An Overview of Quantitative Aspects of Epidemiology in Animal Disease Control in Kenya
1. An Overview of Quantitative
Aspects of Epidemiology in
Animal Disease Control in Kenya
Prepared by: Dr. Momanyi Kelvin Nyariaro
Msc One Health student at the University of
Edinburgh
Contact: momanyink@gmail.com
June, 2015
3. Introduction: Kenyan context(VS)
Definition: Quantitative epidemiology
Veterinary service delivery system in Kenya:
- Directorate of Veterinary Services = PVS
pathway [Trained workforce, diagnostic
capacity, containment & policy]
- Role of other institutions in surveillance e.g.
ILRI, NGOs, Universities, ZDU
- Subscription to WTO Agreement on SPS
(1995)
Image source: http://zdukenya.org/
4. Aspect 1: Monitoring and Surveillance
Approaches:
- Active surveillance
- Passive surveillance
Disease focus:
- Targeted surveillance
- General surveillance
Other:
- Mobile syndromic
surveillance
- Outbreak investigation
Cattle blood sampling (brucellosis incidence study at Kajiado, Kenya;
Photo credit: Momanyi N.K)
Goat blood sampling (brucellosis incidence study at Kajiado, Kenya;
Photo credit: Momanyi N.K)
5. Aspect 2: Epidemiological and Diagnostic
surveys
• Epidemiological surveys
– Animal census/area tests
– Cross-sectional survey
– Longitudinal survey
• Diagnostic surveys
– Strategic animal screening
Mapping Value chains to assess emergence and transmission of
zoonotic diseases; Photo credit: ZED group
PAZ Project-screening goats for brucellosis;
Photo credit: ZED group
Cross border census in the
Amboseli-
Kilimanjaro/Magadi-
Natron Conservation
Area;
Photo source:
http://www.kws.org/info/
news/2013/24april2013ta
nzania.html
6. Aspect 3: Disease tracking, DFZs and
prophylaxis
• Systems for disease tracking
– Geographical Positioning Systems
– Mobile systems
• Prophylaxis
Source: http://www.lidc.org.uk/news/maasai-vets-carry-out-disease-surveillance-86000-animals-google-
mobile-phones
Mass vaccination of rabies;
Photo credit: ZDU
Spraying to control tick-borne infections;
Photo credit: ZED group
7. Aspect 4: Participatory Disease
Surveillance (PDS)
PDS applied in a value chain study in Nairobi;
Photo credit=ZED group
Definition: What is PDS?
Examples
- PE in pastoral areas
- Urban Zoo study (value chain component)
- RVF in Kenya (new insights)
- Vet service change
- Cost effectiveness study
Benefits of PDS
Source: https://cgspace.cgiar.org/handle/10568/21736
8. Aspect 5: Disease modeling
• Definition: What is Disease modeling?
• Example: Prospective climate-based models
Source: http://www.slideshare.net/NanyingiMcNanyingi/perspectives-of-predictive-epidemiology-and-early-warning-systems-for-rift-valley-fever-in-garissa-kenya
9. Intervention areas: Kenyan context (VS)
• Reporting & communication
• Laboratory capacity & network
• Quarantine & isolation
• Early warning systems
• Community participation
• Resource mobilization
10. Conclusion: Take home message
There are many fully-unexploited surveillance and
disease control tools in Kenya
Disease control in Kenya is stratified i.e. some
areas have excellent surveillance and control e.g.
airport, cities etc. while others are marginalized
e.g. pastoral areas
BUT There is good progress
Editor's Notes
Personal introduction
Overview: This presentation will give a brief review of aspects of quantitative epidemiology that are most used in animal disease control in Kenya
Welcome audience
(30 words)
This presentation shall follow the following outline (read from slide)
VS – veterinary services
DFZs-Disease Free Zones
(19 words)
Definition : Thrusfield., 2007 definition=expression and analysis of numerical values of disease in populations
DVS: Elaborate on the PVS pathway:
Trained workforce [Veterinary surgeons (private & public), Para-vets, CAHWs (very significant in marginalized areas), Traditional healers (still important in remote marginalized areas)
Diagnostic facilities [5 regional vet labs= mention some challenges]
Containment [Kabete vet lab = BSL2]
Policy [Animal Health, Welfare and production governed by 26 pieces of legislation e.g.]
New Veterinary policy document draft (GoK., 2015)
Veterinary surgeons and veterinary paraprofessionals Act 2010
Meat inspection Act
Branding Act
Public health Act etc.
Mention the bottom-up reporting system (hierarchy)
Highlight the integral role played by NGOs (through CAHWs), ILRI (research), Universities (vaccination campaigns), ZDU (One Health approach)
SPS agreement: Upheld by the Kenyan constitution (GoK., 2010) and Kenya vision 2030 (GoK., 2007)
Disease Free Zones as flag project for Kenya vision 2030 [first Coast DFZ covering Kilifi, Mombasa & parts of Taita-Taveta and Kwale]
Targeted disease for control and/or eradication = CCPP, RVF, PPR, FMD, CBPP, CCPP, & BSE
(185 words)
References
GoK-Government of Kenya (2015). Veterinary Policy draft, Ministry of Agriculture, Livestock and Fisheries. Accessed from http://www.kilimo.go.ke/, Accessed on 25-5-2015-1051hrs
Thrusfield M. (2007) Veterinary Epidemiology, third edition. Blackwell Science Ltd, a Blackwell publishing company. ISBN: 978-1-405-15627-1. Chapter 2, Page 43
GoK (Government of Kenya) (2010). The Constitution of Kenya, Government Printers, Nairobi, available at: http://kenyalaw.org/k1/index.php?id=398, Accessed on 5-4-2015
GoK (Government of Kenya) (2007) Ministry of Planning and National Development: Kenya Vision 2030
Active surveillance:
Define (FAO., 2014)
Illustrations:
Cross-sectional study of seroprevalence & risk factors for brucellosis in human & animals in Kajiado and Kiambu counties (Ogola et al., 2013)
Active surveillance of priority & notifiable diseases in Kenya e.g. sampling of animals before moving from endemic areas for: CCBP, CCPP, FMD, PPR, LSD, Camel pox & Trypanosomiasis
Passive surveillance:
Define and elaborate on the aspects of passive surveillance (FAO., 2014)
Illustrations: Peripheral PH/Vet services; PH labs; Border health/vet services; clinics/vets/medical personnel
Targeted surveillance:
Define & differentiate it from risk-based surveillance (brucellosis incidence as example)
Tests used = PCR, ELISA
General surveillance:
Syndromic surveillance (Thumbi et al., 2015) and meat inspection which can detect several diseases &/or associated factors
Mobile syndromic surveillance:
Define & illustrate using study by Walker et al., (2011) = Piloting mobile phone-based syndromic surveillance of livestock disease in Kenya
Outbreak investigations
Initiated by cell phone call, radio announcement or word of mouth, then to epidemiologic unit
Example: 2007 RVF outbreak in Kenya (Munyua et al., 2010); highlight the association of rains and RVF outbreaks
Mention the ZDU outbreak website page
(195 words)
References
FAO. (2014). Risk-based disease surveillance – A manual for veterinarians on the design and analysis of surveillance for demonstration of freedom from disease. FAO Animal Production and Health Manual No. 17. Rome, Italy.
Munyua P., Murithi R.M., Wainwright S., Githinji J., Hightower A., Mutonga D., Macharia J., Ithondeka P.M., Musaa J., Breiman R.F., Bloland P., Njenga M.K. (2010). Rift Valley Fever outbreak in livestock in Kenya, 2006-2007, Am J Trop Med Hyg. 2010 Aug;83(2 Suppl): 58-64. doi: 10.4269/ajtmh.2010.09-0292
Ogola E., Thumbi S., Osoro E., Munyua P., Omulo S., Mbatha P., Ochieng L., Marwaga D., Njeru I., Mbaabu M., Wanyoike S. and Njenga K. (2013). Sero-prevalence of brucellois in humans and their animals: A linked cross-sectional study in two selected counties in Kenya. International Society of Disease Surveillance 2013 Conference Abstracts
Thumbi S.M., Njenga M.K, Marsh T.L., Noh S., Otiang E., Munyua P. (2015) Linking Human Health and Livestock Health: A “One Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities, PloS ONE 10(3): e0120761. doi: 10.1371/journal.pone.0120761
Walker J.G., Ogolla E. and Knobei D. (2011) Piloting mobile phone-based syndromic surveillance of livestock disease in Kenya, Epidemiologei et Sante Animale 2011 No. 59/60 pp.19-21
Epidemiological survey:
Define (Thrusfield., 2007) = examination of an aggregate & characteristics
Illustration: Disease levels, production level etc.
Animal census:
Define (Thrusfield., 2007)
Purpose: To advice policy makers (IGAD., 2013)
Illustration: Cross-border report by the Kenya-Tanzania joint wildlife census (KWS., 2010)
Cross & longitudinal surveys
Define terms (Thrusfield., 2007)
Longitudinal study illustration:
2006-2007 Infectious Diseases of East African Livestock (IDEAL) project in western Kenya (Bronsvoort et al., 2013)
PAZ project in western Kenya (Fevre., 2013) & Urban Zoo project
Cross-sectional study illustration: Urban leptospirosis in Kibera area (Halliday et al., 2013)
Mention the new funded Zoonoses and Emerging Livestock Systems (ZELS)-ZooLink project in western Kenya schedule to start late 2015 (BBSRC., 2015)
Diagnostic surveys
Define strategic animal screening (Thrusfield., 2007)
Illustration: Trypanosome cattle screening cattle study in Suba and Teso districts in Kenya (Thumbi et al., 2010)
(150 words)
References
BBSRC (2015) Zoonoses and Emerging Livestock Systems (ZELS)-Reducing the risk to livestock and people. Research Programme bronchure 2014. Accessed online at http://www.bbsrc.ac.uk/funding/opportunities/2012/zoonoses-emerging-livestock-systems/, accessed on 25-5-2015-1253hrs
Bronsvoort M.B., Thumbi M.S., Poole J.E., Kiara H., Auguet T.O., Handel G.I., Jennigs A., Conradie I., Kariuki N.M., Toye G.P., Hanotte O., Coetzer J., and Woolhouse M. (2013). Design and descriptive epidemiology of the Infectious Disease of East African Livestock (IDEAL) project, a longitudinal calf cohort study in western Kenya. BMC Veterinary Research 2013, 9:171 doi: 10.1186/1746-6148-9-171
Fèvre. E.M. (2013). A framework for understanding zoonoses at the livestock-human interface in western Kenya. Presentation at a Workshop: An Integrated Approach to Controlling Brucellosis in Africa, Addis Ababa, 29-31 January 2013. Edinburgh, UK: University of Edinburgh and Nairobi, Kenya: ILRI
GoK (2009) Kenya Population and Housing Census-2009, Kenya National Bureau of Statistics. Accessed online at http://www.knbs.or.ke/index.php?option=com_phocadownload&view=categories&Itemid=599, Accessed on 24-5-2015-1625hrs
Kenya Wildlife Society-KWS (2010) Amboseli-West Kilimanjaro and Magadi-Natron cross border landscape-Aerial total count report. Kenya wildlife service and Tanzania wildlife research institute. Accessed online at Amboseli_West_kili_Magadi_Natron_2010_census_report, Accessed on 24-5-2015-1700hrs
Halliday B.E., Darryn L., Knobel., Kathryn J., Allan., Mark B., Bronsvoort C., Handel I., Agwanda B., Cutler J., Olack B., Ahmed A., Hartskeerl A., Kariuki N.M., Cleaveland S. and Breiman R. (2013) Urban Leptospirosis in Africa: A Cross-Sectional Survey of Leptospira Infection in Rodents in the Kibera Urban Settlement, Nairobi, Kenya. Am. J. Trop. Med. Hyg., 89(6), 2013, pp. 1095–1102 doi:10.4269/ajtmh.13-0415
IGAD (2013) The contribution of Livestock to the Kenyan Economy, Policy Brief: IGAD Centre for Pastoral Areas & Livestock Development, Policy No. ICPALD 4/CLE/8/2013.
Thumbi M.S., Jung’a O.J., Mosi O.R., McOdimba A.F (2010) Spatial distribution of African Animal Trypanosomiasis in Suba and Teso districts in Western Kenya. BMC Research Notes 2010, 3:6
Introduction
Branding of Stock Act, Cap 357 = not compliant with OIE international standards
GPS:
Define = space based satellite navigation providing information on location and time
Illustration: Study by Thomas et al., (2013) tracking free range domestic pigs in western Kenya =new insights into dynamics of disease transmission
Mobile systems:
Define
Illustration: Mobile phones allow Kenyan farmers and veterinarians to issue quick alerts of possible disease outbreaks and track vaccination campaigns (FAO., 2013)
Prophylaxis:
Target/mass vaccination against rabies, FMD, CBPP, CCPP, LSD etc and free animal spraying to control tick-borne infections (PAZ project in western Kenya)
Complements trans-boundary disease control efforts
Emphasize the importance of vaccination as the cheapest and most effective method of animal disease control (GoK., 2014; Lubroth et al., 2007)
Also evoke Bill Gates statement on vaccination of people as their “Big bet for the future” (Bill & Melinda Gates., 2015)
Disease Free Zones
Disease Free Zones as flag project for Kenya vision 2030 [first Coast DFZ covering Kilifi, Mombasa & parts of Taita-Taveta and Kwale]
Targeted disease for control and/or eradication = CCPP, RVF, PPR, FMD, CBPP, CCPP, & BSE
(196 words)
References
Bill and Melinda Gates (2015). Our Big Bet For The Future, 2015 Gates Annual Letter Accessed online at http://www.gatesnotes.com/2015-annual-letter, accessed on 25-5-2015-1310hrs
GoK-Government of Kenya (2014) Strategic plan for the elimination of human rabies in Kenya 2014-2030, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries
Fèvre. E.M. (2013). A framework for understanding zoonoses at the livestock-human interface in western Kenya. Presentation at a Workshop: An Integrated Approach to Controlling Brucellosis in Africa, Addis Ababa, 29-31 January 2013. Edinburgh, UK: University of Edinburgh and Nairobi, Kenya: ILRI
Lubroth J., Rweyemamu M.M., Viljoen G., Diallo A., Dungu B., and Amanfu W. (2007). Veterinary vaccines and their use in developing countries. Rev. sci. tech. Off. Int Epiz, 2007, 26(1), 179-201
Thomas L.F., de Glanville W.A., Cook E.A. and Fevre E.M (2013) The spatial ecology of free-ranging domestic pigs (Suis scrofia) in western Kenya. BMC Veterinary Research 9: 46. doi: 10. 1186/1746-6148-9-46
Define: Systematic use of participatory approaches and methods to epidemiological research and disease surveillance (Jost et al., 2007)
Examples
PE in pastoral areas to learn their practical knowledge of animal disease problems (Kimondiu, Buono & Kiboye., 2015)
Urban Zoo study= Mapping Value chains to assess emergence and transmission of zoonotic diseases;
RVF in Kenya - PDS has increased (Mariner et al., 2011)
Number of cases detected
Knowledge of the range and risks associated with disease (Mariner et al., 2011)
Vet service change
- Deployment of PDS practitioners as a first line of response for investigating potential disease emergencies in Kenya
Benefits: (Mariner et al., 2011)
Increased number of cases detected
Increased range and risk associated with disease
Contributes to strategy and policy reform
Cost effective relative to passive surveillance
Results to more acceptable surveillance systems and control programmes
Effective driver for institutional change (focuses Veterinary Services on the needs and priorities of farmers)
(168 words)
References
Mariner J.C., Hendrickx S., Pfeiffer D.U., Costard S., Knopf L., Okuthe S., Chibeu D., Parmley J., Musenero M., Pisang C., Zingeser J., Jones B.A., Ali S.N., Bett B., McLaws M., Unger F., Araba A., Mehta P., Jost C.C (2011). Integration of participatory approaches into surveillance systems. Rev. sci. tech. Off. int. Epiz., 2011, 30 (3), 653-659
Hannah H., Kimani T., Irungu P., Grace D., and Randolph T. (2012). Participatory disease surveillance: Cost effectiveness relative to passive surveillance in Kajiado County, Kenya. Poster prepared for the 31st conference of the International Society for Veterinary Epidemiology and Economics, Maastricht, the Netherands, 20-24 August 2012. nairobi, Kenya: ILRI
Jost C.C., Mariner J.C., Roeder P.L., Sawitri E. and Macgregor-Skinner G.J (2007). Participatory epidemiology in disease surveillance and research. Rev. sci. tech. Off. int. Epiz., 2007, 26 (3), 537-547
Kimondiu S., Buono N., Kiboye M. (2015). Participatory Epidemiology: Approaches, Methods, experiences in Pastoral Areas in Northern Kenya.
Definition: Use of mathematical equations to predict the effect of a control strategy
Examples:
Prospective climate-based models recently developed that flag areas at risk of RVFV (Britch et al., 2013)
Has not been possible to estimate the predictive reliability and/or precision of weather forecasting models for RVF (Millstone, Odame & Okumu., 2015)
Highlight that this is an area still under exploration in Kenya
(68 words)
References
Britch S.C., Binepal Y.S., Kariithi H.M., Linthicum K.J., Anyamba A., Small J.L., Tucker C.J., Ateya L.O., Orko A.A., Gacheru S., and Wilson W.C (2013). Rift valley fever risk map model and seroprevalence in selected wild ungulates and camels from Kenya. PLoS One. 2013 jun 28;8(6) :e66626, doi: 10. 1371/journal.pone.0066626. Print 2013
Millstone E., Odame H. & Okumu O., (2015). Rift valley fever in Kenya: Policies to prepare and respond, STEPS Working Paper 82, Brighton: STEPS Centre
Remember to Highlight challenges at each intervention area
Strengthen reporting & communication from facilities to counties/central epidemiologic unit.
Strengthen laboratory capacity & network
Increase quarantine & isolation facilities
Increase early warning systems for epidemic preparedness & response
More involvement of communities in surveillance
Resource mobilization to strengthen surveillance & support epidemic response
58 words
Remember to thank them for their attention and welcome any questions
(11 words)