  17. 17. FacilitiesFull scale “district level” parasitology and microbiology diagnostic lab for human and animalsamplesPost-mortem room for animals (pathology)International Livestock Research Institute Health and Safety and equipment laboratorymaintenance standardsInternational supply chain and cold chainWater, electricity, broadband internetExcellent relations with DVS, local leaders, government officials and the wider communityAccess to field (incl 4x4 transport)among highest human and livestock population densities in Eastern Africageographical gradation from the Lake Victoria in the south to the lower slopes of the Mt Elgon uplands inthe north
  18. 18. List of current equipment3x long wheelbase land cruisers forfieldworkLarge refrigerated centrifuges x237C incubators x3Water bathIncubator shakerStomacherShakersMicro-Haematocrit centrifugesAutoclaveDeionizerDissecting microscopesCompound microscopesBalancesAutomated haematology analyserHemocue2x Laminar air flow hoods2x UV cabinetsFridgesBiomedical freezers to -40 and -80Computing facilities and wirelessinternet accessLarge generatorRobust real-time PCR machineELISA readerLAMP PCR equipmentVarious standard equipment forparasitology processing
  19. 19. Studies currently under wayLarge cross-sectional survey of 450 households investigating epidemiology ofendemic zoonoses and co-infectionsZoonoses risk amongst slaughterhouse workersMRSA in pigs and peopleFood chain risk assessment of porcine cysticercosis and brucellosisMolecular epidemiology of brucellosisDevelopment of pen-side diagnostics for cysticercosisPathogen discovery in peridomestic rodents and bats

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