What is killing my cow? Re-assessing diseases in smallholder dairying in Tanzania
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Item One Health ethics: The need for policy before research and action(Poster, 2016-12-07) Cooper, Tarni L.; Kirino, Y.; Alonso, Silvia; Lindahl, Johanna F.; Nga T.H. Le; Grace, DeliaOne Health implies a strong emphasis on ethics, recognising the interdependent relationships of humans, animals and the environment. We argue that the universal ethical principles for human-subject research, presented in the Belmont report as Respect for Persons, Beneficence and Justice, should be applied to custodians of animals and the environment. Drawing on published and unpublished research, we highlight the challenges and opportunities of this approach in practice and policy. Respect for Persons is demonstrated through informed consent. We describe the high rate of consent received in livestock research projects, raising questions around legitimacy, and outline a study to improve comprehension and engagement in the informed consent process for livestock keepers. Beneficence dictates that benefits to research participants are maximized. We outline how a long-term impact assessment was designed with intrinsic value for farmers, using participatory photography. Additionally, we describe efforts towards non-maleficence through providing participants with research board contacts. We provide new data on low contact-rates and discuss possible causes. Justice requires that research risks and benefits are distributed equally. We show how the requirement to sign written consent forms may preclude those working in informal livestock markets from participating in, and therefore sharing risks and benefits of research projects.Item Risk assessment of Q fever infection in cattle keeping pastoralist households in Kajiado County, Kenya(Thesis, 2016) Peter, N.K.Q fever (Coxiella burnetii) is an old zoonotic disease, believed to be widely present in ruminant populations worldwide. It is an occupational disease and like many animal diseases, farm management practices are likely to have a direct impact on the presence and spread of Q fever within and between herds and to humans. The current study was conducted to assess the health risk associated with Q fever infection in pastoralist households in Kajiado County, Kenya. The study carried out was specifically: 1) to identify potential exposure pathways for Q fever infection to pastoralist household members and; 2) to estimate risk associated with Q fever infection in pastoralist individuals through the identified pathways in households with infected cattle. Data for the risk assessment were obtained from literature and a parallel sero-prevalence study conducted in three locations in Kajiado County, namely, Namanga, Mashuru, and Ngong’. These study sites were purposively selected for the study based on the availability of livestock at the time the study was conducted in the month of November to December 2013. Selection of cattle in the selected locations depended on availability of pasture and water and information provided by the local veterinarian personnel. A two-stage sampling method was used to select the villages with cattle herds in the selected locations. Eighty-four cattle herds were randomly selected in the three locations. A structured questionnaire was administered to household heads via personal interviews to collect data on their livestock management practices. Data collected on livestock management practices were used to identify the transmission pathways for Q fever infection to pastoralist household members. A qualitative risk assessment was carried out to assess the health risk associated with Q fever using the Codex Alimentarius Commission framework, which comprises of hazard identification, hazard characterization, exposure assessment and risk characterization. Two major transmission pathways, inhalation and ingestion, were identified. An event tree was constructed to show steps in the potential pathways that lead to human exposure to the pathogen, Coxiella burnetii, which causes Q fever. A risk assessment was then performed using data from the household questionnaire and secondary data from literature and other sources. The potential exposure pathways were identified including: Inhalation pathway through assisting during a reproduction event and without protection; Inhalation pathway through not cleaning/disinfecting boma/site after a reproduction event; Inhalation pathway through accumulation of animal waste/using it in the farm; and Ingestion pathway through consumption of contaminated raw milk. Risk associated with Q fever infection by pastoralist household through the identified pathways in households with infected cattle was estimated as: high in inhalation pathway through assisting during a reproduction event and without protection, and through not cleaning/disinfecting bomas/calving sites after a reproduction event; medium in inhalation pathway through accumulation of animal waste; and high, medium and low for Namanga, Mashuru, and Ngong, respectively, in ingestion of contaminated raw milk. Poor hygiene (self and that of the environment), ingestion of unpasteurized milk and its products and handling/assisting in any reproduction event without protection were among the identified steps through which the household members were exposed to the pathogen. It is recommended that awareness of the disease Q fever among pastoralists should be enhanced. This will promote reduction of environmental contamination, pathogens spread and limit the risk to the public. The community should be educated on the various symptoms of the disease and the control measures that they can practice to reduce exposure to Coxiella burnetii.Item Socio-economics and perceptions of Q-fever infection in a pastoralist system of Kajiado County(Thesis, 2016) Oboge, H.M.Q fever is a zoonotic disease caused by Coxiella burnetii which is ubiquitous in nature and it poses a substantial public health concern. Q fever has a potential to cause detrimental effect on human health and its effect can translate to substantial economic losses in affected households. Livestock is the main source of infection in humans. The overall objective of this study was to evaluate the need for surveillance of Q-fever infection within pastoral systems by the relevant health systems in Kenya. The specific objectives were first to describe the knowledge and perception of pastoralist in Kajiado County on the common infectious diseases affecting them and second to estimate the socio-economic impact of Q fever infection in pastoralist households. The study was conducted in the month of May and June 2015 in Namanga, Mashuru and Ngong sub counties of Kajiado County. Seven focus group discussions were conducted with pastoralists and nine key informant interviews were held at the local health facilities with the health workers in-charge by use of interview guides. Data was collected on diseases that affected household members; their perception on the most prevalent diseases; household members response when one is sick; average medical costs incurred for treatment for each of the common infectious diseases; their knowledge of Q fever. Pairwise ranking and scoring methods were used to determine the most common diseases affecting the community. Additionally, data was collected from secondary sources on prevalence of Q fever in humans, cattle, goats and sheep; household monthly incomes; estimated outcomes of primary Q fever infections in humans. Data which was obtained from focus group discussions were used to rank prevalent diseases based on the scores given by pastoralists. Further statistical analysis was done using Kruskal-Wallis one-way analysis of variance to determine if there was a significant difference in the mean ranks of diseases across the focus group discussions held with pastoralists/farmers and key informant interviews held with health workers. The economic cost of Q fever infection in humans was estimated using a deterministic model which was developed in Microsoft Excel spreadsheet. The estimation of economic cost was based on the reported prevalence of Q fever infection among pastoralist households, average monthly incomes, average treatment costs and the number of days’ people stayed away from work due to illness with Q fever. From the focus group discussions with pastoralists, common cold and malaria were prioritized as the most prevalent disease, while pneumonia, malaria, upper respiratory tract infections and typhoid fever were prioritized by health workers as most common diseases. Both the pastoralists and clinicians had no knowledge of Q fever infection amongst household members. Based on previously estimated prevalence of 26% of Q fever in pastoral systems from secondary sources, the economic impact of Q fever infection in a typical pastoralists household was estimated to be Ksh 4,600 per month. The indirect costs attributed to the number of working days lost were greater than the direct costs such as treatment and transport. Q-fever infection is therefore an important febrile disease in humans and more efforts should be put into increasing its awareness among health workers and pastoralist. Therefore, there is need for surveillance of Q fever infection within pastoral systems by the relevant health delivery systems in Kenya. This can be made possible through combined efforts of pastoralist, veterinarians, health workers, environmental scientists and the government.Item What is killing my cow? Re-assessing diseases in smallholder dairying in Tanzania(Report, 2016-03-31) International Livestock Research InstituteItem Je, nini kinachoua ng’ombe wangu? Visual aid for seeking informed consent on ‘What is killing my cow?’ project, Tanzania(Poster, 2014-03) Cooper, Tarni L.; Wakhungu, Judi W.; Hall, T.Item Towards better-informed consent: Research with livestock-keepers and informal traders in East Africa(Journal Article, 2016-06) Cooper, Tarni L.; Kirino, Y.; Alonso, Silvia; Lindahl, Johanna F.; Grace, DeliaWith the rise of the One Health paradigm, ethicists have called for new research approaches, considering the interdependent relationships of humans, animals, and their environment. These relationships can be particularly complex within resource-poor, smallholder livestock systems, necessitating a rigorous informed-consent process. Little has been published on informed consent beyond human-subject research. This paper outlines two studies on informed consent, for research identifying diseases of animal and human importance, within smallholder livestock value chains.Firstly, a randomized independent-group study compared three communication tools (written, cartoons, and photographs) for informing 22 Tanzanian livestock-keepers before seeking their consent.A significant difference in comprehension and engagement in the informed-consent process was found between tools, and cartoons had the highest (i.e. best combined comprehension and engagement) scores.Most (21 out of 22) farmers answered half or more the questions correctly, but none were able to answer all questions. Comprehension testing allowed identification of common misunderstandings, such as immediate benefits the farmers would receive and the process to be used for relaying research results.Dialogue stimulated by cartoons and photographs allowed researchers to determine and respond to participants’ varied relationships with their livestock.The second study assessed preferred methods for indicating consent among informal-sector milk vendors in Nairobi, Kenya. Of consenting participants, 61% (140/230) indicated consent verbally, 39% (90/230)signed consent and none chose thumbprint. There was a significant enumerator-effect on both overall consent and the methods chosen.Several of these findings echo those published in human-medical research. Additionally, highlighted here is the importance of facilitating dialogue during the informed-consent process in One Health research, for a more nuanced understanding of relationships between humans, animals, and their environment. Also discussed is how a requirement to sign consent forms might limit consent among workers in informal markets, which are commonly studied in One Health research. We suggest expansion of these, and development of further, studies towards improving consent processes in One Health research.Item Cattle diseases in dairy herds in Tanzania: Farmers’ view and laboratory confirmation(Presentation, 2015-09-16) Alonso, Silvia; Unger, Fred; Toye, Philip G.; Jores, Joerg; Wakhungu, Judi W.; Msalya, G.; Grace, DeliaCattle diseases remain a major constraint to increasing dairy productivity in Tanzania, by killing or keeping them sick and under-producing. Recent studies report overall mortality between 12 and 14 % in smallholder dairy cattle across different regions of Tanzania. Many of these diseases can also be transmitted to people, causing illness and/or even death. Existing information on the diseases affecting dairy cattle in Tanzania and their relative importance is limited and relies either on passive reporting by poorly resourced veterinary services or on localised surveys focused on a specific well known diseases. The causes of cattle diseases remain often unknown and differential diagnosis is not conducted leading to mistreatment or ineffective treatment. Addressing this concerns a survey was conducted among cattle farmers in two regions in Tanzania using participatory techniques to collect information on disease importance supported by laboratory investigations on commonly expected cattle pathogens but also those seldom looked for but known to be important in other regions. For this purpose blood samples were collected from cattle (n=402) reported by farmers to be sick and subjected to a range of tests (ELISA) including tick borne diseases, selected zoonoses (brucellosis, Q Fever), infectious bovine rhinotracheitis, bovine viral diarrhea (BVR) and bovine respiratory syncytial virus (BRSV) among other pathogens. Biological sampling was aligned with data collection on farm and diseases management. Results indicate that diseases are common for the region. Among those most prominent were East Cost fever and Anaplasmosis (32 % each). Also important zoonoses were found (e.g. Brucellosis, 11 %). High numbers of positive tested sera were also reported for pathogens commonly not tested for (e.g. IBRV). Preliminary results suggest discrepancies between laboratory results (tested positive sera) and farmer’s perceptions on specific diseases. While for East Cost Fever farmer’s perception on disease importance confirmed laboratory results (37 % versus 32 %) we found a discrepancy for brucellosis (1 % versus 11 %), a neglected zoonoses with the potential of causing chronic, long lasting diseases in humans. Implications of farming management practices on the presence/absence of certain pathogens are currently developed and part of ongoing dissemination efforts.Item Ancient farming styles and old zoonoses: Brucellosis and Q fever among pastoralist and smallholder cattle herds in Tanzania(Poster, 2015-10-07) Alonso, Silvia; Msalya, G.; Toye, Philip G.; Grace, Delia; Unger, FredItem Smallholder dairy farming in Tanzania: Farming practices, animal health and public health challenges and opportunities(Poster, 2014-10-27) Alonso, Silvia; Toye, Philip G.; Msalya, G.; Grace, Delia; Unger, FredSmallholder dairy farming is seen as a viable and promising activity to support the livelihoods of cattle keepers in low-income countries. This farming system, characterized by small herds of improved cattle raised under zero-grazing, is proven to lead to better milk yields, but also to require more constant and demanding inputs and resources to sustain production. Moreover, endemic diseases and the poor knowledge on disease control by farmers, along with the limited availability of veterinary services, presents challenges for effective farming. We conducted a cross-sectional survey among smallholder dairy farmers in Tanzania to understand the farm management practices, animal health, access to veterinary services and knowledge and attitudes towards public health of farmers. We aimed to understand the challenges being faced by farmers and the opportunities to overcome these. In addition, we collected blood samples from sick animals for screening for a range of cattle diseases. Milk production was found to be suboptimal, with only few lactating animals in each herd and average milk yields of 9 litres per day. Cattle diseases were an important threat to farmers, but they lacked knowledge and capacity on disease prevention and control. Farming and milk harvesting practices were in general acceptable, but farmers had very poor knowledge on zoonoses and on practices that can mitigate milk contamination. Improvements on farming practices could be made to limit public risk of direct and milk-borne disease transmission to farmers and consumers.Item Pastoralism in Kenya and Tanzania: Challenges and opportunities in animal health and food security(Poster, 2014-10-27) Wakhungu, Judi W.; Wesongah, J.; Tura, G.; Msalya, G.; Grace, Delia; Unger, Fred; Alonso, SilviaPastoralism is used to describe a society that derives majority of their food and income from livestock. This form of farming system is largely practised in the arid and semi-arid lands (ASAL). It is estimated that 70% of the landmass in the Horn of Africa is dry land; in Kenya 80% of the landmass is classified as ASAL, while approximately half of Tanzania consists of dry land. These dry lands support wild resource harvesting, tourism but most importantly livestock rearing. It is estimated that over 75% of cattle herds in Kenya and 90% in Tanzania are kept by pastoralists who supply the bulk of meat consumed in the countries. In this paper we present current animal health challenges and opportunities being faced by pastoral farmers in Tanzania and Kenya based on primary data collected in Kajiado County, Kenya and Tanga and Morogoro regions in Tanzania. In the midst of many challenges and opportunities, food safety and food security are never assured amongst the pastoralists. We highlight pastoral community high livestock dependency for food and income, market access to livestock products, access to animal and human health services, livestock-wildlife interaction, factors that hinder increase of livestock assets and explore the knowledge of disease and exposure to zoonoses within the pastoral community.Item The known and the unknowns: A multipathogen survey to identify diseases in cattle herds in Tanzania(Poster, 2014-09-17) Alonso, Silvia; Toye, Philip G.; Jores, Joerg; Wakhungu, Judi W.; Msalya, G.; Grace, Delia; Unger, Fredcapacity and infrastructure of government services for disease identification and control are often limited. In the absence of systematic surveillance systems for animal diseases, the information on pathogens affecting livestock has been filled by targeted surveys conducted in certain locations and for specific conditions. The picture provided by these ad hoc surveys can be distorted with a bias towards the most widely known diseases or towards those for which diagnostic methods are more readily available. Participatory rural appraisals with cattle farmers in Tanzania revealed that disease in livestock is one of the main factors contributing to limited productivity and income generation. Often, the causes of livestock disease are unknown and differential diagnosis is not conducted resulting in mistreatment of animals and long-term negative economic impact. In response to this concern, a multipathogen survey was conducted among cattle farmers in two regions in Tanzania to (i) confirm the presence of wellknown cattle pathogens, and (ii) investigate the presence of cattle pathogens rarely looked for in the area before. Sick cattle (n=400) were actively searched among cattle herds and blood samples collected along with information on farming practices. ELISA diagnostic kits were used to detect antibodies against the following cattle pathogens: contagious bovine pleuropneumonia (CBPP), anaplasmosis, theileriosis (x2), babesiosis, brucellosis, Rift Valley fever, Q fever, neospora, infectious bovine rhinotracheitis, bovine viral diarrhea (BVR) and bovine respiratory syncytial virus (BRSV). The results of the survey will be presented. The relative presence of each of the studied pathogens will be presented and the characteristics of the farming populations and factors that may be associated with the relative presence discussed. Finally we will discuss the implications of farming management practices on the presence/absence of certain pathogens.Item Pastoralism: Animal health and food safety situation analysis, Kenya and Tanzania(Poster, 2014-09-17) Wakhungu, Judi W.; Wesongah, J.; Galgalo, T.; Msalya, G.; Grace, Delia; Unger, Fred; Alonso, SilviaPastoralism is a farming system in societies that derive majority of their food and income from livestock production. This form of farming system is practised in the world’s arid and semi arid lands (ASALs). It is estimated that 70% of the landmass in the Horn of Africa is dry land; in Kenya 80% of the landmass is classified as ASAL while approximately half of Tanzania consists of dry land. These dry lands can only be effectively utilised when used for livestock rearing, supporting wildlife resource harvesting and tourism. In this paper we present a current situation analysis of animal health and its implication on food safety based on primary data collected from pastoralists in Kajiado County, Kenya and in Tanga and Morogoro regions in Tanzania. Less than 10% of pastoralists in these communities engage in crop farming to supplement household income, and with their high dependency on livestock rearing, animal health challenges are a significant problem. We report on the livestock diseases with high prevalence and postulate their effects on food safety and food security in pastoral communities. We also explore the extent of species rearing diversification, pastoralist trade orientation, and practices that may expose the community and their trading partners to animal and zoonotic infections. We also assess access to animal health service providers within these pastoral areas and veterinary drug usage that may have significant implications on animal health and food safety.