Community-based surveillance of zoonotic parasites in a 'One Health' world: A systematic review

How studies on zoonotic risks in wildlife implement the one health approach - A systematic review

Background

The recent COVID-19 pandemic and the emergence of infectious diseases at the human-animal interface highlight the global challenge of mitigating zoonotic risks. The One Health approach emphasizes the interconnectedness of human, animal, and environmental health, urging for holistic and interdisciplinary strategies in disease prevention. Despite growing interest, the attention to wildlife in pandemic prevention remains limited. This systematic literature review aims to evaluate recent One Health research on zoonotic diseases and wildlife in terms of study design, interdisciplinary collaboration, and participatory approaches. Key questions addressed include the consideration of One Health domains, disciplinary involvement, and the inclusion of non-academic stakeholders.

Methods

Following PRISMA guidelines, PubMed and Web of Science were searched for primary research papers on zoonotic diseases and wildlife from 2018 to 2023. Eligibility criteria included a focus on wildlife, zoonotic diseases, and adoption of the One Health approach.

Results

A total of 228 primary research papers were retrieved. Out of these, 105 studies were included in the review. Few studies integrated human, animal, and environmental domains simultaneously in data collection (4.8 %) and knowledge generation (29.5 %). While extensive knowledge was generated for animal health (97.1 %) and human health (84.8 %), environmental health (34.3 %) remained underrepresented. Laboratory methods predominated (82.9 %), with limited integration of social science methodologies (19 %). The majority were epidemiological studies (86.7 %), yet analytical design within these was sparse (17.1 %). Participation of non-academic stakeholders was limited (36.2 % included non-academics; 3.8 % encompassed participative approaches).

Conclusions

The synthesis of the domains human, animal and environmental health remained fragmentary in the studies reviewed. Environmental health is underrepresented and the interdisciplinary involvement of social sciences lacks. Neglecting these fields of competence impedes comprehensive understanding of disease dynamics and hampers effective zoonosis prevention strategies. In result, greater inter- and transdisciplinary collaboration, along with participatory approaches, are still needed for advancing One Health research.

Comparative review of One Health and Indigenous approaches to wildlife research in Inuit Nunangat

There is increasing interest in One Health and Indigenous methodologies and approaches in wildlife research, but they are not widely used research applications in the Arctic. Both approaches are wide in scope and originate from different knowledge systems but are often compared synonymously. We review the literature of overlap between the term One Health and Inuit Qaujimajatuqangit (Inuit Indigenous Knowledge) throughout Inuit Nunaat on wildlife research. Three databases (SCOPUS, Web of Science, and BIOSIS) were used to find English language articles and books within the bounds of Inuit Nunaat. While One Health and Inuit Qaujimajatuqangit research approaches share synergies, they are fundamentally disparate owing to their differences in epistemology, including views on the natural environment and wildlife management. We describe current examples of One Health being operationalized in Inuit Nunaat and identify potential to address larger and more complex questions about wildlife health, with examples from terrestrial and marine Arctic wildlife. Both Indigenous methodologies and One Health naturally have a human component at their core, which seamlessly lends itself to discussions on wildlife management, as human actions and regulations directly impact environment and wildlife health.

Shifting focus from resistance to disease tolerance: A review on hybrid house mice

Parasites have been proposed to modulate the fitness of hybridizing hosts in part based on observations in the European house mouse hybrid zone (HMHZ), a tension zone in which hybrids show reduced fitness. We here review evidence (1) for parasite load differences in hybrid versus parental mice and (2) for health and fitness effects of parasites promoting or preventing introgression and hybridization. The question of relative resistance or susceptibility of hybrids to parasites in the HMHZ has long been controversial. Recent field studies found hybrids to be more resistant than mice from parental subspecies against infections with pinworms and protozoans (Eimeria spp.). We argue that the field studies underlying the contradictory impression of hybrid susceptibility have limitations in sample size, statistical analysis and scope, focusing only on macroparasites. We suggest that weighted evidence from field studies indicate hybrid resistance. Health is a fitness component through which resistance can modulate overall fitness. Resistance, however, should not be extrapolated directly to a fitness effect, as the relationship between resistance and health can be modulated by tolerance. In our own recent work, we found that the relationship between health and resistance (tolerance) differs between infections with the related species E. falciformis and E. ferrisi. Health and tolerance need to be assessed directly and the choice of parasite has made this difficult in previous experimental studies of house mice. We discuss how experimental Eimeria spp. infections in hybrid house mice can address resistance, health and tolerance in conjunction.

Dog care and parasitosis in a rural community of Patagonia: An integrative approach

Human interaction with dogs can potentially lead to zoonoses. The aim of this integrative approach is to describe the relationship between dog parasites, dog care, and the human population of a rural Patagonian village. Surveys were carried out to evaluate owners' attitudes towards dogs, and coproparasitological and coproELISA analyses were performed to determine parasitic infection values. Fur samples and vegetable garden soil were also analyzed. A multivariate regression was performed to identify factors determining infection. All households owned at least one dog, of which only 54.9% had been dewormed in the past three months, and almost half of which were allowed to roam freely. Dogs with protozoan and helminth infections represented 68.8% of the total, 50% being parasitized by helminths of 7 species, including the zoonotic Toxocara canis, Uncinaria sp. Ancylostoma sp. and Echinococcus sp. All hair samples were negative, but 42.8% of vegetable gardens harbored Ancylostomatidae larvae. Statistical analyses indicated that the predictor "time since last deworming" explained infections by Cryptosporidium sp. and helminths, while the predictors "number of dogs per household", "sex", and "freedom to roam" explained the infections by helminths. This shows that the longer the time interval since the last deworming treatment, the greater the probability of a dog being infected by some type of parasite, either Cryptosporidium sp. or a helminth. On the other hand, the probability of being infected by helminths increased when there was more than one dog in the household. Furthermore, male dogs and dogs allowed to roam freely were more likely to be infected. Considering the inadequate care and sanitary status of dogs infected with zoonotic species, it is necessary to raise awareness of the need for responsible care of dogs.

Vector-borne zoonotic blood parasites in wildlife from Ecuador: A report and systematic review

Background and Aim:

Ecuador is a hugely diverse country, but information on infectious diseases in local wild animals is scarce. The aim of this study was to screen the presence of blood parasites in free-ranging wild animals admitted to the Wildlife Hospital at Universidad San Francisco de Quito, from April 2012 to January 2019.

Materials and Methods:

We identified blood parasites by microscopic observation of blood smears from free-ranging wildlife species that attended the Wildlife Hospital of Universidad San Francisco de Quito (Ecuador) from April 2012 to January 2019.

Results:

The microscopic evaluations of animals as potential reservoirs for vector-borne zoonotic blood parasites revealed the presence of Anaplasma spp., Babesia spp., Ehrlichia spp., Hepatozoon spp., microfilaria, Mycoplasma spp., and Trypanosoma spp. in previously unreported wildlife species. In addition, we performed a systematic review to understand the current knowledge gaps in the context of these findings.

Conclusion:

Our data contribute to the knowledge of blood parasites in wildlife from Ecuador. Furthermore, the potential transmission of these parasites to humans and domestic animals, current anthropogenic environmental changes in the region, and the lack of information on this suggest the importance of our results and warrant further investigations on infectious diseases in animals and humans and their relationship with environmental health as key domains of the One Health concept.

Unleashing the literature: a scoping review of canine zoonotic and vectorborne disease research in Canis familiaris in North America

Domestic dogs (Canis familiaris) provide important benefits to human beings but can also transmit pathogens. Information on the breadth of canine zoonoses and vectorborne research in North America is scarce. A scoping review was conducted to examine (1) the number and type of canine zoonoses and vectorborne studies in domestic dogs conducted in North America since the start of the 21st century; (2) the main research methods reported; (3) the Inequality-adjusted Human Development Index (IHDI) countries in which research was conducted; and (4) whether collaborative integrated terminology was reported in objectives or methods sections. Title/abstract screening, full-text screening, and data-charting were completed by two reviewers. We identified 507 publications evaluating 43 zoonotic or vectorborne pathogens in domestic dogs. Most studies (n = 391 of 512 (76.37%)) were conducted in the USA. The five most frequently researched pathogens were Ehrlichia spp. (n = 81 of 507 (15.98%)), Borrelia burgdorferi (n = 64 of 507 (12.62%)), Leptospira spp. (n = 54 of 507 (10.65%)), Rabies virus (n = 42 of 507 (8.28%)), and Influenza viruses (n = 41 of 507 (8.09%)). These pathogens can cause moderate to severe health outcomes in human beings and in dogs irrespective of IHDI ranking; our review highlights important counts of research conduct among North American countries.

Systemic factors for enhancing intersectoral collaboration for the operationalization of One Health: a case study in India

Background

One Health is a collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. Operationalization of the One Health approach is still unclear for various local health systems with their respective targets. In this scenario, the empirical study of intersectoral collaboration between the human and animal health systems provides an opportunity to investigate the appropriate strategies and their enabling factors at the local health system level. Thus, this study documented and validated the innovative strategy for intersectoral collaboration, focusing on effectual prevention and control of zoonotic diseases with its enabling factors for a city in western India, Ahmedabad.

Methods

This case study was conducted in three phases: phase I (qualitative data collection, i.e., vignette interview), phase II (quantitative data collection through modified policy Delphi), and phase III (participatory workshop). The vignette data were handled for content analysis, and the Delphi data, like other quantitative data, for descriptive statistics. The participatory workshop adapts the computerized Sensitivity Model^® developed by Vester to analyse the health system dynamics.

Result

Out of the possible 36 strategies, this study validated the top 15 essential (must-have) and five preferred (should-have) strategies for the study area. For operationalization of the One Health approach, the enabling factors that were identified through the systems approach are micro-level factors at the individual level (trust, leadership, motivation, knowledge), meso-level factors at the organizational level (human resource, capacity-building, shared vision, decision-making capacity, laboratory capacity, surveillance), macro-level factors at the system level (coordinated roles, relationships, common platform), and external factors outside of the system (guidelines/policies, community participation, a specific budget, political will, smart technology).

Discussion

This study reveals that the micro-level factors at the individual level are potential levers of the health system. More attention to these factors could be beneficial for the operationalization of the One Health approach. This study recommends a systems approach through a bottom-up exploration to understand the local health system and its enabling factors, which should be accounted for in formulating future One Health policies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12961-021-00727-9.

Urban public squares as potential hotspots of dog-human contact: A spatial analysis of zoonotic parasites detection in Gran Santiago, Chile

Zoonotic parasites are a major public health problem globally, representing a hazard to human health. The infections occur through contact with different parasite forms. Public squares are a common meeting place for people and dogs, becoming a risk area for transmission to other dogs and humans. A spatial analysis of zoonotic parasite distribution in urban public squares in Gran Santiago, Chile was performed to elucidate its importance, exploring spatial aggregation on positivity rates at commune level. A total of 170 stool samples were analysed; 54 (31.7%) were positive for gastrointestinal-zoonotic parasites. Positivity was detected in 27 (79.4%) squares. Diversity of parasite species was variable across sites. Toxocara canis was the most frequently detected (27 samples, 21/34 squares), followed by Toxascaris leonina (13 samples, 10/34 squares), cestode eggs (10 samples, 9/34 squares), Giardia sp. (6 samples, 5/34 squares), Ancylostomatidae-like eggs (4 samples, 4/34 squares), Cryptosporidium spp. (2 samples, 2/34 squares) and Entamoeba spp. (1 sample, 1/34 square). Spatial autocorrelation (SA) was observed at commune level. The local indicators of the spatial association test showed statistical significance for cestode eggs (p < 0.001) with a negative SA (Moran's I Index = -0.2929, CI-95% = -0.3869--0.1989) and Ancylostomatidae (p = 0.046) with a positive SA (Moran's I Index = 0.1404, CI-95% = 0.0499-0.2309). Toxocara canis is the most prevalent geo-helminth in public places of Santiago, Chile. Spatial autocorrelation was detected for cestode eggs and Ancylostomatidae. Diagnosis and detection of parasites is key for the establishment of control/eradication of environmental dissemination following One Health guidelines.

Evaluación de enfermedades transmitidas por vectores en perros de un área de clima sub-frío de México

La distribución geográfica de las enfermedades transmitidas por vectores está influenciada por una dinámica compleja de factores ambientales, sociales y el impacto cambiante de la transmisión de sus vectores, huéspedes intermedios y reservorios. El objetivo del presente estudio fue evaluar la seropositividad a anticuerpos anti-Ehrlichia canis, Anaplasma phagocytophilum, Borrelia burgdorferia y la seropositividad a antígenos de Dirofilaria immitis en perros de un área de México con un clima semifrío. Se tomaron 100 muestras de sangre de caninos de hogares privados y en clínicas veterinarias del estado de Amecameca de Juárez, Estado de México. El análisis de las muestras se llevó a cabo mediante un kit comercial de ELISA (Test SNAP® 4Dx® Plus Canine IDEXX®). A los resultados se observó una seropositividad a anticuerpos anti-E. canis del 30 %, 9 % para A. phagocytophilum, 4 % para B. burgdorferi y 16 % para antígenos de D. immitis. Así mismo, se halló una relación estadísticamente significativa entre la seropositividad a anticuerpos anti-E. canis y perros mayores a un año y de raza. Por otra parte se reportaron resultados similares en perros machos y mayores de un año con seropositividad a D. immitis. Con los resultados obtenidos, se concluye que existe una mayor seropositividad para la infección por E. canis y D. immitis y una asociación significativa en perros mayores de un año. Es de gran relevancia conocer la epidemiología de patógenos transmitidos por garrapatas debido al impacto zoonotico que implican. Se recomiendan investigaciones adicionales, así como medidas preventivas de salud animal y salud pública para reducir el riesgo de infección en perros.

Methodological and Terminological Issues in Animal-Assisted Interventions: An Umbrella Review of Systematic Reviews

Recently, animal-assisted interventions (AAIs), which are defined as psychological, educational, and rehabilitation support activities, have become widespread in different contexts. For many years, they have been a subject of interest in the international scientific community and are at the center of an important discussion regarding their effectiveness and the most appropriate practices for their realization. We carried out an umbrella review (UR) of systematic reviews (SRs), created for the purpose of exploring the literature and aimed at deepening the terminological and methodological aspects of AAIs. It is created by exploring the online databases PubMed, Google Scholar, and Cochrane Library. The SRs present in the high-impact indexed search engines Web of Sciences and Scopus are selected. After screening, we selected 15 SRs that met the inclusion criteria. All papers complained of the poor quality of AAIs; some considered articles containing interventions that did not always correspond to the terminology they have explored and whose operating practices were not always comparable. This stresses the need for the development and consequent diffusion of not only operational protocols, but also research protocols which provide for the homogeneous use of universally recognized terminologies, thus facilitating the study, deepening, and comparison between the numerous experiences described.

Intensity of infection with intracellular Eimeria spp. and pinworms is reduced in hybrid mice compared to parental subspecies

Genetic diversity in animal immune systems is usually beneficial. In hybrid recombinants, this is less clear, as the immune system could also be impacted by genetic conflicts. In the European house mouse hybrid zone, the long-standing impression that hybrid mice are more highly parasitized and less fit than parentals persists despite the findings of recent studies. Working across a novel transect, we assessed infections by intracellular protozoans, Eimeria spp., and infections by extracellular macroparasites, pinworms. For Eimeria, we found lower intensities in hybrid hosts than in parental mice but no evidence of lowered probability of infection or increased mortality in the centre of the hybrid zone. This means ecological factors are very unlikely to be responsible for the reduced load of infected hybrids. Focusing on parasite intensity (load in infected hosts), we also corroborated reduced pinworm loads reported for hybrid mice in previous studies. We conclude that intensity of diverse parasites, including the previously unstudied Eimeria, is reduced in hybrid mice compared to parental subspecies. We suggest caution in extrapolating this to differences in hybrid host fitness in the absence of, for example, evidence for a link between parasitemia and health.

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.

The Presence of Toxocara Eggs on Dog's Fur as Potential Zoonotic Risk in Animal-Assisted Interventions: A Systematic Review

Animal-assisted interventions (AAIs) usually contribute to the well-being and health of users/patients, but it is essential that the animals involved in these activities do not represent a source of zoonoses. This systematic review focused on the evaluation of the potential risk of the transmission of Toxocara by dogs' fur, considering their involvement as the main animal species in AAIs. Three databases were considered: MEDLINE/PubMed, Scopus, and Web of Science, and the PRISMA guidelines were used. Out of 162 articles found, 14 papers were identified as eligible for inclusion in the review. Although the findings were very heterogeneous, they showed that regular parasitological surveillance to plan effective control programs is strongly needed to guarantee the health of pets and consequently the public health, according to the concept of One Health. Since AAIs involve patients and/or users potentially susceptible, it is very important to appropriately treat dogs enrolled in these interventions after an accurate diagnosis of parasitic zoonoses.

Strengthening multi-sectoral collaboration on critical health issues: One Health Systems Mapping and Analysis Resource Toolkit (OH-SMART) for operationalizing One Health

Addressing critical global health issues, such as antimicrobial resistance, infectious disease outbreaks, and natural disasters, requires strong coordination and management across sectors. The One Health approach is the integrative effort of multiple sectors working to attain optimal health for people, animals, and the environment, and is increasingly recognized by experts as a means to address complex challenges. However, practical application of the One Health approach has been challenging. The One Health Systems Mapping and Analysis Resource Toolkit (OH-SMART) introduced in this paper was designed using a multistage prototyping process to support systematic improvement in multi-sectoral coordination and collaboration to better address complex health concerns through an operational, stepwise, and practical One Health approach. To date, OH-SMART has been used to strengthen One Health systems in 17 countries and has been deployed to revise emergency response frameworks, improve antimicrobial resistance national action plans and create multi agency infectious disease collaboration protocols. OH-SMART has proven to be user friendly, robust, and capable of fostering multi-sectoral collaboration and complex system-wide problem solving.

Overcoming challenges for designing and implementing the One Health approach: A systematic review of the literature

Collaborative approaches in health, such as One Health (OH), are promising; nevertheless, several authors point at persistent challenges for designing and implementing OH initiatives. Among other challenges, OH practitioners struggle in their efforts to collaborate across disciplines and domains. This paper aims to provide insights into the existing challenges for designing and implementing OH initiatives, their causes and solutions, and points out strategic solutions with the potential to solve practical challenges. A systematic literature search was performed for emerging challenges and proposed solutions in the process of conducting OH initiatives. Next, a thematic and a causal analysis were performed to unravel challenges and their causes. Finally, solutions were discriminated on whether they were only recommended, or implemented as a proof-of-principle. The 56 included papers describe 21 challenges endured by OH initiatives that relate to different themes (policy and funding; education and training; surveillance; multi-actor, multi-domain, and multi-level collaborations; and evidence). These challenges occur in three different phases: the acquisition of sufficient conditions to start an initiative, its execution, and its monitoring and evaluation. The findings indicate that individual challenges share overlapping causes and crosscutting causal relations. Accordingly, solutions for the successful performance of OH initiatives should be implemented to tackle simultaneously different types of challenges occurring in different phases. Still, promoting collaboration between the wide diversity of stakeholders, as a fundamental aspect in the OH approach, is still by far the most challenging factor in performing OH initiatives. Causes for that are the difficulties in promoting meaningful and equal participation from diverse actors. Solutions proposed for this challenge focused on guiding stakeholders to think and collaborate beyond their professional and cultural silos to generate knowledge co-creation and innovative methodologies and frameworks. Finally, the biggest knowledge gap identified, in terms of proposed solutions, was for monitoring and evaluating OH initiatives. This highlights the need for future research on evaluation methods and tools specific for the OH approach, to provide credible evidence on its added value. When considering challenges endured by former OH initiatives and the proposed solutions for these challenges, practitioners should be able to plan and structure such initiatives in a more successful way, through the strategic pre-consideration of solutions or simply by avoiding known barriers.

Parasite fauna of wild Antillean manatees (Trichechus manatus manatus) of the Andean Region, Colombia

BACKGROUND

Antillean manatees (Trichechus manatus manatus) are large herbivorous aquatic mammals living in limited areas of South, Central and North America. As with other aquatic mammals, Antillean manatees can be infected by a variety of protozoan and metazoan parasites, some of them with zoonotic potential, which affect not only their welfare but also population health status. Therefore, we conducted the first epidemiological survey in Colombian free-ranging Antillean manatees to estimate their actual gastrointestinal parasite status.

RESULTS

In total, 69 faecal samples were collected from free-ranging individual manatees during ecology field studies in the rivers Carare and San Juan and in two associated wetlands in the Andean region of Colombia. Parasite diversity encompassed six different endoparasite species. The highest prevalence was found for protozoan infections with Eimeria nodulosa (47.8%) and Eimeria manatus-like species (type A, B; 43.4%), followed by Entamoeba sp. (14.49%) and Giardia sp. (1.4%) infections. In addition, infections with the trematode Chiorchis fabaceus were detected at a high prevalence (33.3%). Molecular characterization of sirenian Eimeria species led to the distinction of three species, E. nodulosa and two E. manatus-like species (type A, B). Phylogenetic analyses indicated a host-specific adaptation of sirenian Eimeria species as previously reported for Eimeria species from other mammalian hosts.

CONCLUSIONS

This study provides the first record of Antillean manatee infection with Giardia and Entamoeba species in Colombia, representing two important anthropozoonotic parasite genera. This survey should serve as a baseline investigation for future monitoring on parasitic zoonoses in this mammal and encourage for investigations on their impact on both public health and wild manatee welfare.

The Global Burden of Disease of Zoonotic Parasitic Diseases: Top 5 Contenders for Priority Consideration

With the rise of global migration, international trade, and global environmental challenges such as climate change, it is not surprising that the interactions between humans and other animals are shifting. Salient infectious diseases, such as malaria and HIV (which have high burdens of disease), attract sophisticated public health frameworks and funding from global/regional organisations, such as the WHO. This unfortunately detracts attention from the many emerging zoonoses that fall under the radar as neglected tropical diseases (NTDs). This review considers the available literature and the attribution of burden of disease to the most insidious NTDs and recommends which five are deserving of policy prioritisation. In line with WHO analyses of NTDs, intestinal nematode infections, leishmaniasis, schistosomiasis, and lymphatic filariasis should be prioritised, as well as the burden of disease of cryptosporidiosis, which is largely underestimated. Both monitoring and treatment/prevention control methods for cryptosporidiosis are suggested and explored.

Checklist for One Health Epidemiological Reporting of Evidence (COHERE)

One Health is defined as the intersection and integration of knowledge regarding humans, animals, and the environment, yet as the One Health scientific literature expands, there is considerable heterogeneity of approach and quality of reporting in One Health studies. In addition, many researchers who publish such studies do not include or integrate data from all three domains of human, animal, and environmental health. This points to a critical need to unify guidelines for One Health studies. This report details the Checklist for One Health Epidemiological Reporting of Evidence (COHERE) to guide the design and publication format of future One Health studies. COHERE was developed by a core writing team and international expert review group that represents multiple disciplines, including human medicine, veterinary medicine, public health, allied professionals, clinical laboratory science, epidemiology, the social sciences, ecohealth and environmental health. The twin aims of the COHERE standards are to 1) improve the quality of reporting of observational or interventional epidemiological studies that collect and integrate data from humans, animals and/or vectors, and their environments; and 2) promote the concept that One Health studies should integrate knowledge from these three domains. The 19 standards in the COHERE checklist address descriptions of human populations, animal populations, environmental assessment, spatial and temporal relationships of data from the three domains, integration of analyses and interpretation, and inclusion of expertise in the research team from disciplines related to human health, animal health, and environmental health.