The neglected zoonoses—the case for integrated control and advocacy

Assessment of Human Taeniasis and Other Intestinal Parasites in Narok County, Kenya

Data are sparse on the epidemiological picture of Taenia saginata taeniasis in Kenya. Infections are underreported, and their persistence nonetheless negatively impacts the beef industry. Populations vulnerable to taeniasis in the developing world are commonly burdened with other intestinal parasites, ubiquitous in unsanitary environments. This study aimed to estimate the occurrence of human taeniasis in Narok County, Kenya, and screen for the presence of other intestinal parasitic infections. A community-based survey was conducted in five pastoral wards, and stool samples, mainly from adults, subjected to multiple diagnostic tests. One sample tested positive for Taenia spp. by coproantigen enzyme-linked immunosorbent assay (0.3%, 95% CI, 0-1.6, n = 360), and all samples tested negative on multiplex copro-polymerase chain reaction targeting the cytochrome c oxidase subunit 1 gene and copromicroscopy. Microscopy (n = 361) additionally identified Entamoeba histolytica/dispar/moshkovskii at a prevalence of 15.5% (95% CI, 12.1-19.6), Giardia spp. at 5.3% (95% CI, 3.4-8.1), Hymenolepis spp. at 1.1% (95% CI, 0.4-2.8), and hookworm at 0.3% (95% CI, 0-1.6). Grazing livestock near the homestead (< 2 km) and a formal education background were associated with a reduced likelihood of Giardia spp. infection (AOR 0.07, 95% CI 0-0.36, p=0.011, and AOR 0.06, 95% CI 0.01-0.50, p=0.014, respectively). Our findings suggest a very low prevalence of human taeniasis in the population. The occurrence of other pathogenic zoonotic intestinal parasites highlights a public health concern and calls for a One Health approach in the enhancement of hygiene initiatives.

Countering Zoonotic Diseases: Current Scenario and Advances in Diagnostics, Monitoring, Prophylaxis and Therapeutic Strategies

Human life and health have interacted reciprocally with the surrounding environment and animal fauna for ages. This relationship is evident in developing nations, where human life depends more on the animal population for food, transportation, clothing, draft power, and fuel sources, among others. This inseparable link is a potent source of public health issues, especially in outbreaks of zoonotic diseases transmitted from animals to humans. Zoonotic diseases are referred to as diseases that are naturally transmitted between vertebrate animals and humans. Among the globally emerging diseases in the last decade, 75% are of animal origin, most of which are life-threatening. Since most of them are caused by potent new pathogens capable of long-distance transmission, the impact is widespread and has serious public health and economic consequences. Various other factors also contribute to the transmission, spread, and outbreak of zoonotic diseases, among which industrialization-led globalization followed by ecological disruption and climate change play a critical role. In this regard, all the possible strategies, including advances in rapid and confirmatory disease diagnosis and surveillance/monitoring, immunization/vaccination, therapeutic approaches, appropriate prevention and control measures to be adapted, and awareness programs, need to be adopted collaboratively among different health sectors in medical, veterinary, and concerned departments to implement the necessary interventions for the effective restriction, minimization, and timely control of zoonotic threats. The present review focuses on the current scenario of zoonotic diseases and their counteracting approaches to safeguard their health impact on humans.

Underreporting of Cases in the COVID-19 Outbreak of Borriana (Spain) during Mass Gathering Events in March 2020: A Cross-Sectional Study

Determining the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many locations during the first wave of the COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana (Valencia Community, Spain) in March 2020, a cross-sectional study was performed in June 2020 querying the public health register. Logistic regression models were used. Of a total of 468 symptomatic COVID-19 cases diagnosed in the outbreak through anti-SARS-CoV-2 serology, 36 cases were reported (7.7%), resulting in an underreporting proportion of 92.3% (95% confidence interval [CI], 89.5-94.6%), with 13 unreported cases for every reported case. Only positive SARS-CoV-2 polymerase chain reaction cases were predominantly reported due to a limited testing capacity and following a national protocol. Significant factors associated with underreporting included no medical assistance for COVID-19 disease, with an adjusted odds ratio [aOR] of 10.83 (95% CI 2.49-47.11); no chronic illness, aOR = 2.81 (95% CI 1.28-6.17); middle and lower social classes, aOR = 3.12 (95% CI 1.42-6.85); younger age, aOR = 0.97 (95% CI 0.94-0.99); and a shorter duration of illness, aOR = 0.98 (95% CI 0.97-0.99). To improve the surveillance of future epidemics, new approaches are recommended.

Integrated Approaches of Prevention and Medicine for Dealing with Central Nervous System Brucellosis: A Case from a Non-Epidemic Area - China, 2023

What is already known about this topic?

Brucellosis of the central nervous system (CNS) is rare and frequently fatal, often being overlooked or misdiagnosed.

What is added by this report?

In April 2023, the Jinan CDC identified a case of CNS brucellosis in a 54-year-old woman through cerebrospinal fluid (CSF) culture. Upon confirming the diagnosis of brucellosis, the Jinan CDC immediately informed Qilu Hospital of Shandong University, to which the patient had been transferred, and she was subsequently tracked and successfully treated.

What are the implications for public health practice?

The successful outcome can be attributed to the effective integration of a system that facilitated coordinated and collaborative actions between public health services and clinical institutions.

Current and potential use of animal disease data by stakeholders in the global south and north

What cannot be measured will not be managed. The Global Burden of Animal Diseases (GBADs) will generate information on animal disease burdens by species, production system, type and gender of farmer and consumer, geographical region, and time period. To understand the demand for burden of animal disease (BAD) data and how end-users might benefit from this, we reviewed the literature on animal diseases prioritisation processes (ADPP) and conducted a survey of BAD information users. The survey covered their current use of data and prioritizations as well as their needs for different, more, and better information. We identified representative (geography, sector, species) BAD experts from the authors' networks and publicly available documents and e-mailed 1485 experts. Of 791 experts successfully contacted, 271 responded (34% response rate), and 185 complete and valid responses were obtained. Most respondents came from the public sector followed by academia/research, and most were affiliated to institutions in low- and middle-income countries (LMICs). Of the six ADPPs commonly featured in literature, only three were recognised by more than 40% of experts. An additional 23 ADPPs were used. Awareness of ADDPs varied significantly by respondents. Respondents ranked animal disease priorities. We used exploded logit to combine first, second and third disease priorities to better understand prioritzation and their determinants. Expert priorities differed significantly from priorities identified by the ADDPs, and also from the priorities stated veterinary services as reported in a survey for a World Organisation of Animal Health (WOAH) technical item. Respondents identified 15 different uses of BAD data. The most common use was presenting evidence (publications, official reports, followed by disease management, policy development and proposal writing). Few used disease data for prioritzation or resource allocation, fewer routinely used economic data for decision making, and less than half were aware of the use of decision support tools (DSTs). Nearly all respondents considered current BAD metrics inadequate, most considered animal health information insufficiently available and not evidence-based, and most expressed concerns that decision-making processes related to animal health lacked transparency and fairness. Cluster analysis suggested three clusters of BAD users and will inform DSTs to help them better meet their specific objectives. We conclude that there is a lack of satisfaction with current BAD information, and with existing ADDPs, contributing to sub-optimal decision making. Improved BAD data would have multiple uses by different stakeholders leading to better evidenced decisions and policies; moreover, clients will need support (including DSTs) to optimally use BAD information.

Parenteral Vaccination with a Live Brucella melitensis Mutant Protects against Wild-Type B. melitensis 16M Challenge

Susceptibility to brucellosis remains prevalent, even in herds vaccinated with conventional vaccines. Efforts are underway to develop an improved brucellosis vaccine, and possibly a universal vaccine, given that Brucella species are highly homologous. To this end, two B. melitensis mutants were developed, znBM-lacZ (znBMZ) and znBM-mCherry (znBM-mC), and were tested for their ability to confer systemic immunity against virulent B. melitensis challenge. To assess the extent of their attenuation, bone-marrow-derived macrophages and human TF-1 myeloid cells were infected with both mutants, and the inability to replicate within these cells was noted. Mice infected with varying doses of znBM-mC cleared the brucellae within 6-10 weeks. To test for efficacy against systemic disease, groups of mice were vaccinated once by the intraperitoneal route with either znBMZ or B. abortus S19 vaccine. Relative to the PBS-dosed mice, znBMZ vaccination greatly reduced splenic brucellae colonization by ~25,000-fold compared to 700-fold for S19-vaccinated mice. Not surprisingly, both znBMZ and S19 strains induced IFN-γ+ CD4+ T cells, yet only znBMZ induced IFN-γ+ CD8+ T cells. While both strains induced CD4+ effector memory T cells (Tems), only znBMZ induced CD8+ Tems. Thus, these results show that the described znBM mutants are safe, able to elicit CD4+ and CD8+ T cell immunity without a boost, and highly effective, rendering them promising vaccine candidates for livestock.

Investigation of optimized observation periods for estimating a representative home range of free-roaming domestic dogs

Free-roaming domestic dogs (FRDD), as vectors of zoonotic diseases, are of high relevance for public health. Understanding roaming patterns of dogs can help to design disease control programs and disease transmission simulation models. Studies on GPS tracking of dogs report stark differences in recording periods. So far, there is no accepted number of days required to capture a representative home range (HR) of FRDD. The objective of this study was to evaluate changes in HR size and shape over time of FRDD living in Chad, Guatemala, Indonesia and Uganda and identify the period required to capture stable HR values. Dogs were collared with GPS units, leading to a total of 46 datasets with, at least, 19 recorded days. For each animal and recorded day, HR sizes were estimated using the Biased Random Bridge method and percentages of daily change in size and shape calculated and taken as metrics. The analysis revealed that the required number of days differed substantially between individuals, isopleths, and countries, with the extended HR (95% isopleth value) requiring a longer recording period. To reach a stable HR size and shape values for 75% of the dogs, 26 and 21 days, respectively, were sufficient. However, certain dogs required more extended observational periods.

Exploiting genomics for antimicrobial resistance surveillance at One Health interfaces

The intersection of human, animal, and ecosystem health at One Health interfaces is recognised as being of key importance in the evolution and spread of antimicrobial resistance (AMR) and represents an important, and yet rarely realised opportunity to undertake vital AMR surveillance. A working group of international experts in pathogen genomics, AMR, and One Health convened to take part in a workshop series and online consultation focused on the opportunities and challenges facing genomic AMR surveillance in a range of settings. Here we outline the working group's discussion of the potential utility, advantages of, and barriers to, the implementation of genomic AMR surveillance at One Health interfaces and propose a series of recommendations for addressing these challenges. Embedding AMR surveillance at One Health interfaces will require the development of clear beneficial use cases, especially in low-income and middle-income countries. Evidence of directionality, risks to human and animal health, and potential trade implications were also identified by the working group as key issues. Addressing these challenges will be vital to enable genomic surveillance technology to reach its full potential for assessing the risk of transmission of AMR between the environment, animals, and humans at One Health interfaces.

The global burden of neglected zoonotic diseases: Current state of evidence

The majority of emerging infectious diseases are zoonoses, most of which are classified as "neglected". By affecting both humans and animals, zoonoses pose a dual burden. The disability-adjusted life year (DALY) metric quantifies human health burden since it combines mortality and morbidity. This review aims to describe and analyze the current state of evidence on neglected zoonotic diseases (NZDs) burden and start a discussion on the current understanding of the global burden of NZDs. We identified 26 priority NZDs through consulting three international repositories for national prioritization exercises. A systematic review of global and national burden of disease (BoD) studies was conducted using pre-selected databases. Data on diseases, location and DALYs were extracted for each eligible study. A total of 1887 records were screened, resulting in 74 eligible studies. The highest number of BoD was found for non-typhoidal salmonellosis (23), whereas no estimates were found for West Nile, Marburg and Lassa fever. Geographically, the highest number of studies was performed in the Netherlands (11), China (5) and Iran (4). The number of BoD retrieved mismatched the perceived importance in national prioritization exercises. For example, anthrax was considered a priority NZD in 65 countries; however, only one national study estimating BoD was retrieved. By summing the available global estimates, the selected NZDs caused at least 21 million DALYs per year, a similar order of magnitude to (but less than) the burden due to foodborne disease (included in the Foodborne Disease Burden Epidemiology Reference Group). The global burden of disease landscape of NZDs remains scattered. There are several priority NZDs for which no burden estimates exist, and the number of BoD studies does not reflect national disease priorities. To have complete and consistent estimates of the global burden of NZDs, these diseases should be integrated in larger global burden of disease initiatives.

Comparison of Oral Microbial Composition and Determinants Encoding Antimicrobial Resistance in Dogs and Their Owners

Consolidated studies on animal, human, and environmental health have become very important for understanding emerging zoonotic diseases and the spread of antimicrobial resistance (AMR). The aim of this study was to analyse the oral microbiomes of healthy dogs and their owners, including determinants of AMR. Shotgun metagenomic sequencing detected 299 bacterial species in pets and their owners, from which 70 species were carried by dogs and 229 species by humans. Results demonstrated a unique microbial composition of dogs and their owners. At an order level, Bacteroidales were the most prevalent oral microbiota of dogs with significantly lower prevalence in their owners where Actinomycetales and Lactobacillales predominated. Porphyromonas and Corynebacterium were the most prevalent genera in dogs, whereas Streptococcus and Actinomyces were in animal owners. The resistances to macrolides, tetracyclines, lincosamides and Cfx family A class broad-spectrum β-lactamase were detected in both animal and human microbiomes. Resistance determinants to amphenicols, aminoglycosides, sulphonamides, and quaternary ammonium compounds were detected exceptionally in dogs. In conclusion, the study demonstrated different bacterial composition in oral microbiomes of healthy dogs without clinical signs of periodontal disease and their owners. Due to the low numbers of the samples tested, further investigations with an increased number of samples should be performed.

Brucellae as resilient intracellular pathogens: epidemiology, host-pathogen interaction, recent genomics and proteomics approaches, and future perspectives

Brucellosis is considered one of the most hazardous zoonotic diseases all over the world. It causes formidable economic losses in developed and developing countries. Despite the significant attempts to get rid of Brucella pathogens in many parts of the world, the disease continues to spread widely. Recently, many attempts proved to be effective for the prevention and control of highly contagious bovine brucellosis, which could be followed by others to achieve a prosperous future without rampant Brucella pathogens. In this study, the updated view for worldwide Brucella distribution, possible predisposing factors for emerging Brucella pathogens, immune response and different types of Brucella vaccines, genomics and proteomics approaches incorporated recently in the field of brucellosis, and future perspectives for prevention and control of bovine brucellosis have been discussed comprehensively. So, the current study will be used as a guide for researchers in planning their future work, which will pave the way for a new world without these highly contagious pathogens that have been infecting and threatening the health of humans and terrestrial animals.

China's One Health governance system: the framework and its application

One Health is an interdisciplinary approach that promotes the resolution of complex health issues through collaboration across multiple disciplines. In addition to accountability, the One Health governance structure fosters shared understanding, trust, and an appreciation for diverse perspectives and requirements. This article provides a comprehensive analysis of the current integration of the One Health approach within China's existing health governance framework. It also proposes strategies for further improvement, with emphasis on the level of implementation and contributions to the advancement of One Health governance through an examination of current health policies.

Targeted protein degradation might present a novel therapeutic approach in the fight against African trypanosomiasis

African trypanosomiasis (AT) is a hemoparasitic disease caused by infection with African trypanosomes and it is prevalent in many sub-Saharan African countries, affecting both humans and domestic animals. The disease is transmitted mostly by haematophagous insects of the genus Glossina while taking blood meal, in the process spreading the parasites from an infected animal to an uninfected animal. The disease is fatal if untreated, and the available drugs are generally ineffective and resulting in toxicities. Therefore, it is still pertinent to explore novel methods and targets for drug discovery. Proteolysis-targeting chimeras (PROTACs) present a new strategy for development of therapeutic molecules that mimic cellular proteasomal-mediated protein degradation to target proteins involved in different disease types. PROTACs have been used to degrade proteins involved in various cancers, neurodegenerative diseases, and immune disorders with remarkable success. Here, we highlight the problems associated with the current treatments for AT, discuss the concept of PROTACs and associated targeted protein degradation (TPD) approaches, and provide some insights on the future potential for the use of these emerging technologies (PROTACs and TPD) for the development of new generation of anti-Trypanosoma drugs and the first "TrypPROTACs".

Using mechanistic models to highlight research priorities for tick-borne zoonotic diseases: Improving our understanding of the ecology and maintenance of Kyasanur Forest Disease in India

The risk of spillover of zoonotic diseases to humans is changing in response to multiple environmental and societal drivers, particularly in tropical regions where the burden of neglected zoonotic diseases is highest and land use change and forest conversion is occurring most rapidly. Neglected zoonotic diseases can have significant impacts on poor and marginalised populations in low-resource settings but ultimately receive less attention and funding for research and interventions. As such, effective control measures and interventions are often hindered by a limited ecological evidence base, which results in a limited understanding of epidemiologically relevant hosts or vectors and the processes that contribute to the maintenance of pathogens and spillover to humans. Here, we develop a generalisable next generation matrix modelling framework to better understand the transmission processes and hosts that have the greatest contribution to the maintenance of tick-borne diseases with the aim of improving the ecological evidence base and framing future research priorities for tick-borne diseases. Using this model we explore the relative contribution of different host groups and transmission routes to the maintenance of a neglected zoonotic tick-borne disease, Kyasanur Forest Disease Virus (KFD), in multiple habitat types. The results highlight the potential importance of transovarial transmission and small mammals and birds in maintaining this disease. This contradicts previous hypotheses that primates play an important role influencing the distribution of infected ticks. There is also a suggestion that risk could vary across different habitat types but currently more research is needed to evaluate this relationship. In light of these results, we outline the key knowledge gaps for this system and future research priorities that could inform effective interventions and control measures.

Activation of mucosal immunity as a novel therapeutic strategy for combating brucellosis

Brucellosis is a disease of livestock that is commonly asymptomatic until an abortion occurs. Disease in humans results from contact of infected livestock or consumption of contaminated milk or meat. Brucella zoonosis is primarily caused by one of three species that infect livestock, Bacillus abortus in cattle, B. melitensis in goats and sheep, and B. suis in pigs. To aid in disease prophylaxis, livestock vaccines are available, but are only 70% effective; hence, improved vaccines are needed to mitigate disease, particularly in countries where disease remains pervasive. The absence of knowing which proteins confer complete protection limits development of subunit vaccines. Instead, efforts are focused on developing new and improved live, attenuated Brucella vaccines, since these mimic attributes of wild-type Brucella, and stimulate host immune, particularly T helper 1-type responses, required for protection. In considering their development, the new mutants must address Brucella's defense mechanisms normally active to circumvent host immune detection. Vaccination approaches should also consider mode and route of delivery since disease transmission among livestock and humans is believed to occur via the naso-oropharyngeal tissues. By arming the host's mucosal immune defenses with resident memory T cells (TRMs) and by expanding the sources of IFN-γ, brucellae dissemination from the site of infection to systemic tissues can be prevented. In this review, points of discussion focus on understanding the various immune mechanisms involved in disease progression and which immune players are important in fighting disease.

Prevention of exposure to zoonoses in rural Latin America: Social ecological factors in a diverse regional context

Zoonotic diseases have serious impacts on human health and well-being, but they are often overlooked in rural Latin America. The design of effective preventive interventions is complex and requires an integrative approach from evidence-based information analyzed through robust theoretical frameworks. We conducted a systematized literature review and qualitative framework-guided thematic analysis to identify social ecological factors affecting the prevention and exposure to zoonotic diseases. Although resources for research are limited in Latin America, we found several studies with relevant results. We extracted and interpreted 8 themes as factors affecting the prevention, transmission, and exposure to zoonosis. These themes included knowledge and misconceptions, low risk perception, gaps in knowledge and communication, psychological effect of diseases, culture and traditions, inequality, disarticulated prevention programs, and organizational responsibility. Alongside this, we compiled and present the recommendations for actions to reduce the impact of zoonoses in these populations. The factors and recommendations here presented can be adapted to inform the design and improvement of preventive programs, focused on One Health and aiming to reduce the impact of zoonotic diseases in rural settings.

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We identified relevant social and behavioural factors affecting the prevention of Zoonotic diseases in Latin America.

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Knowledge, risk perceptions, and communication quality were relevant individual factors.

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Inequity and unarticulated programs were relevant social factors.

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Characterization of the context-specific social ecology can improve the development of effective interventions.

Global variation in force-of-infection trends for human Taenia solium taeniasis/cysticercosis

Infection by Taenia solium poses a major burden across endemic countries. The World Health Organization (WHO) 2021–2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified T. solium control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa, and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab-seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab-seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in T. solium transmission rates indicate the need for setting-specific intervention strategies to achieve the WHO goals.

Cystic Echinococcosis: An Impact Assessment of Prevention Programs in Endemic Developing Countries in Africa, Central Asia, and South America

Background. Cystic echinococcosis (CE), caused by the tapeworm species, Echinococcus granulosus sensu stricto (G1), is one of many primary neglected zoonoses worldwide. Within endemic developing countries, CE has multiple effects on animal and human health and well-being. To address such effects, veterinary and human medical sector collaboration on prevention program delivery is essential. To begin preliminary evaluations of county specific prevention programs, a critically appraised topic (CAT) was conducted. It sought to answer: What impact do CE prevention programs have on human and animal disease prevalence, in populations living in endemic developing countries within Africa, Central Asia, and South America? Methodology. The aim was to assess the ability of prevention and control program outputs to produce measurable differences in health, social, and economic outcomes (e.g., improved access to medical services, positive behavioral change, or reduced treatment costs, respectively). Included articles were obtained using predefined inclusion/exclusion criteria from the four databases (CAB Abstracts and Global Health; the National Library of Medicine (PubMed); ScienceDirect; and WHO Institutional Repository of Information Sharing (IRIS)). The articles were appraised using three checklists: the Royal College of Veterinary Surgeons (RCVS), the Critical Appraisals Skills Programme (CASP), and the Joanna Briggs Institute checklists. Results. Ten articles were selected. Geographically, 20% of studies were conducted in South America, 30% in Africa, and 50% in Central Asia. For definitive hosts, dogs, CoproELISA antigen testing, before and after Praziquantel (PZQ) de-worming, was a primary focus. For humans, who are intermediate hosts (IH), disease surveillance methods, namely ultrasound (US), were commonly assessed. Whilst for sheep, also acting as IH, disease prevention methods, such as the EG95 livestock vaccine and de-worming farm dogs, were evaluated. Common to all studies were issues of program sustainability, in terms of regular human US screening, dog de-worming, and annual sheep vaccination. This was attributed to transient and remote human or animal populations; limited access to adequate roads or hospitals; few skilled health workers or veterinarians; an over-reliance on communities to administer preventatives; and limited resources. Conclusion. Despite variations in result validity and collection periods, useful comparisons of CE endemic countries produced key research and program recommendations. Future research recommendations included testing the significance of multiple program outcomes in relation to prevalence (e.g., the social outcome: behavioral change), further research on the impact of livestock vaccinations, and the CE transmission role of waterways and sanitation. Program recommendations included calculating and distinguishing between stray versus owned dog populations; formal representation of internal and external stakeholder interests through institutional organization; establishing sustainable guidelines around the frequency of PZQ and vaccination administration; improved veterinary-human medical training and resource sharing; and combined prevention methods and multiple canine disease management.

Social insights on the implementation of One Health in zoonosis prevention and control: a scoping review

BACKGROUND

The One Health (OH) concept has been promoted widely around the globe. OH framework is expected to be applied as an integrated approach to support addressing zoonotic diseases as a significant global health issue and to improve the efficiency and effectiveness of zoonosis prevention and control. This review is intended to overview the social impact of the implementation of OH on zoonosis prevention and control.

METHODS

A scoping review of studies in the past 10 years was performed to overview the integration feature of OH in zoonosis prevention and control and the social impacts of OH. PubMed and Web of Science were searched for studies published in English between January 2011 and June 2021. The included studies were selected based on predefined criteria.

RESULTS

Thirty-two studies were included in this review, and most of them adopted qualitative and semi-qualitative methods. More than 50% of the studies focused on zoonosis prevention and control. Most studies were conducted in low- and middle-income countries in Africa and Asia. Applying OH approach in diseases control integrates policymakers, stakeholders, and academics from various backgrounds. The impact of OH on economic is estimated that it may alleviate the burden of diseases and poverty in the long term, even though more financial support might be needed at the initial stage of OH implementation. OH implementation considers social and ecological factors related to zoonosis transmission and provides comprehensive strategies to assess and address related risks in different communities according to regions and customs.

CONCLUSIONS

Based on reviewed literature, although there seems to be a lack of guidelines for assessing and visualizing the outcomes of OH implementation, which may limit the large-scale adoption of it, evidence on the contributions of implementing OH concepts on zoonosis prevention and control indicates long-term benefits to society, including a better integration of politics, stakeholders and academics to improve their cooperation, a potential to address economic issues caused by zoonosis, and a comprehensive consideration on social determinants of health during zoonosis prevention and control.

Knowledge, Attitude and Practices (KAP) of Ruminant Livestock Farmers Related to Zoonotic Diseases in Elassona Municipality, Greece

Zoonotic diseases represent a significant health and economic burden in countries that rely on small ruminant milk production, such as Greece. Greece is endemic for many zoonotic diseases, some of which have occupational determinants. Our aim was to evaluate knowledge, attitude, and practices of livestock ruminant farmers concerning zoonoses. This study was performed as a cross-sectional study, using a questionnaire. We interviewed ruminant farmers (n = 204) from 33 settlements of an area with intense agrarian activity. Three index variables, namely knowledge score, attitude score, and practice score, were constructed. The relations between the explanatory variables and the three indexes were assessed based on linear regression analyses. Regarding practices, 23 (11.3%) consume unpasteurized milk or products from unpasteurized milk and no one takes precautionary measures when assisting animals in parturition or during handling birth material. Education level was positively associated with better knowledge and practices, while close veterinary supervision of the farm was associated with better practices regarding the zoonoses prevention. The results indicate the need for continuous awareness and education actions. Close contact with a veterinarian can be utilized as a key tool both with the current brucellosis vaccination program and in the design of awareness campaigns regarding zoonoses in collaboration with other public health personnel.

Strategic planning, components and evolution in zoonotic diseases frameworks: one health approach and public health ethics

Zoonotic diseases are seen as a major public health concern. Routes of the rapid transmission of zoonotic diseases and the economic damage they cause to communities are all reasons why health institutions and systems need to pay more attention to these diseases. Strategic planning is one of the important tasks of policymakers in every organization and system. It is a very reliable and useful tool for leading all kinds of organizations, including health organizations. Countries with clear policy plans have succeeded in controlling and reducing zoonotic diseases. Such countries used appropriate strategic planning and pursued annual goals to control and prevent diseases. Three important steps (strategy development, strategy implementation and strategy evaluation) should be considered in developing a strategic planning for controlling and prevention of zoonotic diseases. Health systems need to develop strategic planning in order to upgrade their capabilities in combating zoonotic diseases. These programs must be flexible, in line with the one health approach, based on the current needs, and aligned with the new challenges faced with health systems. The strategic planning is directly related to national and international policies, organizational goals and missions, dynamism, degree of complexity, and organizational structure of each country's health system.

Parasitology and One Health-Perspectives on Africa and Beyond

This concept paper reviews issues pertaining to parasitic and vector-borne infections, of humans, animals, or both, of topical relevance to the African continent as well as to neighbouring and interconnected geographies. This analysis is carried out through the "One Health" lens, being mindful of the central role of agriculture and livestock keeping in Africa's sustainable development. The possible agricultural transformation that the continent may undergo to fulfil the rising demand for animal protein of its growing population, coupled with the ongoing climate changes, may lead to potentially enhanced interactions among humans, domesticated and wild animals, in a fast-changing environment. In this view, tackling parasitic conditions of livestock can prove being multidimensionally beneficial by improving animal health as well as communities' food security, livelihood and public health. Accordingly, the value of applying the One Health approach to drug discovery and development in the fight against parasitic neglected tropical diseases and zoonoses, is also underscored. Overall, this article upholds the adoption of a holistic, global, interdisciplinary, multisectoral, harmonised and forward-looking outlook, encompassing both life and social sciences, when dealing with parasitic conditions of humans and animals, in Africa and beyond, in COVID-19 times and further.

Spillover, hybridization, and persistence in schistosome transmission dynamics at the human-animal interface

Zoonotic spillover and hybridization of parasites are major emerging public and veterinary health concerns at the interface of infectious disease biology, evolution, and control. Schistosomiasis is a neglected tropical disease of global importance caused by parasites of the Schistosoma genus, and the Schistosoma spp. system within Africa represents a key example of a system where spillover of animal parasites into human populations has enabled formation of hybrids. Combining model-based approaches and analyses of parasitological, molecular, and epidemiological data from northern Senegal, a region with a high prevalence of schistosome hybrids, we aimed to unravel the transmission dynamics of this complex multihost, multiparasite system. Using Bayesian methods and by estimating the basic reproduction number (R0 ), we evaluate the frequency of zoonotic spillover of Schistosoma bovis from livestock and the potential for onward transmission of hybrid S. bovis × S. haematobium offspring within human populations. We estimate R0 of hybrid schistosomes to be greater than the critical threshold of one (1.76; 95% CI 1.59 to 1.99), demonstrating the potential for hybridization to facilitate spread and establishment of schistosomiasis beyond its original geographical boundaries. We estimate R0 for S. bovis to be greater than one in cattle (1.43; 95% CI 1.24 to 1.85) but not in other ruminants, confirming cattle as the primary zoonotic reservoir. Through longitudinal simulations, we also show that where S. bovis and S. haematobium are coendemic (in livestock and humans respectively), the relative importance of zoonotic transmission is predicted to increase as the disease in humans nears elimination.

An Ebola, Neisseria and Trypanosoma human protein interaction census reveals a conserved human protein cluster targeted by various human pathogens

Filovirus ebolavirus (ZE; Zaire ebolavirus, Bundibugyo ebolavirus), Neisseria meningitidis (NM), and Trypanosoma brucei (Tb) are serious infectious pathogens, spanning viruses, bacteria and protists and all may target the blood and central nervous system during their life cycle. NM and Tb are extracellular pathogens while ZE is obligatory intracellular, targetting immune privileged sites. By using interactomics and comparative evolutionary analysis we studied whether conserved human proteins are targeted by these pathogens. We examined 2797 unique pathogen-targeted human proteins. The information derived from orthology searches of experimentally validated protein-protein interactions (PPIs) resulted both in unique and shared PPIs for each pathogen. Comparing and analyzing conserved and pathogen-specific infection pathways for NM, TB and ZE, we identified human proteins predicted to be targeted in at least two of the compared host-pathogen networks. However, four proteins were common to all three host-pathogen interactomes: the elongation factor 1-alpha 1 (EEF1A1), the SWI/SNF complex subunit SMARCC2 (matrix-associated actin-dependent regulator of chromatin subfamily C), the dolichyl-diphosphooligosaccharide--protein glycosyltransferase subunit 1 (RPN1), and the tubulin beta-5 chain (TUBB). These four human proteins all are also involved in cytoskeleton and its regulation and are often addressed by various human pathogens. Specifically, we found (i) 56 human pathogenic bacteria and viruses that target these four proteins, (ii) the well researched new pandemic pathogen SARS-CoV-2 targets two of these four human proteins and (iii) nine human pathogenic fungi (yet another evolutionary distant organism group) target three of the conserved proteins by 130 high confidence interactions.

Rift Valley fever knowledge, mitigation strategies and communication preferences among male and female livestock farmers in Eastern Province, Rwanda

The Government of Rwanda reported an outbreak of Rift Valley fever (RVF) in the Eastern Province in 2018. To respond to the outbreak, vaccination and education campaigns about the disease were carried out. Because RVF cases continue to be detected in Rwanda and the disease impacts livelihoods and health, accurate knowledge and communication are imperative. The objectives of this study were to evaluate knowledge and risk perceptions of RVF transmission among livestock farmers in Nyagatare District, Eastern Province, Rwanda, and to compare RVF knowledge, risk perceptions, and farming practices between male and female livestock farmers. This cross-sectional, quantitative study was conducted in selected sectors of Nyagatare District in the Eastern Province of Rwanda in June 2019. A 34-question survey was used to ask about demographics, livestock ownership, risk perceptions about zoonotic diseases and livestock management, RVF knowledge, preferred communication sources and information sharing strategies, and protective strategies for RVF mitigation while working with livestock. Livestock farmers were interviewed at three milk collection centers, two village meeting points, a farm cooperative meeting, and during door-to-door visits in villages. In total, 123 livestock farmers were interviewed. The survey found that most livestock farmers lacked knowledge about epizootic and zoonotic transmission of RVF, more male livestock farmers were familiar with RVF and risk mitigation strategies, and female livestock farmers are not viewed as reliable sources of information. Additionally, most livestock farmers had not vaccinated their animals against RVF despite past vaccination campaigns. Radio was the most popular communication channel. These findings show that RVF knowledge and information sharing are inadequate among livestock farmers in Eastern Province. Therefore, vaccination and education campaigns may need to be reevaluated within the context of these trends in order to prepare for future RVF outbreaks.

This study was conducted in order to evaluate RVF knowledge and awareness as well as communication and mitigation strategies among livestock farmers in Eastern Province, Rwanda. Rwanda declared an outbreak of RVF in 2018 and cases have continued to be detected. Thus, evaluating the status of knowledge, preventive strategies, and information sharing among livestock farmers is crucial in mitigating future outbreaks. Our team conducted a survey of knowledge, risk perceptions, mitigation strategies, and communication practices among livestock farmers from selected sectors within Nyagatare District and compared them between male and female livestock farmers in order to analyze gender-nuanced differences between these groups. Sectors were chosen for sampling based on their proximity to previous outbreak areas. Survey questionnaire results showed that knowledge and risk perceptions differed between male and female livestock farmers, and that they could be generally improved among all livestock farmers. Female livestock farmers and non-farming community members were viewed as unreliable sources of information which could impact information dissemination. Many farmers also reported that their livestock herds were not vaccinated for the disease despite previous vaccination campaigns. Communication strategies and information sources also differed between male and female livestock farmers, which highlights a need to consider gender in improving RVF vaccination and education campaign coverage. These findings pose implications for future community-based public health interventions as well as policy development for RVF control and mitigating future RVF outbreaks within Rwanda.

A shorter post-exposure prophylaxis regimen for rabies, Pakistan

OBJECTIVE

To assess the cost and effectiveness of the two-site, 1-week, intradermal rabies post-exposure prophylaxis regimen recommended by the World Health Organization (WHO) in 2018.

METHODS

We compared the number of rabies vaccine and rabies immunoglobulin ampoules consumed at The Indus Hospital in Karachi, Pakistan and their cost before and after implementing WHO's 2018 recommendations. In 2017, patients with suspected rabies-infected bites were treated using the two-site, 4-week, Thai Red Cross regimen, which involved administering four rabies vaccine doses intradermally over 4 weeks and infiltrating immunoglobulin into serious wounds, with the remainder injected into a distant muscle. In 2018, patients received three vaccine doses intradermally over 1 week, with a calculated amount of immunoglobulin infiltrated into wounds only. Remaining immunoglobulin was saved for other patients. The survival of patients bitten by apparently rabid dogs was used as a surrogate for effectiveness.

FINDINGS

Despite treating 8.5% more patients in 2018 (5370 patients) than 2017 (4948 patients), 140 fewer ampoules of rabies vaccine and 436 fewer ampoules of rabies immunoglobulin were used, at a cost saving of 4202 United States dollars. Of 56 patients bitten by apparently rabid dogs, 50 were alive at 6-month follow-up. The remaining six patients could not be contacted but did not present to any hospital with rabies.

CONCLUSION

The new regimen was more economical than the two-site, 4-week regimen and was equally effective. This regimen is recommended for preventing rabies in countries where the disease is endemic and rabies vaccine and immunoglobulin are in short supply.

Neurocysticercosis: Current Perspectives on Diagnosis and Management

Porcine cysticercosis, human taeniasis, and (neuro)cysticercosis are endemic in many low- and middle-income countries (LMIC) where they present a significant health burden to affected communities. Neurocysticercosis (NCC) is one of the leading causes of human epilepsy in many hyperendemic regions in Latin America, Asia, and sub-Saharan Africa. The World Health Organization (WHO) reports an estimated 2.5-8.3 million cases of NCC annually with a disability-adjusted life year (DALY) burden of 2.8 million, but as for all neglected tropical diseases (NTDs), these values are likely to be underestimated. Diagnosis of NCC is complex and most accurately diagnosed using clinical neuroimaging that is unavailable in most hyperendemic regions in LMIC. On January 28, 2021, WHO will launch its road map for the NTDs' "Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030." Taeniasis/cysticercosis is targeted for control success considered as steady increase in the number of countries with intensified control in hyperendemic areas [increasing from 2 (3%) in 2020 to 4 (6%) in 2023, to 9 (14%) by 2025, and to 17 (27%) by 2030]. Cross-cutting targets that include 100% access to at least basic water supply, sanitation, and hygiene in areas endemic for NTDs and 75% integrated treatment coverage for preventative chemotherapy will additionally impact on the taeniasis/cysticercosis/NCC complex. With no vaccine available for humans, prevention of infection depends on communication to the public of the life cycle of a complex zoonosis to promote behavior change, underpinned by practical control measures including treatment of human taeniasis and (neuro)cysticercosis with albendazole and praziquantel [widely used as part of the mass drug administration (MDA) deworming programs], surgery where appropriate, and effective vaccination and deworming for pigs supported by meat inspection. Here, we review recent advances in tools and implementation for Taenia solium taeniasis/(neuro)cysticercosis (TSTC) control and milestones on the onward path to elimination.

Prioritization of zoonotic diseases of public health significance in Nigeria using the one-health approach

Nigeria, with a population of over 190 million people, is rated among the 10 countries with the highest burden of infectious and zoonotic diseases globally. In Nigeria, there exist a sub-optimal surveillance system to monitor and track priority zoonoses. We therefore conducted a prioritization of zoonotic diseases for the first time in Nigeria to guide prevention and control efforts. Towards this, a two-day in-country consultative meeting involving experts from the human, animal, and environmental health backgrounds prioritized zoonotic diseases using a modified semi-quantitative One Health Zoonotic Disease Prioritization tool in July 2017. Overall, 36 of 52 previously selected zoonoses were identified for prioritization. Five selection criteria were used to arrive at the relative importance of prioritized diseases based on their weighted score. Overall, this zoonotic disease prioritization process marks the first major step of bringing together experts from the human-animal-environment health spectrum in Nigeria. Importantly, the country ranked rabies, avian influenza, Ebola Virus Disease, swine influenza and anthrax as the first five priority zoonoses in Nigeria. Finally, this One Health approach to prioritizing important zoonoses is a step that will help to guide future tracking and monitoring of diseases of grave public health importance in Nigeria.

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Nigeria is among the top ten countries with the highest burden of infectious and zoonotic diseases globally.

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One Health approach resulted in prioritization of important zoonoses and will guide their future tracking and monitoring.

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Rabies, avian influenza, Ebola Virus Disease, swine influenza and anthrax as the first five priority zoonoses in Nigeria.

Lyssavirus Vaccine with a Chimeric Glycoprotein Protects across Phylogroups

Rabies is nearly 100% lethal in the absence of treatment, killing an estimated 59,000 people annually. Vaccines and biologics are highly efficacious when administered properly. Sixteen rabies-related viruses (lyssaviruses) are similarly lethal, but some are divergent enough to evade protection from current vaccines and biologics, which are based only on the classical rabies virus (RABV). Here we present the development and characterization of LyssaVax, a vaccine featuring a structurally designed, functional chimeric glycoprotein (G) containing immunologically important domains from both RABV G and the highly divergent Mokola virus (MOKV) G. LyssaVax elicits high titers of antibodies specific to both RABV and MOKV Gs in mice. Immune sera also neutralize a range of wild-type lyssaviruses across the major phylogroups. LyssaVax-immunized mice are protected against challenge with recombinant RABV and MOKV. Altogether, LyssaVax demonstrates the utility of structural modeling in vaccine design and constitutes a broadened lyssavirus vaccine candidate.

Zoonotic disease preparedness in sub-Saharan African countries

BACKGROUND

The emergence of high consequence pathogens such as Ebola and SARS-CoV-2, along with the continued burden of neglected diseases such as rabies, has highlighted the need for preparedness for emerging and endemic infectious diseases of zoonotic origin in sub-Saharan Africa (SSA) using a One Health approach. To identify trends in SSA preparedness, the World Health Organization (WHO) Joint External Evaluation (JEE) reports were analysed. JEEs are voluntary, collaborative processes to assess country's capacities to prevent, detect and rapidly respond to public health risks. This report aimed to analyse the JEE zoonotic disease preparedness data as a whole and identify strengths and weaknesses.

METHODS

JEE zoonotic disease preparedness scores for 44 SSA countries who had completed JEEs were analysed. An overall zoonotic disease preparedness score was calculated as an average of the sum of all the SSA country zoonotic disease preparedness scores and compared to the overall mean JEE score. Zoonotic disease preparedness indicators were analysed and data were collated into regions to identify key areas of strength.

RESULTS

The mean 'Zoonotic disease' preparedness score (2.35, range 1.00-4.00) was 7% higher compared to the mean overall JEE preparedness score (2.19, range 1.55-3.30), putting 'Zoonotic Diseases' 5th out of 19 JEE sub-areas for preparedness. The average scores for each 'Zoonotic Disease' category were 2.45 for 'Surveillance Systems', 2.76 for 'Veterinary Workforce' and 1.84 for 'Response Mechanisms'. The Southern African region scored highest across the 'Zoonotic disease' categories (2.87).A multisectoral priority zoonotic pathogens list is in place for 43% of SSA countries and 70% reported undertaking national surveillance on 1-5 zoonotic diseases. 70% of SSA countries reported having public health training courses in place for veterinarians and 30% had veterinarians in all districts (reported as sufficient staffing). A multisectoral action plan for zoonotic outbreaks was in place for 14% countries and 32% reported having an established inter-agency response team for zoonotic outbreaks. The zoonotic diseases that appeared most in reported country priority lists were rabies and Highly Pathogenic Avian Influenza (HPAI) (both 89%), anthrax (83%), and brucellosis (78%).

CONCLUSIONS

With 'Zoonotic Diseases' ranking 5th in the JEE sub-areas and a mean SSA score 7% greater than the overall mean JEE score, zoonotic disease preparedness appears to have the attention of most SSA countries. However, the considerable range suggests that some countries have more measures in place than others, which may perhaps reflect the geography and types of pathogens that commonly occur. The category 'Response Mechanisms' had the lowest mean score across SSA, suggesting that implementing a multisectoral action plan and response team could provide the greatest gains.

Bovine tuberculosis prevalence and risk factors in selected districts of Bangladesh

A cross-sectional survey was conducted in selected districts of Bangladesh to estimate the prevalence of bovine tuberculosis (bTB), and to identify the risk factors for bTB. We included 1865 farmed cattle from 79 herds randomly selected from five districts. Herd and animal level data were collected using semi-structured interviews with cattle herd owners. The single intradermal comparative tuberculin test (SICTT) was used to estimate the prevalence of bTB. The risk factors were identified using mixed-effect multiple logistic regression analyses. The overall herd and animal level prevalences of bTB were estimated to be 45.6% (95% Confidence Interval [CI] = 34.3–57.2%) and 11.3 (95% CI = 9.9–12.8%), respectively, using the OIE recommended >4 mm cut-off. The true animal level prevalence of bTB was estimated to be 11.8 (95% Credible Interval = 2.1–20.3%). At the herd level, farm size, bTB history of the farm and type of husbandry were significantly associated with bTB status in univariable analysis. Similarly, age group, sex, pregnancy status and parity were significantly associated with bTB at cattle level. However, in multivariable analysis only herd size at the herd level and age group and pregnancy status at the cattle level were significant. Compared to a herd size of 1–10, the odds of bTB were 22.8 (95% CI: 5.2–100.9) and 45.6 times (95% CI: 5.0–417.7) greater in herd sizes of >20–50 and >50, respectively. The odds of bTB were 2.2 (95% CI: 1.0–4.5) and 2.5 times (95% CI: 1.1–5.4) higher in cattle aged >3–6 years and > 6 years, compared to cattle aged ≤1 year. Pregnancy increased the odds of bTB by 1.7 times (95% CI: 1.2–2.4) compared to non-pregnant cattle. Taken together, the results suggest high herd and animal level prevalence of bTB in these 5 districts, with the greatest risk of bTB in older and pregnant cattle within large herds (>20), and highlight an urgent need for continued surveillance and implementation of bTB control programs in Bangladesh.

Experiences of the one-health approach by the Uganda Trypanosomiasis Control Council and its secretariat in the control of zoonotic sleeping sickness in Uganda

Elimination of sleeping sickness from endemic countries like Uganda is key if the affected communities are to exploit the potential of the available human and livestock resources (production and productivity). Trypanosoma brucei rhodesiense, the parasite that causes acute sleeping sickness in humans, is transmitted by tsetse flies and co-exists in non-human animal reservoirs. Uganda by Act of Parliament in 1992 decided to handle the complex approach to control of sleeping sickness and animal trypanosomiasis by establishing the Uganda Trypanosomiasis Control Council (UTCC) and its secretariat the Coordinating Office for the Control of Trypanosomiasis in Uganda (COCTU). The Institutional arrangement aimed to promote engagement with key stakeholders across nine key ministries and the community, all vital for control of zoonotic sleeping sickness, creating a One Health platform, long before such practice was common. From 2006, approaches by the Public Private Partnership, Stamp Out Sleeping Sickness (SOS) have required involvement of stakeholders in the promotion of insecticide treated cattle as live tsetse baits, targeting elimination of zoonotic sleeping sickness. Experiences in promoting sustainability of these interventions have been captured in this study as part of the Tackling Infections to Benefit Africa (TIBA) partnership. Meeting transcripts, focus group discussions and questionnaires were used to collect data from the different stakeholders involved in a rapid impact live bait study over 12 months from Dec 2017. The study provides unprecedented insights into the stakeholders involved in the application of a One health approach for control of zoonotic sleeping sickness across the most important active human African trypanosomiasis focus in East Africa. This unique study is fundamental in guiding multi-stakeholder engagement if the goal to eliminate zoonotic sleeping sickness is to be realised. A major challenge is timely feedback to the community as regards human and animal disease status; rapid diagnostic services that can be delivered from facilities established in close proximity to the affected communities and well equipped in-country reference laboratories are key to delivering effective control and best One Health Approach.

Emerging and re-emerging bacterial zoonoses in Nigeria: current preventive measures and future approaches to intervention

A characteristic of bacterial zoonoses, diseases caused by bacteria that can be transmitted to humans from animals, is a propensity to re-emerge. Several studies demonstrate their ongoing transmission in Nigeria, the most populous country in Africa. However, as local epidemiological data on bacterial zoonoses are inadequate the extent and impact of these infectious diseases is under-reported. Consequently, they are not a targeted priority of national public health policies. This limited recognition is despite indications of their possible roles in the widespread prevalence of non-malarial undifferentiated fever in Nigeria. While a number of animal reservoirs and arthropod vectors have been identified in the transmission routes of these diseases, an escalation of cases of undiagnosed febrile illness highlights the urgent need for a comprehensive assessment of other potential reservoirs, vectors and transmission cycles that may increase the local risk of infection with bacterial zoonoses. Animal health interventions have been proposed as a cost-effective strategy. Here, we present a broad overview of bacterial zoonotic infections of humans in Nigeria in the context of evolving epidemiological patterns. Further, we propose that facilitating the operation of a community-based One Health program is essential to providing the comprehensive epidemiological information that is required to improve prioritization of bacterial zoonoses. This would provide a driver for much needed investment in relevant public health interventions in Africa's most populous country.

Public policy for controlling the taeniasis/cysticercosis complex in Colombia

The teniosis/cysticercosis (T/C) complex is a parasitic disease caused by the cestodes Taenia solium and Taenia saginata, and is considered as a neglected zoonosis by the World Health Organization (WHO) and the Colombian Ministry of Health and Social Protection. (1-3) This parasitic infection is a public health and environmental problem in Latin-American, African and Asian countries, and is currently being introduced to developed countries through immigrant communities. Estimates are that 2 500 000 people are infected with this complex and that twice as many individuals develop the parasite at the tissue level. This disease is associated to 50 000 deaths every year, but these figures need to be updated. (4-8)

The Fate and Management of Sick and Dying Cattle - Consequences on Small-Scale Dairy Farmers of Peri-Urban Areas in India

Background:

The livestock plays an important role in the economy of farmers. The mismanagement of sick and dying cattle leads to an increase in sanitation cost of municipalities, incidences of diseases by exposed carcasses, and hence more expenditure on avoidable health catastrophes.

Objective:

The objective is to study the fate of sick and failing cattle and their detailed management regarding disposal of dead cattle.

Materials and Methods:

The qualitative research approach was used. The dual strategies of purposive sampling and snowballing were employed to identify potential respondents. The study was conducted 15 in-depth interviews among smallholder dairy farmers, scientists, officials of National Dairy Research Institute (NDRI), municipality officials, and veterinarians in peri-urban areas of Karnal, Haryana, located in North India. Data were analyzed based on the contents of these audio-recorded interviews. The recordings have transcribed and translated. After translation completion, a content analysis was performed manually to identify emerging themes and interconnections.

Results:

This article highlighted three core themes such as impact of low literacy and awareness levels, role of informal forms of disposal, and preference of informal channels over municipality.

Conclusions:

There is a gap in current practices and management of sick and dying cattle. Small-scale farmers prefer to dispose their cattle in an informal way. It needs to improve animal welfare by modeling guidelines for disposal of dead cattle and its consequences pertaining to zoonoses.

Prevalence of Mycobacterium bovis infection in traditionally managed cattle at the wildlife-livestock interface in South Africa in the absence of control measures

Cattle are the domestic animal reservoir for Mycobacterium bovis (M. bovis) which also affects other domestic animals, several wildlife species and humans leading to tuberculosis. The study area is in a resource-poor community that is surrounded by several game parks, where M. bovis infection has been previously diagnosed in wildlife. A cross-sectional study was carried out to determine the prevalence of M. bovis infection in 659 cattle from a total of 192 traditionally managed herds using the BOVIGAM® interferon gamma assay (IFN-γ). Infection was confirmed by post mortem examination and M. bovis isolation from three test-positive cattle. Genotyping of the M. bovis isolates was done using spoligotyping and VNTR (variable number of tandem repeats typing). The apparent M. bovis prevalence rate in cattle at animal level was 12% with a true population prevalence of 6% (95% Confidence interval (C.I) 3.8 to 8.1) and a herd prevalence of 28%. Spoligotyping analysis revealed that the M. bovis isolates belonged to spoligotype SB0130 and were shared with wildlife. Three VNTR profiles were identified among the SB0130 isolates from cattle, two of which had previously been detected in buffalo in a game reserve adjacent to the study area. The apparent widespread presence of M. bovis in the cattle population raises a serious public health concern and justifies further investigation into the risk factors for M. bovis transmission to cattle and humans. Moreover, there is an urgent need for effective bTB control measures to reduce infection in the communal cattle and prevent its spread to uninfected herds.

Control of Taenia solium; A Case for Public and Private Sector Investment

The zoonotic helminth T. solium is one of the leading causes of acquired epilepsy in endemic countries, resulting in a high burden both in human health and social stigma of affected people (1-3). In 2012 T. solium was highlighted as a priority for control in the World Health Assembly resolution 66.12 (4). Despite a call for validated control strategies by 2015 and a "Tool Kit" of control options being available, relatively few examples of successfully implemented and sustainable control programs are available (5-7). A minimal control strategy focusing solely on the porcine host has also been proposed although the cost-effectiveness of such has yet to be explored (8). Although acknowledgment has been made of the need for initiatives to be sustainable, we are yet to see sufficient consideration of the balance between the provision of public and private goods, and the need for engagement of the people and organizations in the pork value chains within T. solium control strategies. We utilized a food chain risk analysis model to determine the incremental cost-effectiveness ratio (ICER) in terms of $/infective meal avoided, of combining a pharmaceutical intervention in pigs with strengthened meat hygiene services. The addition of a vaccination and treatment protocol, at an additional 10.3% cost, was illustrated to have the potential to improve the ICER of improving meat inspection by 74.6%. The vaccination and treatment protocol also had the potential to reduce the losses borne by the pork industry of condemned meat by 66%, highlighting the potential to leverage private sector investment in T. solium control.

Current status of human rabies prevention: remaining barriers to global biologics accessibility and disease elimination

Introduction: Rabies is a serious, neglected tropical disease. Zoonotic agents are RNA viruses (Genus Lyssavirus, Family Rhabdoviridae), global in distribution. As an acute, progressive, incurable encephalitis, rabies has the highest case fatality of any infectious disease. Warm-blooded vertebrates are susceptible hosts. Major mammalian reservoirs include mesocarnivores and bats. Given wildlife perpetuation, rabies is not eradicable, but is preventable and controllable, especially under newly available international guidelines. Areas covered: Literature review over the past 5 years reveals development of sensitive, specific diagnostic tests and safe and highly effective human and veterinary vaccines. Yet, tens of thousands of human fatalities occur annually, usually in Africa and Asia, primarily after canine exposure. Human and domestic animal vaccination, before or after exposure, is the single greatest preventative strategy following a rabid animal bite. Expert opinion: Significant progress occurred during the twenty-first century regarding vaccine development, doses, and schedules. Remaining barriers to widespread rabies vaccination include an inter-related set of economic, cultural, social, educational, ecological and technological factors. A basic understanding of local and regional root causes of cases historically allows for broader accessibility to vaccination in a trans-disciplinary fashion to meet the global elimination of human rabies caused via dogs (GEHRD) by 2030.

Dog health and demographic surveillance survey in Western Kenya: Demography and management practices relevant for rabies transmission and control

Background: Domestic dogs transmit 99% of the estimated 59,000 human rabies deaths occurring globally annually. To achieve the global target of zero human deaths from rabies by 2030, effective mass dog vaccination campaigns that break rabies transmission cycles in dog populations are required. This study describes the design of a dog health and demographic surveillance study established within a human health and demographic surveillance study in Western Kenya. Using baseline data from the dog cohort study, we quantify demographic parameters and describe management practices relevant for rabies transmission. Methods: All dogs in 1213 households participating in a linked human and animal health syndromic surveillance study were recruited. Data on household demographics, dog ownership, dog age and sex ratios, reproductive indices, rabies vaccination, management practices, dog movement and health status were collected at least monthly. Results: 460 of 1213 (38%) of the study households owned dogs (mean 2 dogs/household), and 526 (70%) of those without dogs had owned dogs previously. 802 dogs were recruited into the study, more than half (52%) of those with known ages were ≤ 1 year old. The dog:human ratio in the study population was 1:7, the dog density 54 dogs/km2, and the female: male dog sex ratio was 1:1.3. Rabies vaccination was low (5% coverage), and only 48 (12%) male dogs and 13 (5%) female dogs were castrated and spayed, respectively. Dogs were predominantly local breed (99%), mainly kept for security purposes, almost always (97%) left to scavenge for leftovers and 61% roamed freely. Conclusion: Low vaccination coverage, unrestricted dog movement, and high dog population turnover with a large proportion of dogs below one-year-old support endemic rabies circulation in this population. These gaps present opportunities for the design of effective dog rabies control plans to break rabies transmission cycles in this part of Kenya.

Neglected zoonotic diseases in Nigeria: role of the public health veterinarian

Zoonotic diseases accounts for about 75% of emerging infectious disease and can be devastating to both human and animal health globally. A subset of zoonotic diseases is referred to as "neglected zoonotic diseases - NZDs" as they mainly affect poor populations who live in close proximity to domestic or wild animals often in areas where access to health and adequate sanitary facilities are not available. Furthermore, underestimation of the burden of NZD has continually led to its further neglect in least developed countries such as Nigeria. Controlling zoonotic infections including NZDs in animals is crucial in reducing human infections. Veterinarians provides an understanding of the epidemiology of infectious diseases in animal population and are therefore integral for the overall reduction in global burden of NZDs worldwide. Due to the current lack of and in some cases weak involvement of Veterinarians in policy issues related to zoonotic diseases, there is need to elucidate their importance in NZDs control in Nigeria. This review therefore summarises the neglected zoonotic diseases so far documented in Nigeria and also highlight the important role of the Veterinarian in their prevention and control within both human and animal population. Important recommendations to strengthen the role of the public health Veterinarian for sustainable control of NZDs were made.

Context-dependent costs and benefits of tuberculosis resistance traits in a wild mammalian host

Disease acts as a powerful driver of evolution in natural host populations, yet individuals in a population often vary in their susceptibility to infection. Energetic trade-offs between immune and reproductive investment lead to the evolution of distinct life history strategies, driven by the relative fitness costs and benefits of resisting infection. However, examples quantifying the cost of resistance outside of the laboratory are rare. Here, we observe two distinct forms of resistance to bovine tuberculosis (bTB), an important zoonotic pathogen, in a free-ranging African buffalo (Syncerus caffer) population. We characterize these phenotypes as "infection resistance," in which hosts delay or prevent infection, and "proliferation resistance," in which the host limits the spread of lesions caused by the pathogen after infection has occurred. We found weak evidence that infection resistance to bTB may be heritable in this buffalo population (h 2 = 0.10) and comes at the cost of reduced body condition and marginally reduced survival once infected, but also associates with an overall higher reproductive rate. Infection-resistant animals thus appear to follow a "fast" pace-of-life syndrome, in that they reproduce more quickly but die upon infection. In contrast, proliferation resistance had no apparent costs and was associated with measures of positive host health-such as having a higher body condition and reproductive rate. This study quantifies striking phenotypic variation in pathogen resistance and provides evidence for a link between life history variation and a disease resistance trait in a wild mammalian host population.

Sero-prevalence and associated risk factors of Brucellosis among Malaria negative febrile out-patients in Wakiso district, Central Uganda

Objective

Brucellosis is a zoonotic disease usually acquired through direct contact with the infected animals and consumption of contaminated milk and meat products. In humans Brucellosis presents similar signs with other febrile diseases like Malaria, typhoid and other febrile conditions. This study was carried out to determine the prevalence of Brucella abortus among patients with fever but were negative for Malaria.

Results

A cross-sectional study was carried out in Namayumba Health Centre IV, Wakiso district involving 200 participants. Blood samples was screened for B. abortus using Serum Agglutination Test and confirmed with Tube Agglutination test. A questionnaire was used to collect data on socio-demographic characteristics and human Brucellosis related risk factors. Human B. abortus sero-prevalence was at 7.5% (n = 200). The prevalence was high among participants aged 18–35 years (13.3%), muslims 12 (14.0%), those with no formal education (33.3%) and divorced 2 (14.3%). Consuming of raw milk (OR 2.162, 95% CI 0.021–1.379) and being a Muslim (OR 6.101, 95% CI 1.601–23.248) were associated with increased risk of Brucella abortus. It was concluded that human Brucella infection due to Brucella abortus is commonly associated with consumers of raw milk products and muslims in Wakiso district.

Microarray analysis of lncRNA expression in rabies virus infected human neuroblastoma cells

Rabies, caused by the rabies virus (RABV), is the oldest known zoonotic infectious disease. Although the molecular mechanisms of RABV pathogenesis have been investigated extensively, the interactions between host and RABV are not clearly understood. It is now known that long non-coding RNAs (lncRNAs) participate in various physiological and pathological processes, but their possible roles in the host response to RABV infection remain to be elucidated. To better understand the pathogenesis of RABV, RNAs from RABV-infected and uninfected human neuroblastoma cells (SK-N-SH) were analyzed using human lncRNA microarrays. We identified 896 lncRNAs and 579 mRNAs that were differentially expressed after infection, indicating a potential role for lncRNAs in the immune response to RABV. Differentially expressed RNAs were examined using Gene Ontology (GO) analysis and were tentatively assigned to biological pathways using the Kyoto Encyclopedia of Genes and Genomes (KEGG). A lncRNA-mRNA-transcription factor co-expression network was constructed to relate lncRNAs to regulatory factors and pathways that may be important in virus-host interactions. The network analysis suggests that E2F4, TAF7 and several lncRNAs function as transcriptional regulators in various signaling pathways. This study is the first global analysis of lncRNA and mRNA co-expression during RABV infection, provides deeper insight into the mechanism of RABV pathogenesis, and reveals promising candidate for future investigation.

The prevalence of brucellosis and bovine tuberculosis in ruminants in Sidi Kacem Province, Morocco

Bovine tuberculosis (BTB) and brucellosis are major endemic zoonoses in ruminants in Morocco that impact on both animal and human health. This study presents an assessment of the epidemiological and socioeconomic burden of bacterial zoonoses in Sidi Kacem Province in Northern Morocco from a cross-sectional survey of 125 cattle and/or small ruminant-owning households. In total, 1082 sheep and goats were examined from 81 households. The single intradermal comparative cervical test to screen for bovine tuberculosis was undertaken on 1194 cattle from 123 households and all cattle were blood sampled. Cattle and small ruminant sera were tested for brucellosis using the standard Rose Bengal Test (sRBT) and the modified Rose Bengal Test (mRBT). Bacteriology was performed on 21 milk samples obtained from cattle that were seropositive for brucellosis for isolation and phenotyping of circulating Brucella strains. Individual and herd prevalence for BTB in cattle of 20.4% (95% CI 18%-23%) and 57.7% (95% CI 48%-66%), respectively, were observed in this study. The prevalence of brucellosis in cattle at individual and herd level was 1.9% (95% CI 1.2%-2.8%) and 9% (95% CI 4.5%-1.5%), respectively. Brucella pathogens were isolated from three cattle milk samples and were identified as B. abortus using Bruceladder® multiplex PCR and B. abortus biovar 1 by classical phenotyping. All small ruminants were seronegative to sRBT, two were positive to mRBT. A higher risk of BTB and brucellosis was observed in cattle in intensive livestock systems, in imported and crossed breeds and in animals from larger herds (>15). The three risk factors were usually present in the same herds, leading to higher transmission risk and persistence of both zoonoses. These results highlight the importance of implementing control strategies for both BTB and brucellosis to reduce productivity losses and the risk of transmission to humans. Prioritising control for BTB and brucellosis in intensive livestock production systems is essential for human and animal health.

New guidelines for the diagnosis and treatment of neurocysticercosis: a difficult proposal for patients in endemic countries

INTRODUCTION

Recent guidelines for the diagnosis and treatment for neurocysticercosis (NC) from the Infectious Disease Society of America/American Society of Tropical Medicine and Hygiene were developed to be used in the United States and Canada, where only a small fraction of NC cases occur. Areas covered: The paper discusses the strengths and weakness of the proposed guidelines. Expert commentary: Although these new guidelines bring much needed attention to a neglected parasitic disease, some of the recommendations made are based on insufficient and/or inadequate evidence. The authors only recommend one specific immunological assay for use in the diagnosis of NC, when evidence clearly supports other options. The authors strongly recommend dual-anthelminthic for patients with multiple active parenchymal cysts on the basis of one clinical trial that was stopped early. The authors recommend surgical removal of cysts in the fourth ventricle and long-term treatment for subarachnoid NC despite their own admission that there is little evidence to support these recommendations. We propose that clinicians should approach some of the recommendations in the new guidelines with caution and call for the establishment of gold-standard guidelines that can be used and adapted for the diagnosis and treatment of patients with NC worldwide.

Animal influence on water, sanitation and hygiene measures for zoonosis control at the household level: A systematic literature review

INTRODUCTION

Neglected zoonotic diseases (NZDs) have a significant impact on the livelihoods of the world's poorest populations, which often lack access to basic services. Water, sanitation and hygiene (WASH) programmes are included among the key strategies for achieving the World Health Organization's 2020 Roadmap for Implementation for control of Neglected Tropical Diseases (NTDs). There exists a lack of knowledge regarding the effect of animals on the effectiveness of WASH measures.

OBJECTIVES

This review looked to identify how animal presence in the household influences the effectiveness of water, hygiene and sanitation measures for zoonotic disease control in low and middle income countries; to identify gaps of knowledge regarding this topic based on the amount and type of studies looking at this particular interaction.

METHODS

Studies from three databases (Medline, Web of Science and Global Health) were screened through various stages. Selected articles were required to show burden of one or more zoonotic diseases, an animal component and a WASH component. Selected articles were analysed. A narrative synthesis was chosen for the review.

RESULTS

Only two studies out of 7588 met the inclusion criteria. The studies exemplified how direct or indirect contact between animals and humans within the household can influence the effectiveness of WASH interventions. The analysis also shows the challenges faced by the scientific community to isolate and depict this particular interaction.

CONCLUSION

The dearth of studies examining animal-WASH interactions is explained by the difficulties associated with studying environmental interventions and the lack of collaboration between the WASH and Veterinary Public Health research communities. Further tailored research under a holistic One Health approach will be required in order to meet the goals set in the NTDs Roadmap and the 2030 Agenda for Sustainable Development.