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Welcome to the Kenya One Health Conference

  1. 1. Welcome to the Kenya One Health Conference 6th December 2021 Bernard Bett & Lian Thomas
  2. 2. Who is ILRI? CGIAR global partnership for a food secure future • Poverty alleviation through agricultural research • 15 research centres • More than 8,000 scientists,researchers, technicians and support staff https://www.cgiar.org
  3. 3. What does OHRECA do? Established to significantly enhance human, animal and environment health by: • Supporting One Health networks • Developing capacityin One Health • Undertaking applied One Health research • Strengthen pathwaysfrom evidence to policy and practice Click to add text
  4. 4. OHRECA Activities • Applied research within Food Safety, Emerging Infectious Diseases, Neglected Zoonoses & Antimicrobial Resistance • Capacity Strengthening at different levels • Cohorts of Graduate Fellows • Community level outreach • Behavior change for value chain actors • National and Regional Network Building
  5. 5. Supporting One Health Networks
  6. 6. Who are we?
  7. 7. Visit the OHRECA page on ILRI website • Visit our website: ilri.org/research/facilities/one-health-centre • Subscribe to our newsletter: http://eepurl.com/hn8DEX • Follow us on Twitter: @ohreca_ilri
  8. 8. House Keeping • Please mute your mics when joining • Turn on video’s when speaking unless bandwidth issues • Please contribute your thoughts in the chat function • This session is being recorded
  9. 9. Why have a Kenya One Health Conference? • Showcase One Health related work in Kenya • Develop a framework for One Health Research that is appropriate to the Kenyan context • Identify initial elements to a demand driven OH research agenda and capacity building strategy based on the needs of policy makers in the countries
  10. 10. Conference process • Through a combination of keynote speakers and selected presentations we will explore many aspects of One Health in Kenya • Audience participation will be vital in identifying the key messages which we can use to build our One Health Research Framework • Messages will be disseminated through blogs, on social media and on our dedicated website (https://www.ilri.org/kenya-one-health- conference) • Join in with your thoughts on www.mentimeter.com • Share tweets, retweet and tag us in your posts @Ohreca_ilri and use the #KOHC2021
  11. 11. #KOHC2021 Organizing Committee
  12. 12. #KOHC2021 Special mention
  13. 13. Thank you
  14. 14. Official Opening of the Conference Dr JimmySmith, Director General ILRI
  15. 15. Keynote: Development of Rift Valley fever vaccine suitable for human and livestock use Prof George Warimwe (KEMRI Wellcome Trust)
  16. 16. Introduction to Mentimeter app for conference interaction Michael Victor
  17. 17. 17 Mentimeter Download on App store or go to www.menti.com …an interactive presentation tool that allows users to engage their audiences in real time • Multiple choice • Open ended questions • Spectrum questions • Quiz competitions • Word clouds Using in OH Kenya conference to get participant feedback and engagement so as to develop an inclusive OH research agenda
  18. 18. 3-minute flash talks Dr Keli Gerken Mr Ackson Tyson Mwale Dr Dennis Makau Mr James Akoko Mr Titus Mutwiri
  19. 19. Thank you
  20. 20. Antimicrobial resistance in slaughterhouses in Western Kenya Dr Katie Hamilton
  21. 21. Antimicrobial resistance in slaughterhouses in western Kenya Kenya One Health Conference 6th December 2021 Katie A. Hamilton, Sam M. Njoroge, Kelvin Momanyi, Maurice K. Murungi, Christian O. Odinga, Nicholas Bor, Allan Ogendo, Josiah Makhandia, Joseph G. Ogola, Eric M. Fèvre, Laura C. Falzon
  22. 22. Food chain Domestic animals Peri- domestic wildlife Humans Environment The definition of One Health I am using today includes the food system alongside, the traditional humans, environment, domestic animals and peri-domestic wildlife. Defining One Health
  23. 23. Antimicrobial resistance Antimicrobial resistance(AMR) in bacteriais regarded as one of: • The most serious globalpublic health threats of this century. • Over the last decade, increasing levels of resistance to clinicallyrelevantantibiotics– includingcarbapenems and colistinwhich are considered antibioticsof last resort – have been reported in both human and animalpopulations. • Focus on Escherichia coli, as an exemplar emerging pathogen, which exists in a diversity of hosts, in the environment,on food, in waste, etc. • Escherichia coli can be a harmless gut commensal, some pathogenicstrainscan cause life-threateningbloodstream infectionsand common illnesses. • Escherichia coli can also cause disease in animals, leading to severe economic losses due to mortalityand morbidity. • Escherichia coli was categorized by the World Health Organizationasa priority pathogen due to its widespread antibioticresistance.
  24. 24. Slaughterhouses Hotspots for pathogen transmission given frequent interactions between people, animals, and the surrounding environment Risk to slaughterhouse workers and meat consumers Optimal sentinel sites for surveillance and interventions Study objectives: Microbiological assessmentof the slaughterhouse working environment Engage stakeholders in discussionson AMR
  25. 25. Study site Bungoma Busia Kakamega
  26. 26. floor equipment dressed carcass water workers meat box
  27. 27. Focus group discussions and workshops County Veterinary Officers (CVO) Sub-County Veterinary Officers (SCVO) Meat Inspectors (MI) Slaughterhouse Workers (SHW) from Busia, Bungoma & Kakamega counties
  28. 28. Results of the biological sampling We collected 193 samples from 13 slaughterhouses (9 ruminant & 4 pig) in 11 sites Isolates were identified in 101 (52.3%) of the samples • Isolates present in samples taken in all slaughterhouses • No difference between pig and ruminant slaughterhouse samples Highest proportion of isolates in samples from: • Carcass (67.5%) • Boot socks (63.6%) • Meat box (63.2%)
  29. 29. AntimicrobialSusceptibility Tests done on 98 isolates (21 pig and 77 ruminant) Highest frequency of resistance: - Streptomycin (73.5%) - Ampicillin (55.1%) - Tetracycline (50.0%) - Tri-sulfa (45.9%)
  30. 30. Multi-Drug Resistance (MDR) (i.e. resistanceto 3 or more classes) in 50/98 (51.0%) of the isolates tested No significant difference between isolates from ruminant and pig slaughterhouse samples Highest proportion of MDR isolates in boot socks (62.5%)
  31. 31. ExtendedSpectrum Beta-Lactamase are enzymes that confer resistanceto most beta–lactamantibioticsincluding penicillins and cephalosporins Expressed by 16/98(16.3%) of the isolates tested 11 ruminant samples 5 pig samples Identified in 8 of the 11 sites sampled Highest proportion in boot sock (37.5%) and meat box (30.8%) samples Extended Spectrum Beta-Lactamase Enzymes
  32. 32. Stakeholders
  33. 33. Inadequate use of drugs Under/over-dosing Withdrawal periods Indiscriminate prescriptions by professionals CVO: “If we vets also continue looking at all animals like they are ‘antibiotic deficient’, that is the disease we treat, this problem will continue escalating.”
  34. 34. Infrastructure Inadequate clothing – lack of protective clothing Underinvestment in infrastructure and equipment Reliable water source Perimeter fence Waste disposal Laboratory capacity and surveillance Inadequate funding & staff
  35. 35. Multi-sectoral approach Challenge to coordinate between stakeholders Opportunity to include medics for public sensitization National Action Plan on Prevention and Containment of AMR
  36. 36. Drug advice Drug failure Anti-malarials [humans] Ectoparasitic & anthelmintic drugs [livestock] Counterfeit drugs Amoxicillin and Alalmycin Self-diagnosis Hospital in case of complications Drugs are freely available Muloi et al. doi: 10.7189/jogh.09.020412
  37. 37. Reasons for resistance Incorrect drug usage, e.g. under-dosing SHW: “Sometimes you visit the chemist or clinic where a dose is prescribed for you but you don’t have enough cash so maybe the drugs cost like 600 and you have 200. So because the doctor wants money they tell you to go with a little drug and ask after how many days will you get the money? You tell him tomorrow. You take the drugs for a few days and notice a change then stop, which also contributes because you have not finished the dose."
  38. 38. Transmission of resistance Occupational risk SHW: “So, maybe there are diseases that affect the animals and is undergoing treatment. The animal is taken to the slaughterhouse without completing the treatment, when slaughtering the animal, there is the interaction between human and the animal. In case there are injury to the human, there may be mixing of blood of the animal and human blood and hence we can also be affected."
  39. 39. SHW: “Educate us on how we would be handling maybe the meat before it reaches… Which other ways are we handling where, educating us on getting a knife, cutting meat, how to hang the meat so that it doesn’t get bacteria from the ground, like you said, dust usually contains bacteria, so you educate us before undertaking the work.” An educational video that we produced and shared with all participants taking part in the study: https://youtu.be/T472S-zYZf0 Dealing with resistance Education Training Hygiene
  40. 40. Acknowledgements BBSRC Impact Acceleration Account UoL Knowledge Exchange Funding Schemes ZooLinK Funders ZooLinK field and lab team Stakeholders
  41. 41. Thank you
  42. 42. Integrating Ecosystem and Public Health into Urban Planning in Nairobi Dr Mitchelle Kasudi
  43. 43. 44 Background Urbanization – the population shift from rural to urban areas 1 in 3 urban dwellers live in slums/informal settlements.
  44. 44. 45 Health services Accessto portable water Food systems Air quality Transport Employment Crime and security Education Physical housing Recreational environments GAPS IN URBAN HEALTH • Weak linkage between urban planning,urban health and urban biodiversity • Minimal interaction and coordinated effort amongst stakeholders • Weak integrated surveillance systems to monitor and survey various determinants of health in urban areas Develop an interdisciplinary project on urban ecosystem health, integrating urban planning, ecology and human health
  45. 45. 46 Why Nairobi? • It is a rapidly urbanizing city • Annual population growth rate of 3.96% • 60% of Nairobi’s residents live in informal settlements • High infectious and non-communicable diseases burden • Fragmented landscapes – few green spaces, concrete jungles, polluted waterways, Nairobi National Park Relationship betweeneconomic development(illustrated byGNP)and causesof death
  46. 46. 47 • Literature review • Theory of change • Identify relevant stakeholders • Contact stakeholders • Key informant interviews • Snowballing • 30 institutions • 18 responded, 12 meetings done • 4 research institutions • 3 urban planning • 3 public health • 3 ecosystem health • Data collection • Transcription • Thematic analysis • Generate and validate hypotheses with government planning authorities • Test hypotheses in the field and lab Data analysis plan Approach 31% 23% 23% 23% Urban Health Sectors Research Urban planning Public health Ecosystem health
  47. 47. 48 THEORY OF CHANGE
  48. 48. 49 Emerging Themes ❑ Weak coordination • Clear individual roles but ill-defined linkages between sectors • Competing priorities ❑ Minimal operationalisation • Frameworks exist, but poor implementation • Political changes • Little accountability • Funding ❑ Weak research-policy interface • Researchers are consulted ❑ Unintegrated surveillance systems
  49. 49. 50 Research Ecosystem health Public health Urban planning Weak coordination 100% 100% 100% 67% Research incoorporation 100% 67% 67% 67% Challenge with implementation 0% 33% 100% 67% Surveillance system 75% 33% 0 0 0% 20% 40% 60% 80% 100% Respondents Themes Themes/Sector • 75% - existing partnerships but weak linkages. • 83% - govt involves research in planning decisions, 50% challenge with implementation (NGOs & private sector) • 75% - research should be incorporated into urban planning decisions (100% research institutions consulted) • 33% carried out surveillance • Nairobi Urban Health Demographics Surveillance System (NUHDSS) Emerging Themes
  50. 50. 51 Conclusions Future work • Series of meetings/workshops • Generate and validate hypotheses • Major stakeholder meeting • Build a fundable research programme • Weak linkages exist within the urban health sectors • Challenge with implementation and operationalisation of policies and frameworks • There is need to form new and strengthen existing urban health surveillance systems
  51. 51. 52 Acknowledgements Eric Fevré Dishon Muloi Maurice Karani Lydia Kisoo Eugine Lusanji Mitchelle Kasudi kasudimitch@gmail.com @ZoonoticDiseases
  52. 52. Thank you
  53. 53. Reflective session and reactions on Menti Dr Nicholas Bor
  54. 54. Lunch Break Visit:https://cgspace.cgiar.org/handle/10568/110005 to view posters submitted for the conference
  55. 55. Crimean Congo Haemorrhagic Fever Virus in Humans, Animals and Ticks in Kenya Bernard Agwanda
  56. 56. Seroprevalence of Crimean Congo Hemorrhagic Fever Virus (CCHFV) among Livestock, Wildlife and Ticks in Kenya By *B. Agwanda, #V. Obanda, € I.Blanco and ¥O. Lwande *Zoology Dept. National Museums of Kenya #Kenya Wildlife Research and Training Institute € Clinical sciences Dept, Uppsala University Sweden ¥Clinical Microbiology Dept, Umea University Sweden
  57. 57. Introduction ▪ CCHFV is a tick-borne zoonotic disease, with high-case fatality rate-40%. ▪ No Licensed vaccine and medicine currently ▪ Previous reports in Kenya include: ▪ PCR-confirmed fatal human case, ▪ CCHFV antibodies detection in humans and ▪ virus isolations from Hyalomma ticks. Yet, basic information about its epidemiology is lacking. Dunster et al (2002).Emerg. Infect. Dis.; 8(9): 1005–1006 Lwandeet al. (2012)Vector-Borneand Zoonotic Diseases. 1;12(9):727-32. Sang et al. (2011)Emerging infectious diseases;17(8):1502.
  58. 58. Seroepidemiology of CCHFV in Wildlife-Livestock management systems ▪ Aim: To determine the prevalence of CCHFV in cattle and buffalo in different wildlife-livestock managementsystems ✓ Wildlife closed system (Lake Nakuru N Park- LNNP) ✓ Closed wildlife-livestock system(Olpejeta conservancy-OC) ✓ Open wildlife-livestock (Maasai Mara Ecosystem-MME) ▪ Seroepidemiological study of the sera of 148 cattle, 23 sheep and 17 goats from 18 households from the three ecosystems in 2014, 2016, and 2019. ▪ Sera were analysed for the presence of antibodies to CCHFV using the commercially available double-antigen ELISA kit Blanco-Penedoet al., 2021. Dairy 2021, 2(3), 425-434 Map of Kenya showing the locationof study area
  59. 59. LivestockPresence Influences the Seroprevalence of CCHFV on SympatricWildlife in Kenya Obandaet al., 2021. . Vector-Borne and Zoonotic DiseasesVol. 21, No. 10 21(10):809-816 Map of Kenya showing the location of study area and Crimean-Congo hemorrhagic fever (CCHF). Results
  60. 60. Results Obandaet al., 2021. . Vector-Borne and Zoonotic DiseasesVol. 21, No. 10 21(10):809-816 Seropositivity in Cattle and buffalo in differentmanagement systems
  61. 61. Results Obandaet al., 2021. . Vector-Borne and Zoonotic DiseasesVol. 21, No. 10 21(10):809-816
  62. 62. Results Overall, 31.5% CCHFV seropositivity was observed Blanco-Penedoet al., 2021. Dairy 2021, 2(3), 425-434 CCHF IgG-positive cases among the sampled cattle by different ecosystems in Kenya.
  63. 63. Discussion ▪ Apparently high CCHFV exposure among buffaloes shows natural circulates in the wild in Kenya in spatially disconnectedfoci ▪ Habitat overlap between cattle and buffalo makes cattle a ‘‘bridge species’’ or super spreader host for CCHFV raising transmission risks to humans ▪ The effect of animal management system on prevalence is depended on tick control on the cattle and not the animal per se ▪ Buffalo, a host with a longer life span than livestock, is a reservoir and may serve as a sentinel population for longitudinal surveillance of CCHFV ▪ Elevated exposure rate in adult cattle points to longer period of exposure to CCHF vector- ticks Obandaet al., 2021. . Vector-Borne and Zoonotic DiseasesVol. 21, No. 10 21(10):809-816
  64. 64. Summary ▪ High prevalence CCHFV-specific antibodies in discrete cattle populations points to CCHFV circulation in the region ▪ The role of environmental and managementfactors in the transmission of CCHFV among dairy species requires further studies ▪ Surveillance in ticks and human still wanting especially among livestock keepers and handlers ▪ PCR and genomic surveillance needed to understand epidemiological bridges between wildlife, cattle, human, ticks and places Blanco-Penedoet al., 2021. Dairy 2021, 2(3), 425-434
  65. 65. Acknowledgements Umeå University Prof. Clas Ahlm Assoc Prof. Olivia Wesula Lwande SwedishUniversity of Agricultural Sciences Dr. IsabelBlanco Penedo ResearchPermitting andCompliance Wildlife ResearchandTraining Institute Dr. Vincent Obanda The project was funded by the Swedish Research Council (2019-04366) The study (on going)leverages on strengths and opportunitiesfrom Swedish and Kenyan(SWED-KEN) researchers through capacity buildingand institutionaldevelopmentin research on prevalenceand distributionof CCHFV in humans, ticks, livestockand wild mammals in Kenya
  66. 66. Thank you
  67. 67. Investigating zoonotic disease risk in forced migration using a One Health framework Dr Dorien Braam
  68. 68. 3-minute flash talks Dr TessaCornell Rachel Maina Dr Alice Kiarie Miss Igizeneza Acsa Dr Konongoi Limbaso
  69. 69. Thank you
  70. 70. One Health studies at the animal-human- environmental interface in Oloisukut conservancy, Narok County Dr Erastus Mulinge, Zipporah Gitau and Christina Trabanco
  71. 71. One Health Studies at the Human- Animal-Environment interface in the Oloisukut Conservancy, Narok County Presenters: Erastus Mulinge Zipporah Gitau and Christina Trabanco Other members: Malika Kachani, Eberhard Zeyhle, David Odongo, Deanna Overton, Peter Gathura , Jackson Mpario & Japhet Magambo
  72. 72. Oloisukut Conservancy: Ideal site for One Health Studies: People, Animals and Environment (Wildlife)
  73. 73. Introduction - One Health • “An integrative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and the environment”. • In 2012, Kenya implemented the One Health approach and created the Zoonotic Disease Unit (ZDU) • Collaborative inter-ministerial unit. • 5-year implementation plan. • Created a list of 17 priority zoonotic diseases to better guide policy and prioritization of resources. http://www.zoonotic-diseases.org/zdu-road- map-to-one-health/
  74. 74. Study Site: Oloisukut Conservancy • Established in 2006. • Trans Mara West, Narok County, Kenya, part of the greater Mara – Serengeti ecosystem. • Covers an area of 23,000 acres, 51 individually owned and registered parcels. • Membership of 109 heads (12, 500 residents) • Average of 10 to 15 individuals per household • The livestock population included: • 21,200 cattle • 35,850 sheep and goats • 881 dogs
  75. 75. PROJECT ACTIVITIES One Health: people, animals, environment. One Health approach: funding, data collection, analysis, implementation of control interventions as opposed to separate budget and health professionals working in silos - Incentives: - 881 dogs vaccinated and treated against intestinal parasites - Adults and children treated against soil-transmitted helminths - Samples collected from people, dogs, livestock and wildlife for disease prevalence. - Intestinal helminths in dogs: Dr. Erastus Mulinge. - Prevalence of intestinal parasitic infections in humans: Zipporah Gitau - Knowledge, Attitudes and Practices: Dr. Christina Trabanco.
  76. 76. Sample collection, processing Cattle, sheep, goats, dog samples KAP Surveys Human study Dog study
  77. 77. Intestinal helminths in dogs Dr. Erastus Mulinge, KEMRI
  78. 78. Cystic Echinococcosis, Cysticercosis & Coenurosis 8 Source: Eberhard Zeyhle, Dr. Alex Sabuni and Internet - Dogs are reservoirs of several zoonotic parasites of public health significance worldwide. - Dogs are associated with mechanical transmission of intestinal parasites to humans mainly through coprophagy or contact with other body parts.
  79. 79. Other zoonotic infections caused by dog parasites Cutaneous larva migrans, Ocular larva migrans, visceral larva migrans Sparganosis Cryptosporidiosis and giardiasis 9 Sources: Internet
  80. 80. Materials and methods • Vaccination against rabies/canine distemper and deworming • 100 dog faecal samples collected and processed (microscope, PCR) • 76/109 households sampled
  81. 81. 65 39 18 13 10 10 5 2 1 1 0 10 20 30 40 50 60 70 No. of dogs infected Helminths Prevalence of intestinal helminths (n = 100) Helminths Hookworm Spirometra spp. Taeniids Toxocara spp. Trichuris spp. Spirocerca lupi Physaloptera spp. Strongyloides spp. Dipylidium caninum Results Public health: Toxocara spp., Ancylostoma caninum, Taenia serialis, Strongyloides spp., Mesocestoides sp., Spirometra spp Animal health: Ancylostoma caninum, Spirocerca lupi, Mesocestoides sp., Physaloptera spp. Wildlife acquired: Taenia serialis, Taenia madoquae, Mesocestoides sp.,Spirometra theileri, Toxocara spp., Physaloptera spp., Spirocerca lupi.
  82. 82. Conclusions • Nine genera of intestinal helminths were detected in dogs • Ancylostoma Spp. was the most common helminth • The first molecular detection of S. theileri, D. caninum and Mesocestoides sp. in Kenya • Zoonotic helminths in dogs pose a public health risk to residents of the conservancy • The helminths reported here confirm the interaction of domestic dogs with wildlife • The control of helminth infections in dogs, humans and wildlife calls for collaborative effort from the human, animal and environment health professionals in the context of the One Health approach. 12
  83. 83. Prevalence of intestinal parasitic infections in humans. Zipporah Gitau, MSc student, University of Nairobi Contributing authors: Erastus Mulinge, Eberhard Zeyhle, Jackson Mpario, Tabitha Irungu, Joyce Nyambura, Japhet Magambo, Malika Kachani, David O. Odongo
  84. 84. Introduction • Parasitic worms are of major public health importance. • Globally, 3.5 billion affected. • Focus: intestinal parasites: soil-transmitted helminths, Schistosoma, protozoa. • Common in areas with poor sanitation and hygienic practices. • Transmission: fecal-oral, food, water, insects and animals (zoonotic). • Control: WHO Global Strategy is based on regular deworming.
  85. 85. National school-based deworming Program in Kenya • Begun in 2012. • Aim: reduce infection and associated morbidity. • Main target: areas with high worm infections. • Challenges • Deworming does not protect children from re-infection. • School-based rather than community treatment. • Drug resistance. • Environmental contamination. • Importance of Animal- Human transmission
  86. 86. Materials and methods • Recruitment of participants • Fecal sample collection • Sample processing
  87. 87. Results: Prevalence of intestinal parasitic infections among the community Intestinal Parasites Helminths Formal ether concentration method Kato-Katz technique Trichiuris trichiura 111 (28.3%) 125 (30.4%) Ascaris lumbricoides 20 (5.1%) 18 (4.4%) Ancylostoma duodenale/Nectar americanus 5 (1.3%) 6 (1.5%) Hymnelopsis nana 4 (1.0%) 1 (0.2%) Taenia spp. 1 (0.3%) 2 (0.5%) Strongyloides stercoralis 1 (0.3%) 0 Protozoa Entamoeba histolytica/dispar/moshkovskii 130 (33.2%) 0 Entamoeba coli 96 (24.5%) 0 Giardia lamblia 40 (10.2%) 0 Iodamoeba butschlii 32 (8.2%) 0 Chilomastix mesnili 4 (1.0%) 0 Total parasites count 444 152 Total population sampled 392 411 Total population infected 226 132 Overall Prevalence of intestinal parasites 57.65% 32.12%
  88. 88. Prevalence by age and gender Age group ( years) Total sampled Positive males Positive females Positive (%) 2-4 59 10 9 32.2 5-14 208 48 45 44.71 15-24 54 3 7 18.52 25-39 46 1 6 15.22 >40 44 1 5 13.64 Total 411 63 (15.33%) 72 ( 17.52%) 32.85 • Infections were generally more prevalent in females than males, 17.52% and 15.33% respectively. • Age groups between 5-14 years were more infected 44.71%. • Infections decrease with age.
  89. 89. Discussion and recommendation • The high prevalence of intestinal protozoan infections suggests poor water, sanitation and hygiene conditions. • The high prevalence of helminth infections among the non-targeted population requires a greater focus of interventions. • The presence of Taenia spp. confirms the occurrence of zoonoses in the community. It is recommended that the entire community is included in a comprehensive helminth and protozoan control program.
  90. 90. Knowledge, Attitude, and Practices relating to risk factors for zoonotic diseases in the Oloisukut Conservancy: A One Health Approach Christina Trabanco, Western University of Health Sciences Contributing authors: Deanna Overton, Eberhard Zeyhle, Erastus Mulinge, Peter Gathura, Jackson Mpario, Fanglong Dong, Japhet Magambo, Malika Kachani
  91. 91. Materials and Methods • 15 households out of 109 included in final analysis. • One Health Approach and Participatory Epidemiology used to collect data about people, animals and their environment. • Goals • Highlight the major risk factors and dire needs that perpetuate the transmission of 7 neglected zoonotic diseases prioritized by WHO and ZDU. • Understand the cultural norms specific to conservancy residents. • Tailor culturally sensitive and sustainable control strategies that will be recommended for implementation at the local level. • Knowledge, Attitudes and Practices (KAP) surveys assessed the degree of: • Knowledge of zoonotic diseases, transmission, treatment, and prevention. • Attitudes towards zoonotic diseases. • Practices or general behaviors that impact the risk of exposure.
  92. 92. 0 2 4 6 8 10 12 14 16 Number of participants Zoonotic diseases Knowledge of zoonotic diseases Do you know it? Does it affect people? Does it affect animals? Knowledge, Attitude, and Practices Survey
  93. 93. Focus Group Discussion (an example) • Coenurus cerebralis / Taenia multiceps larvae (Ormilo): disease that many pastoralists were concerned about and dealt with. • An adult goat presented with clinical signs: • Isolation from the herd • Circling, ataxia • Necropsy conducted, with permission of owner. • Parasite shown to community members. • Members were educated on the route of transmission and the prevention measures, including not feeding brains to dogs. Coenurus cerebralis cyst found in the brain of a goat. The community was educated on the transmission factors and prevention measures
  94. 94. Disease transmission / prevention • Rabies: close contact with dogs • Anthrax: eating infected meat • Tuberculosis: and Brucellosis: drinking raw milk • Sleeping sickness: tsetse flies brought by elephants • Cystic echinococcosis: infected dogs and infected meat • Foot and Mouth Disease: wildlife • Malignant Catarrhal Fever: wildebeests • East Coast Fever: ticks/wildlife Vaccines dewormers health education water health center
  95. 95. Conclusion • Limited awareness of zoonotic diseases. • Limited understanding of transmission routes. • Most familiar with rabies and diseases that affect livestock production: TB, brucellosis. • Improper water, sanitation, and hygiene practices, cohabitation with animals, and presence of wildlife increase risks of transmission. • Factors that contribute to perpetuating diseases: • Lack of access to clean water • Lack of health education • Lack of access to health care • Lack of access veterinary health care • Lack of access to education (adults, children) • This pilot study provided baseline data and identified adapted control measures for the implementation of sustainable interventions. • The proposed combination of the One Health approach and the participatory epidemiology could be used in other pastoral communities for disease control and prevention.
  96. 96. Community projects initiated • Rain-water harvesting to provide a continuous water supply. • Ministry of Water pledged to assist in the construction of additional dams. • The County Director of Health deployed a clinical officer, a lab technician and provided additional equipment and supplies to the local health center. • The County Veterinary Services implemented vector control programs and selective livestock breeding programs to increase meat and milk yield. • Veterinary officer made available and livestock vaccination implemented. • Local agrovet company planned a certified veterinary drug depot. • Community recommended implementation of preventive measures against predators: protective fences and lion lights. Intersectoral collaboration and the community participation were crucial to the implementation of these interventions
  97. 97. Acknowledgments • Jackson Mpario, Director Conservancy • County Director of Health, Narok • County Director of Veterinary services, Narok • Ministry of Water, Narok County • All those who helped make this research possible including: • Household heads in the Oloisukut Conservancy • Officers of the conservancy including Bernard Sankale, Leonard Kinanta, and Charles Ntiayai • Staff at the University of Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI) • Tonny Teya and Mathews Mutinda, KEMRI
  98. 98. Thank you
  99. 99. Reflective session and reactions on Menti Dr Nicholas Bor
  100. 100. ‘What is One Health Research and how can we do it better? A round table discussion’ Panelists: Prof Eleanor Opondo, Dr Jeanette Dawa, Prof Salome Bukachi, Dr JasonSircely and Prof Eric Fevre Moderator: Dr Ekta Patel
  101. 101. END of Day 1 See you tomorrow

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