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Muwonge A, Wee BA, Mugerwa I, Nabunya E, Mpyangu CM, Bronsvoort BMDC, Ssebaggala ER, Kiayias A, Mwaka E, Joloba M. An open-source digital contact tracing system tailored to haulage. Front Digit Health 2023; 5:1199635. [PMID: 37538199 PMCID: PMC10394895 DOI: 10.3389/fdgth.2023.1199635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023] Open
Abstract
Digital contact tracing presents numerous advantages compared to manual contact tracing methods, especially in terms of enhanced speed and automation. Nevertheless, a lack of comprehensive evaluation regarding functionality, efficiency, benefits, and acceptance within communities remains. Here we primarily focus on the functionality of THEA-GS, an open-source digital contact tracing tool developed through consultation with stakeholders. Additionally, we provide insights from its implementation on a limited sample of haulage drivers in Uganda, serving as a representative case for a low- and middle-income country. THEA-GS comprises two primary components: (a) a smartphone application, and (b) a suite of server-programs responsible for data processing and analysis, including databases and a web-based interface featuring dashboards. In essence, the mobile application records the timestamped location of haulage drivers within the road network and identifies possible transmission hotspots by analyzing factors such as the duration of stops and the communities associated with them. The tool can be integrated with national infrastructure to compare drivers' diagnostic results and contact structure, thereby generating individual and community risk assessments relative to the road network. During the Omicron-variant wave of the COVID-19 pandemic, a total of 3,270 haulage drivers were enrolled between October 2021 and October 2022. Around 75% of these drivers utilized THEA-GS for approximately two months. Based on an analysis of 3,800 test results, which included 48 positive cases, 125 contacts, and 40 million time-stamped GPS points, THEA-GS shows a significant speed improvement, being approximately 90 times faster than MCT. For instance, the average time from sample collection to notifying a case and their contacts was approximately 70 and 80 min, respectively. The adoption of this tool encountered challenges, mainly due to drivers' awareness of its purpose and benefits for public health. THEA-GS is a place-based digital contact tracing tool specifically designed to assist National Public Health Institutions in managing infectious disease outbreaks involving the haulage industry as a high-risk group. While its utility, acceptance, and accuracy have not been fully evaluated, our preliminary tests conducted in Uganda indicate the tool's functionality is robust, but social acceptance and adoption are heavily reliant on establishing trust among users.
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Affiliation(s)
- Adrian Muwonge
- Digital One Health Laboratory, The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
- Blockchain Technology Laboratory, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Bryan A. Wee
- Digital One Health Laboratory, The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Emma Nabunya
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Barend M. de C. Bronsvoort
- Digital One Health Laboratory, The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Aggelos Kiayias
- Blockchain Technology Laboratory, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Erisa Mwaka
- Department of Anatomy, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses Joloba
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
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González Gordon L, Porphyre T, Muhanguzi D, Muwonge A, Boden L, Bronsvoort BMDC. A scoping review of foot-and-mouth disease risk, based on spatial and spatio-temporal analysis of outbreaks in endemic settings. Transbound Emerg Dis 2022; 69:3198-3215. [PMID: 36383164 PMCID: PMC10107783 DOI: 10.1111/tbed.14769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
Foot-and-mouth disease (FMD) is one of the most important transboundary animal diseases affecting livestock and wildlife species worldwide. Sustained viral circulation, as evidenced by serological surveys and the recurrence of outbreaks, suggests endemic transmission cycles in some parts of Africa, Asia and the Middle East. This is the result of a complex process in which multiple serotypes, multi-host interactions and numerous socio-epidemiological factors converge to facilitate disease introduction, survival and spread. Spatial and spatio-temporal analyses have been increasingly used to explore the burden of the disease by identifying high-risk areas, analysing temporal trends and exploring the factors that contribute to the outbreaks. We systematically retrieved spatial and spatial-temporal studies on FMD outbreaks to summarize variations on their methodological approaches and identify the epidemiological factors associated with the outbreaks in endemic contexts. Fifty-one studies were included in the final review. A high proportion of papers described and visualized the outbreaks (72.5%) and 49.0% used one or more approaches to study their spatial, temporal and spatio-temporal aggregation. The epidemiological aspects commonly linked to FMD risk are broadly categorizable into themes such as (a) animal demographics and interactions, (b) spatial accessibility, (c) trade, (d) socio-economic and (e) environmental factors. The consistency of these themes across studies underlines the different pathways in which the virus is sustained in endemic areas, with the potential to exploit them to design tailored evidence based-control programmes for the local needs. There was limited data linking the socio-economics of communities and modelled FMD outbreaks, leaving a gap in the current knowledge. A thorough analysis of FMD outbreaks requires a systemic view as multiple epidemiological factors contribute to viral circulation and may improve the accuracy of disease mapping. Future studies should explore the links between socio-economic and epidemiological factors as a foundation for translating the identified opportunities into interventions to improve the outcomes of FMD surveillance and control initiatives in endemic contexts.
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Affiliation(s)
- Lina González Gordon
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute at The Royal (Dick) School of Veterinary StudiesUniversity of EdinburghEaster BushMidlothianUK
- Global Academy of Agriculture and Food SystemsUniversity of EdinburghEaster BushMidlothianUK
| | - Thibaud Porphyre
- Laboratoire de Biométrie et Biologie EvolutiveUniversité de Lyon, Université Lyon 1, CNRS, VetAgro SupMarcy‐l’ÉtoileFrance
| | - Dennis Muhanguzi
- Department of Bio‐Molecular Resources and Bio‐Laboratory Sciences, College of Veterinary Medicine, Animal Resources and BiosecurityMakerere UniversityKampalaUganda
| | - Adrian Muwonge
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute at The Royal (Dick) School of Veterinary StudiesUniversity of EdinburghEaster BushMidlothianUK
| | - Lisa Boden
- Global Academy of Agriculture and Food SystemsUniversity of EdinburghEaster BushMidlothianUK
| | - Barend M. de C Bronsvoort
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute at The Royal (Dick) School of Veterinary StudiesUniversity of EdinburghEaster BushMidlothianUK
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Kelly RF, Gonzaléz Gordon L, Egbe NF, Freeman EJ, Mazeri S, Ngwa VN, Tanya V, Sander M, Ndip L, Muwonge A, Morgan KL, Handel IG, Bronsvoort BMDC. Bovine Tuberculosis Antemortem Diagnostic Test Agreement and Disagreement in a Naturally Infected African Cattle Population. Front Vet Sci 2022; 9:877534. [PMID: 35873684 PMCID: PMC9301138 DOI: 10.3389/fvets.2022.877534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
The interferon-gamma (IFN-γ) assay and single comparative cervical skin test (SCITT) are used to estimate bovine tuberculosis (bTB) prevalence globally. Prevalence estimates of bTB, caused by Mycobacterium bovis, are poorly quantified in many Sub-Saharan African (SSA) cattle populations. Furthermore, antemortem diagnostic performance can vary at different stages of bTB pathogenesis and in different cattle populations. In this study, we aim to explore the level of agreement and disagreement between the IFN-γ assay and SCITT test, along with the drivers for disagreement, in a naturally infected African cattle population. In, 2013, a pastoral cattle population was sampled using a stratified clustered cross-sectional study in Cameroon. A total of 100 pastoral cattle herds in the North West Region (NWR) and the Vina Division (VIN) were sampled totalling 1,448 cattle. Individual animal data and herd-level data were collected, and animals were screened using both the IFN-γ assay and SCITT. Serological ELISAs were used to detect exposure to immunosuppressing co-infections. Agreement analyses were used to compare the performance between the two bTB diagnostic tests, and multivariable mixed-effects logistic regression models (MLR) were developed to investigate the two forms of IFN-γ assay and SCITT binary disagreement. Best agreement using the Cohen's κ statistic, between the SCITT (>2 mm) and the IFN-γ assay implied a ‘fair-moderate' agreement for the NWR [κ = 0.42 (95%CI: 0.31–0.53)] and ‘poor-moderate' for the VIN [κ = 0.33 (95% CI: 0.18–0.47)]. The main test disagreement was the animals testing positive on the IFN-γ assay and negative by the SCITT. From MLR modeling, adults (adults OR: 7.57; older adults OR = 7.21), females (OR = 0.50), bovine leucosis (OR = 2.30), and paratuberculosis positivity (OR = 6.54) were associated with IFN-γ-positive/SCITT-negative disagreement. Subsets to investigate diagnostic test disagreement for being SCITT-positive and IFN-γ-negative also identified that adults (adults OR = 15.74; older adults OR = 9.18) were associated with IFN-γ-negative/SCITT-positive disagreement. We demonstrate that individual or combined use of the IFN-γ assay and SCITT can lead to a large variation in bTB prevalence estimates. Considering that animal level factors were associated with disagreement between the IFN-γ assay and SCITT in this study, future work should further investigate their impact on diagnostic test performance to develop the approaches to improve SSA prevalence estimates.
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Affiliation(s)
- Robert F. Kelly
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
- *Correspondence: Robert F. Kelly
| | - Lina Gonzaléz Gordon
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nkongho F. Egbe
- School of Life Sciences, University of Lincoln, Lincoln, United Kingdom
| | - Emily J. Freeman
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Stella Mazeri
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Victor N. Ngwa
- School of Veterinary Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | | | - Melissa Sander
- Tuberculosis Reference Laboratory Bamenda, Hospital Roundabout, Bamenda, Cameroon
| | - Lucy Ndip
- Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon
| | - Adrian Muwonge
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Kenton L. Morgan
- Institute of Ageing and Chronic Disease and School of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Ian G. Handel
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Barend M. de C. Bronsvoort
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
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Evans MJ, Gibson A, Fielding H, Ohal P, Pandey P, Kumar A, Singh SK, Airikkala-Otter I, Abela-Ridder B, Gamble L, Handel I, Bronsvoort BMDC, Mellanby RJ, Mazeri S. Free-roaming dog population dynamics in Ranchi, India. Res Vet Sci 2022; 143:115-123. [PMID: 35007799 DOI: 10.1016/j.rvsc.2021.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 11/24/2022]
Abstract
Rabies causes approximately 20,000 human deaths in India each year. Nearly all of these occur following dog bites. Large-scale, high-coverage dog rabies vaccination campaigns are the cornerstone of rabies elimination strategies in both human and dog populations, although this is particularly challenging to achieve in India as a large proportion of the dog population are free-roaming and unowned. Further, little is known about free-roaming dog ecology in India which makes defining optimum vaccination strategies difficult. In this study, data collected using a mobile phone application during three annual mass vaccination and neutering (surgical sterilisation of both males and females) campaigns of free-roaming dogs in Ranchi, India (during which a total of 43,847 vaccinations, 26,213 neuter surgeries and 28,172 re-sight observations were made) were interrogated, using two novel approaches to estimate the proportion of neutered dogs that were lost from the city (assumed due to mortality or migration) between campaign years. Analysis revealed high losses of neutered dogs each year, ranging from 25.3% (28.2-22.8) to 55.8% (57.0-54.6). We also estimated that the total population declined by 12.58% (9.89-15.03) over the three-year period. This demonstrates that there is a high turnover of free-roaming dogs and that despite neutering a large number of dogs in an annual sterilisation campaign, the decline in population size was modest over a three-year time period. These findings have significant implications for the planning of rabies vaccination campaigns and population management programmes as well as highlighting the need for further research into the demographics of free-roaming, unowned dogs in India.
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Affiliation(s)
- M J Evans
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK.
| | - A Gibson
- The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, UK; Mission Rabies, Cranborne, Dorset, UK
| | - H Fielding
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK
| | - P Ohal
- Hope & Animal Trust, Ranchi, Jharkhand, India
| | - P Pandey
- Department of Agriculture Animal Husbandry and Cooperative, (Animal Husbandry Division) Govt. of Jharkhand, India
| | - A Kumar
- Hope & Animal Trust, Ranchi, Jharkhand, India
| | - S K Singh
- Hope & Animal Trust, Ranchi, Jharkhand, India
| | - I Airikkala-Otter
- WVS India, Gramya Bhavan/RDO-Building Complex, Aruvankadu, 643202 Nilgiris District, Tamil Nadu, India
| | - B Abela-Ridder
- Department for the Control of Neglected Tropical Diseases, World Health Organization, Genève, Switzerland
| | - L Gamble
- Mission Rabies, Cranborne, Dorset, UK
| | - I Handel
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK
| | - B M D C Bronsvoort
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK; The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, UK
| | - R J Mellanby
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK; The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, UK
| | - S Mazeri
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK; The Roslin Institute, The University of Edinburgh, Roslin, Midlothian, UK
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Kelly RF, Jennings A, Hunt J, Hamman SM, Mazeri S, Nkongho EF, Ngwa VN, Tanya V, Sander M, Ndip L, Bessell PR, Morgan KL, Handel IG, Muwonge A, Bronsvoort BMDC. The epidemiology of bacterial zoonoses in pastoral and dairy cattle in Cameroon, Central Africa. Zoonoses Public Health 2021; 68:781-793. [PMID: 34129288 DOI: 10.1111/zph.12865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 01/22/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
Previous work identified that bacterial zoonoses (Brucella species, Coxiella burnetii and Leptospira hardjo) were present in Cameroonian pastoral cattle. To assess the characteristics of this zoonotic risk, we analyse seroprevalence of each pathogen and the associated management, herd and environmental factors in Cameroonian pastoral and dairy cattle. Cross-sectional samples included pastoralist herds in the Northwest Region (NWR n = 750) and Vina Division (VD n = 748) and small holder dairy herds in the NWR (n = 60). Exposure to Brucella spp., C. burnetii and L. hardjo were screened for using commercial ELISAs and population adjusted estimates made. In addition, individual, herd and ecological metadata were collected and used to identify risk factors associated with animal-level seropositivity. In the pastoral cattle, seroprevalence to Brucella spp. was relatively low but was higher in the NWR (4.2%, CI: 2.5%-7.0%) than the VD (1.1%: CI 0.5%-2.4%), while L. hardjo seroprevalence was much higher though similar in the NWR (30.7%, CI 26.3%-35.5%) and VD (35.9%, CI 31.3%-40.7%). No differences were noted in C. burnetii seroprevalence between the two study sites (NWR: 14.6%, CI 11.8%-18.0%. VD: 12.4%, 9.6%-15.9%). Compared to pastoral, dairy cattle had lower seroprevalences for L. hardjo (1.7%, CI: 0.0%-4.9%), C. burnetii (0.0%, CI 0.0%-6.0%) but similar for Brucella spp. (5.0%, CI 0.0%-10.6%). Increased odds of Brucella spp. seropositivity were associated with owning sheep or rearing sheep and fencing cattle in at night. Adult cattle had increased odds of being seropositive for both C. burnetii and L. hardjo. Additionally, exposure to C. burnetii was associated with local ecological conditions and L. hardjo was negatively associated with cattle undertaking transhumance. This work highlights that exposure to these 3 important production diseases and occupational zoonoses are widespread in Cameroonian cattle. Further work is required to understand transmission dynamics between humans and livestock to inform implementation of effective control measures.
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Affiliation(s)
- Robert F Kelly
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Amy Jennings
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Jennifer Hunt
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Saidou M Hamman
- Regional Centre of Wakwa, Institute of Agricultural Research for Development, Ngaoundere, Cameroon
| | - Stella Mazeri
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Egbe F Nkongho
- School of Life Sciences, University of Lincoln, Lincoln, UK
| | - Victor N Ngwa
- School of Veterinary Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | | | - Melissa Sander
- Tuberculosis Reference Laboratory Bamenda, Hospital Roundabout, Bamenda, Cameroon
| | - Lucy Ndip
- Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon
| | - Paul R Bessell
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Kenton L Morgan
- Institute of Ageing and Chronic Disease and School of Veterinary Science, University of Liverpool, Neston, UK
| | - Ian G Handel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Adrian Muwonge
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Barend M de C Bronsvoort
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, UK
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Abstract
Vitamin D plays a critical role in calcium homeostasis and in the maintenance and development of skeletal health. Vitamin D status has increasingly been linked to non-skeletal health outcomes such as all-cause mortality, infectious diseases and reproductive outcomes in both humans and veterinary species. We have previously demonstrated a relationship between vitamin D status, assessed by the measurement of serum concentrations of the major vitamin D metabolite 25 hydroxyvitamin D (25(OH)D), and a wide range of non-skeletal health outcomes in companion and wild animals. The aims of this study were to define the host and environmental factors associated with vitamin D status in a cohort of 527 calves from Western Kenya which were part of the Infectious Disease of East African Livestock (IDEAL) cohort. A secondary aim was to explore the relationship between serum 25(OH)D concentrations measured in 7-day old calves and subsequent health outcomes over the following 12 months. A genome wide association study demonstrated that both dietary and endogenously produced vitamin D metabolites were under polygenic control in African calves. In addition, we found that neonatal vitamin D status was not predictive of the subsequent development of an infectious disease event or mortality over the 12 month follow up period.
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Affiliation(s)
- Rebecca Callaby
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, EH25 9RG, Midlothian, UK
- Centre for Tropical Livestock Genetics and Health (CTLGH), The Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - Emma Hurst
- The Vitamin D Animal Laboratory (VitDAL), The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, EH25 9RG, Midlothian, UK
| | - Ian Handel
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, EH25 9RG, Midlothian, UK
| | - Phil Toye
- International Livestock Research Institute and Centre for Tropical Livestock Genetics and Health, Nairobi, Kenya
| | - Barend M de C Bronsvoort
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, EH25 9RG, Midlothian, UK
- Centre for Tropical Livestock Genetics and Health (CTLGH), The Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - Richard J Mellanby
- The Vitamin D Animal Laboratory (VitDAL), The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, EH25 9RG, Midlothian, UK.
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Marron O, Thomas G, Burdon Bailey JL, Mayer D, Grossman PO, Lohr F, Gibson AD, Gamble L, Chikungwa P, Chulu J, Handel IG, de C Bronsvoort BM, Mellanby RJ, Mazeri S. Factors associated with mobile phone ownership and potential use for rabies vaccination campaigns in southern Malawi. Infect Dis Poverty 2020; 9:62. [PMID: 32503667 PMCID: PMC7275584 DOI: 10.1186/s40249-020-00677-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rabies is a fatal but preventable viral disease, which causes an estimated 59 000 human deaths globally every year. The vast majority of human rabies cases are attributable to bites from infected domestic dogs and consequently control of rabies in the dog population through mass vaccination campaigns is considered the most effective method of eliminating the disease. Achieving the WHO target of 70% vaccination coverage has proven challenging in low-resource settings such as Sub Saharan Africa, and lack of public awareness about rabies vaccination campaigns is a major barrier to their success. In this study we surveyed communities in three districts in Southern Malawi to assess the extent of and socio-economic factors associated with mobile phone ownership and explore the attitudes of communities towards the use of short message service (SMS) to inform them of upcoming rabies vaccination clinics. METHODS This study was carried out between 1 October-3 December 2018 during the post-vaccination assessment of the annual dog rabies campaign in Blantyre, Zomba and Chiradzulu districts, Malawi. 1882 questionnaires were administered to households in 90 vaccination zones. The surveys gathered data on mobile phone ownership and use, and barriers to mobile phone access. A multivariable regression model was used to understand factors related to mobile phone ownership. RESULTS Most survey respondents owned or had use of a mobile phone, however there was evidence of an inequality of access, with higher education level, living in Blantyre district and being male positively associated with mobile phone ownership. The principal barrier to mobile phone ownership was the cost of the phone itself. Basic feature phones were most common and few owned smartphones. SMS was commonly used and the main reason for not using SMS was illiteracy. Attitudes to receiving SMS reminders about future rabies vaccination campaigns were positive. CONCLUSIONS The study showed a majority of those surveyed have the use of a mobile phone and most mobile phone owners indicated they would like to receive SMS messages about future rabies vaccination campaigns. This study provides insight into the feasibility of distributing information about rabies vaccination campaigns using mobile phones in Malawi.
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Affiliation(s)
- Orla Marron
- Veterinary surgeon, Apt 35, The Barley House, Cork St, Dublin, 8 Ireland
| | | | | | | | | | | | | | | | - Patrick Chikungwa
- Department of Animal Health and Livestock Development, Blantyre, Malawi
| | - Julius Chulu
- Department of Animal Health and Livestock Development, Blantyre, Malawi
| | - Ian G. Handel
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Barend M. de C Bronsvoort
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Richard J. Mellanby
- The Royal (Dick) School of Veterinary Studies, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Stella Mazeri
- The Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
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8
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Porphyre T, Bronsvoort BMDC, Gunn GJ, Correia-Gomes C. Multilayer network analysis unravels haulage vehicles as a hidden threat to the British swine industry. Transbound Emerg Dis 2020; 67:1231-1246. [PMID: 31880086 DOI: 10.1111/tbed.13459] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/20/2019] [Accepted: 12/21/2019] [Indexed: 11/29/2022]
Abstract
When assessing the role of live animal trade networks in the spread of infectious diseases in livestock, attention has focused mainly on direct movements of animals between premises, whereas the role of haulage vehicles used during transport, an indirect route for disease transmission, has largely been ignored. Here, we have assessed the impact of sharing haulage vehicles from livestock transport service providers on the connectivity between farms as well as on the spread of swine infectious diseases in Great Britain (GB). Using all pig movement records between April 2012 and March 2014 in GB, we built a series of directed and weighted static multiplex networks consisting of two layers of identical nodes, where nodes (farms) are linked either by (a) the direct movement of pigs and (b) the shared use of haulage vehicles. The haulage contact definition integrates the date of the move and the duration Δ s that lorries are left contaminated by pathogens, hence accounting for the temporal aspect of contact events. For increasing Δ s , descriptive network analyses were performed to assess the role of haulage on network connectivity. We then explored how viruses may spread throughout the GB pig sector by computing the reproduction number R . Our results showed that sharing haulage vehicles increases the number of contacts between farms by >50% and represents an important driver of disease transmission. In particular, sharing haulage vehicles, even if Δ s < 1 day, will limit the benefit of the standstill regulation, increase the number of premises that could be infected in an outbreak, and more easily raise R above 1. This work confirms that sharing haulage vehicles has significant potential for spreading infectious diseases within the pig sector. The cleansing and disinfection process of haulage vehicles is therefore a critical control point for disease transmission risk mitigation.
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Affiliation(s)
- Thibaud Porphyre
- The Roslin Institute, University of Edinburgh, Midlothian, Scotland
| | | | - George J Gunn
- Epidemiology Research Unit, Department of Veterinary and Animal Science, Scotland's Rural College (SRUC), Inverness, Scotland
| | - Carla Correia-Gomes
- Epidemiology Research Unit, Department of Veterinary and Animal Science, Scotland's Rural College (SRUC), Inverness, Scotland
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9
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Duchatel F, Bronsvoort BMDC, Lycett S. Phylogeographic Analysis and Identification of Factors Impacting the Diffusion of Foot-and-Mouth Disease Virus in Africa. Front Ecol Evol 2019. [DOI: 10.3389/fevo.2019.00371] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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10
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Meunier NV, Panti A, Mazeri S, Fernandes KA, Handel IG, Bronsvoort BMDC, Gamble L, Mellanby RJ. Randomised trial of perioperative tramadol for canine sterilisation pain management. Vet Rec 2019; 185:406. [PMID: 31320545 DOI: 10.1136/vr.105009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 11/03/2022]
Abstract
Surgical sterilisation to manage free-roaming dog populations is widely used in many countries. However, few studies have examined optimal postoperative pain management regimens at low-resource, high-throughput veterinary clinics. The aim of this study was to examine the efficacy of two intravenous analgesic regimens, preoperative administration of meloxicam and tramadol, or meloxicam alone, in free-roaming dogs undergoing sterilisation. A total of 125 dogs were included, with 64 dogs in the meloxicam-tramadol arm and 61 dogs in the meloxicam-only arm in a non-inferiority study design. Pain levels in sterilisation surgery patients were assessed at four time points after surgery using the Colorado State University Canine Acute Pain Scale, a Visual Analogue Scale and a modified version of the Glasgow Composite Measure Pain Scale - Short Form. Non-inferiority was supported for each of the main scoring outcomes using non-inferiority margins of 0.5, 5 and 0.8, respectively. One dog from the meloxicam-tramadol group and four dogs in the meloxicam-only arm required rescue analgesia, with no difference between groups (P=0.21).The study demonstrated that meloxicam was effective in controlling postoperative pain in a high proportion of dogs. The addition of tramadol alongside meloxicam treatment was not found to be of clinical benefit.
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Affiliation(s)
- Natascha V Meunier
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | - Ambra Panti
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | - Stella Mazeri
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | | | - Ian G Handel
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | - Barend M de C Bronsvoort
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | | | - Richard J Mellanby
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
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11
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de Glanville WA, Thomas LF, Cook EAJ, Bronsvoort BMDC, Wardrop N, Wamae CN, Kariuki S, Fèvre EM. General contextual effects on neglected tropical disease risk in rural Kenya. PLoS Negl Trop Dis 2018; 12:e0007016. [PMID: 30576335 PMCID: PMC6342328 DOI: 10.1371/journal.pntd.0007016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/22/2019] [Accepted: 11/22/2018] [Indexed: 01/20/2023] Open
Abstract
The neglected tropical diseases (NTDs) are characterized by their tendency to cluster within groups of people, typically the poorest and most marginalized. Despite this, measures of clustering, such as within-group correlation or between-group heterogeneity, are rarely reported from community-based studies of NTD risk. We describe a general contextual analysis that uses multi-level models to partition and quantify variation in individual NTD risk at multiple grouping levels in rural Kenya. The importance of general contextual effects (GCE) in structuring variation in individual infection with Schistosoma mansoni, the soil-transmitted helminths, Taenia species, and Entamoeba histolytica/dispar was examined at the household-, sublocation- and constituency-levels using variance partition/intra-class correlation co-efficients and median odds ratios. These were compared with GCE for HIV, Plasmodium falciparum and Mycobacterium tuberculosis. The role of place of residence in shaping infection risk was further assessed using the spatial scan statistic. Individuals from the same household showed correlation in infection for all pathogens, and this was consistently highest for the gastrointestinal helminths. The lowest levels of household clustering were observed for E. histolytica/dispar, P. falciparum and M. tuberculosis. Substantial heterogeneity in individual infection risk was observed between sublocations for S. mansoni and Taenia solium cysticercosis and between constituencies for infection with S. mansoni, Trichuris trichiura and Ascaris lumbricoides. Large overlapping spatial clusters were detected for S. mansoni, T. trichiura, A. lumbricoides, and Taenia spp., which overlapped a large cluster of elevated HIV risk. Important place-based heterogeneities in infection risk exist in this community, and these GCEs are greater for the NTDs and HIV than for TB and malaria. Our findings suggest that broad-scale contextual drivers shape infectious disease risk in this population, but these effects operate at different grouping-levels for different pathogens. A general contextual analysis can provide a foundation for understanding the complex ecology of NTDs and contribute to the targeting of interventions.
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Affiliation(s)
- William A. de Glanville
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Lian F. Thomas
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Elizabeth A. J. Cook
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Barend M. de C. Bronsvoort
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Nicola Wardrop
- Department of Geography and Environment, University of Southampton, Highfield Campus, Southampton, United Kingdom
| | - Claire N. Wamae
- School of Pharmacy and Health Sciences, United States International University, Nairobi, Kenya
| | - Samuel Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Neston, United Kingdom
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12
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Kelly RF, Callaby R, Egbe NF, Williams DJL, Victor NN, Tanya VN, Sander M, Ndip L, Ngandolo R, Morgan KL, Handel IG, Mazeri S, Muwonge A, de C Bronsvoort BM. Association of Fasciola gigantica Co-infection With Bovine Tuberculosis Infection and Diagnosis in a Naturally Infected Cattle Population in Africa. Front Vet Sci 2018; 5:214. [PMID: 30238010 PMCID: PMC6136300 DOI: 10.3389/fvets.2018.00214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/15/2018] [Indexed: 01/24/2023] Open
Abstract
Bovine tuberculosis (bTB), caused by Mycobacterium bovis, remains a major livestock and public health problem in both high and low-income countries. With the current absence of an effective vaccine, control in cattle populations is reliant on regular testing and removal of positive animals. However, surveillance and control are hampered by imperfect diagnostic tests that have poorly described properties in naturally infected populations. Recent research in cattle co-infected with the temperate liver fluke, Fasciola hepatica, has raised concerns about the performance of the intradermal skin test in high fluke incidence areas. Further, recent studies of parasitic co-infections have demonstrated their impact on Th1 and Th2 responses, concurrent disease pathology and susceptibility to mycobacterial infections. Here we report for the first time the association of co-infection with the tropical liver fluke, Fasciola gigantica, with the presence of bTB-like lesions and the IFN-γ response in naturally infected African cattle. After adjusting for age and sex we observed a complex interaction between fluke status and breed. Fulani cattle had a higher risk of having bTB-like lesions than the mixed breed group. The risk of bTB-like lesions increased in the mixed breed group if they had concurrent evidence of fluke pathology but was less clear in the coinfected Fulani breed. Further, we observed a slight decline in the IFN-γ levels in fluke infected animals. Finally we explored factors associated with IFN-γ false negative results compared to the presence of bTB-like lesions. Fulani cattle had a higher risk of having a false negative result compared to the mixed breed group. Further, the mixed breed cattle had an increased risk of being false negative if also co-infected with fluke. Interesting, as with the risk of bTB-like lesions, this association was less clear in the Fulani cattle with weak evidence of a slight decrease in risk of having a false negative test result when fluke pathology positive. This interesting interaction where different breeds appear to have different responses to co-infections is intriguing but further work is needed to confirm and understand more clearly the possible confounding effects of different other co-infections not measured here, breed, management or exposure risks.
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Affiliation(s)
- Robert F. Kelly
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | - Rebecca Callaby
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | - Nkongho F. Egbe
- Microbiology and Parasitology Unit, Faculty of Allied Medical Science, University of Calabar, Calabar, Nigeria
| | - Diana J. L. Williams
- Veterinary Parasitology, Institute of Infection and Global Health and School of Veterinary Science, Liverpool, United Kingdom
| | - Ngu Ngwa Victor
- School of Veterinary Medicine and Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | | | - Melissa Sander
- Tuberculosis Reference Laboratory Bamenda, Hospital Roundabout, Bamenda, Cameroon
| | - Lucy Ndip
- Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon
| | - Richard Ngandolo
- Laboratoire de Recherches Vétérinaires et Zootechniques de Farcha, N'Djamena, Chad
| | - Kenton L. Morgan
- Institute of Ageing and Chronic Disease and School of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Ian G. Handel
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | - Stella Mazeri
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | - Adrian Muwonge
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | - Barend M. de C Bronsvoort
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
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13
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Mbu ET, Sauter F, Zoufaly A, Bronsvoort BMDC, Morgan KL, Noeske J, Abena JLF, Sander MS. Tuberculosis in people newly diagnosed with HIV at a large HIV care and treatment center in Northwest Cameroon: Burden, comparative screening and diagnostic yields, and patient outcomes. PLoS One 2018; 13:e0199634. [PMID: 29944701 PMCID: PMC6019259 DOI: 10.1371/journal.pone.0199634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/11/2018] [Indexed: 01/18/2023] Open
Abstract
Background Diagnosis of tuberculosis in people living with HIV is challenging due to non-specific clinical presentations and inadequately sensitive diagnostic tests. The WHO recommends screening using a clinical algorithm followed by rapid diagnosis using the Xpert MTB/RIF assay, and more information is needed to evaluate these recommendations in different settings. Methods From August 2012 to September 2013, consecutive adults newly diagnosed with HIV in Bamenda, Cameroon, were screened for TB regardless of symptoms by smear microscopy and culture; the Xpert MTB/RIF assay was performed retrospectively. Time to treatment and patient outcomes were obtained from routine registers. Results Among 1,149 people enrolled, 940 (82%) produced sputum for lab testing; of these, 68% were women, the median age was 35 years (IQR, 28–42 years), the median CD4 count was 291cells/μL (IQR, 116–496 cells/μL), and 86% had one or more of current cough, fever, night sweats, or weight loss. In total, 131 people (14%, 95% CI, 12–16%) had sputum culture-positive TB. The WHO symptom screening algorithm had a sensitivity of 92% (95%CI, 86–96%) and specificity of 15% (95%CI, 12–17%) in this population. Compared to TB culture, the sensitivity of direct smear microscopy was 25% (95% CI, 18–34%), and the sensitivity of Xpert was 68% (95% CI, 58–76); the sensitivity of both was higher for people reporting more symptoms. Only one of 69 people with smear-negative/culture-positive TB was started on TB treatment prior to culture positivity. Of 71 people with bacteriologically-confirmed TB and known outcome after 6 months, 13 (17%) had died, including 11 people with smear-negative TB and 6 people with both smear and Xpert-negative TB. Conclusions Use of the most sensitive rapid diagnostic test available is critical in people newly diagnosed with HIV in this setting to maximize the detection of bacteriologically-confirmed TB. However, this intervention is not sufficient alone and should be combined with more comprehensive clinical diagnosis of TB to improve outcomes.
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Affiliation(s)
| | - Florian Sauter
- Approved Treatment Center for HIV/AIDS, Bamenda Regional Hospital, Bamenda, Cameroon
| | - Alexander Zoufaly
- Approved Treatment Center for HIV/AIDS, Bamenda Regional Hospital, Bamenda, Cameroon
| | | | - Kenton L. Morgan
- Institute of Veterinary Science, University of Liverpool, Leahurst, United Kingdom
| | | | | | - Melissa S. Sander
- Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon
- * E-mail:
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14
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de Glanville WA, Conde-Álvarez R, Moriyón I, Njeru J, Díaz R, Cook EAJ, Morin M, Bronsvoort BMDC, Thomas LF, Kariuki S, Fèvre EM. Poor performance of the rapid test for human brucellosis in health facilities in Kenya. PLoS Negl Trop Dis 2017; 11:e0005508. [PMID: 28388625 PMCID: PMC5413359 DOI: 10.1371/journal.pntd.0005508] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 05/02/2017] [Accepted: 03/20/2017] [Indexed: 02/07/2023] Open
Abstract
Human brucellosis is considered to be an important but typically under-diagnosed cause of febrile illness in many low and middle-income countries. In Kenya, and throughout East Africa, laboratory diagnosis for the disease is based primarily on the febrile antigen Brucella agglutination test (FBAT), yet few studies of the diagnostic accuracy of this test exist. Assessment of the performance of the FBAT is essential for its appropriate clinical use, as well as for evaluating surveillance data reported by public health systems. To assess FBAT performance, we collected sera from people with symptoms compatible with brucellosis attending two health facilities in Busia County, Kenya. Sera were tested using the FBAT and results compared with those from the Rose Bengal Test (RBT), an assay with well-known performance characteristics. Positives on either test were confirmed using the classical serum agglutination test (SAT)-Coombs test combination and a rapid IgM/IgG lateral flow immunochromatography assay (LFA). A questionnaire focussing on known risk factors for exposure to Brucella spp. was also conducted, and relationships with FBAT positivity examined using logistic regression. Out of 825 recruited individuals, 162 (19.6%) were classified as positive using the FBAT. In contrast, only eight (1.0%) were positive using the RBT. Of the 162 FBAT positives, one (0.62%) had an atypical agglutination in SAT and three (1.9%) showed low Coombs titres. Out of 148 FBAT positive individuals tested using the LFA, five (3.4%) were IgM positive and none were IgG positive. Poor or no correlation was observed between FBAT results and most established risk factors for Brucella infection. We observed substantial disagreement between the FBAT and a number of well-known serological tests, with the majority of reactive FBAT results appearing to be false positives. Poor FBAT specificity, combined with a lack of confirmatory testing, strongly suggests overdiagnosis of brucellosis is common in this low prevalence setting. This is expected to have important economic impacts on affected patients subjected to the long and likely unnecessary courses of multiple antibiotics required for treatment of the disease. Brucellosis is a debilitating disease of people caused by infection with one of a number of different Brucella species. In almost all cases, people acquire the infection through exposure to infected animals or contaminated animal products. Human brucellosis is well known for its wide range of symptoms, and is often clinically indistinguishable from other infectious diseases, such as malaria or typhoid. Diagnosing the disease therefore typically relies on laboratory tests. A wide range of tests are available, but little is known about the accuracy of the principal test used in Government health facilities in Kenya, the febrile Brucella agglutination test (FBAT). In this study, we identified people with symptoms compatible with brucellosis attending health centres in Kenya. By comparing results from the FBAT performed on samples collected from these individuals with the results from a range of well-established diagnostic tests, we were able to show that the FBAT produces large numbers of false positive results. We expect that this leads to a high levels of overdiagnosis of brucellosis in some parts of Kenya. Treatment of the disease involves multiple weeks of multiple antibiotics, and these incorrect diagnoses may have important and unnecessary negative impacts on affected patients.
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Affiliation(s)
- William A de Glanville
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Raquel Conde-Álvarez
- Institute for Tropical Health, Navarra Institute for Sanitary Research and Department of Microbiology and Parasitology, Medical School, University of Navarra, Pamplona, Spain
| | - Ignacio Moriyón
- Institute for Tropical Health, Navarra Institute for Sanitary Research and Department of Microbiology and Parasitology, Medical School, University of Navarra, Pamplona, Spain
| | - John Njeru
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.,Institute for Bacterial Infections and Zoonoses, Friedrich Loeffler Institute, Berlin, Germany
| | - Ramón Díaz
- Institute for Tropical Health, Navarra Institute for Sanitary Research and Department of Microbiology and Parasitology, Medical School, University of Navarra, Pamplona, Spain
| | - Elizabeth A J Cook
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Matilda Morin
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Barend M de C Bronsvoort
- Epidemiology, Economics and Risk Assessment Group, The Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Lian F Thomas
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Samuel Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya.,Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
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15
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Morgan KL, Handel IG, Tanya VN, Hamman SM, Nfon C, Bergman IE, Malirat V, Sorensen KJ, de C Bronsvoort BM. Accuracy of herdsmen reporting versus serologic testing for estimating foot-and-mouth disease prevalence. Emerg Infect Dis 2016; 20:2048-54. [PMID: 25417556 PMCID: PMC4257810 DOI: 10.3201/eid2012.140931] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Herdsman-reported disease prevalence is widely used in veterinary epidemiologic studies, especially for diseases with visible external lesions; however, the accuracy of such reports is rarely validated. Thus, we used latent class analysis in a Bayesian framework to compare sensitivity and specificity of herdsman reporting with virus neutralization testing and use of 3 nonstructural protein ELISAs for estimates of foot-and-mouth disease (FMD) prevalence on the Adamawa plateau of Cameroon in 2000. Herdsman-reported estimates in this FMD-endemic area were comparable to those obtained from serologic testing. To harness to this cost-effective resource of monitoring emerging infectious diseases, we suggest that estimates of the sensitivity and specificity of herdsmen reporting should be done in parallel with serologic surveys of other animal diseases.
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16
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Muwonge A, Malama S, Bronsvoort BMDC, Biffa D, Ssengooba W, Skjerve E. A comparison of tools used for tuberculosis diagnosis in resource-limited settings: a case study at Mubende referral hospital, Uganda. PLoS One 2014; 9:e100720. [PMID: 24967713 PMCID: PMC4072677 DOI: 10.1371/journal.pone.0100720] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 05/23/2014] [Indexed: 11/29/2022] Open
Abstract
Background This study compared TB diagnostic tools and estimated levels of misdiagnosis in a resource-limited setting. Furthermore, we estimated the diagnostic utility of three-TB-associated predictors in an algorithm with and without Direct Ziehl-Neelsen (DZM). Materials and Methods Data was obtained from a cross-sectional study in 2011 conducted at Mubende regional referral hospital in Uganda. An individual was included if they presented with a two weeks persistent cough and or lymphadenitis/abscess. 344 samples were analyzed on DZM in Mubende and compared to duplicates analyzed on direct fluorescent microscopy (DFM), growth on solid and liquid media at Makerere University. Clinical variables from a questionnaire and DZM were used to predict TB status in multivariable logistic and Cox proportional hazard models, while optimization and visualization was done with receiver operating characteristics curve and algorithm-charts in Stata, R and Lucid-Charts respectively. Results DZM had a sensitivity and specificity of 36.4% (95% CI = 24.9–49.1) and 97.1%(95% CI = 94.4–98.7) compared to DFM which had a sensitivity and specificity of 80.3%(95% CI = 68.7–89.1) and 97.1%(95% CI = 94.4–98.7) respectively. DZM false negative results were associated with patient’s HIV status, tobacco smoking and extra-pulmonary tuberculosis. One of the false negative cases was infected with multi drug resistant TB (MDR). The three-predictor screening algorithm with and without DZM classified 50% and 33% of the true cases respectively, while the adjusted algorithm with DZM classified 78% of the true cases. Conclusion The study supports the concern that using DZM alone risks missing majority of TB cases, in this case we found nearly 60%, of who one was an MDR case. Although adopting DFM would reduce this proportion to 19%, the use of a three-predictor screening algorithm together with DZM was almost as good as DFM alone. It’s utility is whoever subject to HIV screening all TB suspects.
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Affiliation(s)
- Adrian Muwonge
- Department of Food Safety and Infection Biology, Centre for Epidemiology and Biostatistics, Norwegian University of Life Sciences, Oslo, Norway
- The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Midlothian, Edinburgh, United Kingdom
- * E-mail:
| | - Sydney Malama
- Institute of Economic and Social Research University of Zambia, Lusaka, Zambia
| | - Barend M. de C. Bronsvoort
- The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Midlothian, Edinburgh, United Kingdom
| | - Demelash Biffa
- College of Medicine, University of Arizona, Tucson, Arizona, United States of America
| | - Willy Ssengooba
- Mycobacteriology Laboratory, Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eystein Skjerve
- Department of Food Safety and Infection Biology, Centre for Epidemiology and Biostatistics, Norwegian University of Life Sciences, Oslo, Norway
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17
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Pugh CA, Bronsvoort BMDC, Handel IG, Summers KM, Clements DN. What can cohort studies in the dog tell us? Canine Genet Epidemiol 2014; 1:5. [PMID: 26401322 PMCID: PMC4574393 DOI: 10.1186/2052-6687-1-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/25/2014] [Indexed: 12/18/2022] Open
Abstract
This paper addresses the use of cohort studies in canine medicine to date and highlights the benefits of wider use of such studies in the future. Uniquely amongst observational studies, cohort studies offer the investigator an opportunity to assess the temporal relationship between hypothesised risk factors and diseases. In human medicine cohort studies were initially used to investigate specific exposures but there has been a movement in recent years to more broadly assess the impact of complex lifestyles on morbidity and mortality. Such studies do not focus on narrow prior hypotheses but rather generate new theories about the impact of environmental and genetic risk factors on disease. Unfortunately cohort studies are expensive both in terms of initial investment and on-going costs. There is inevitably a delay between set up and the reporting of meaningful results. Expense and time constraints are likely why this study design has been used sparingly in the field of canine health studies. Despite their rather limited numbers, canine cohort studies have made a valuable contribution to the understanding of dog health, in areas such as the dynamics of infectious disease. Individual exposures such as neutering and dietary restriction have also been directly investigated. More recently, following the trend in human health, large cohort studies have been set up to assess the wider impact of dog lifestyle on their health. Such studies have the potential to develop and test hypotheses and stimulate new theories regarding the maintenance of life-long health in canine populations.
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Affiliation(s)
- Carys A Pugh
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG UK
| | - Barend M de C Bronsvoort
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG UK
| | - Ian G Handel
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG UK
| | - Kim M Summers
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG UK
| | - Dylan N Clements
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG UK
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18
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Peiso OO, Bronsvoort BMDC, Handel IG, Volkova VV. A review of exotic animal disease in Great Britain and in Scotland specifically between 1938 and 2007. PLoS One 2011; 6:e22066. [PMID: 21818292 PMCID: PMC3144883 DOI: 10.1371/journal.pone.0022066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 06/16/2011] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Incursions of contagious diseases of livestock into disease-free zones are inevitable as long as the diseases persist elsewhere in the world. Knowledge of where, when and how incursions have occurred helps assess the risks, and regionalize preventative and reactive measures. METHODOLOGY Based on reports of British governmental veterinary services, we review occurrence of the former OIE List A diseases, and of Aujeszky's disease, anthrax and bovine tuberculosis (bTB) in farm-animals in Great Britain (GB) between 1938 and 2007. We estimate incidence of each disease on GB agricultural holdings and fraction of susceptible farm-animals culled to control the disease each year. We then consider the frequency and incidence of the diseases in Scotland alone. The limitations of available data on historical disease occurrence and denominator populations are detailed in Text S2. CONCLUSIONS The numbers of livestock and poultry farmed in GB grew over the years 1938-2007; the number of agricultural holdings decreased. An amalgamation of production on larger holdings took place from the 1940s to the 1980s. The maximum annual incidence of a reviewed disease in GB 1938-2007 was reported for bTB, 1.69% of holdings in 1961. This was followed by Newcastle disease, 1.50% of holdings in 1971, and classical swine fever, 1.09% of holdings in 1940. The largest fractional cull of susceptible livestock in a single year in each of the four decades 1950s-1980s was due to a viral disease primarily affecting swine. During the periods 1938-1949 and 2000-2007 this was due to outbreaks of foot and mouth disease. In the absence of incursions of the former OIE List A diseases in the 1990s, this was due to bTB. Over the 70 years, the diseases were reported with lower frequency and lower annual incidence in Scotland, as compared to when these statistics are considered for GB as a whole.
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Affiliation(s)
- Onneile O. Peiso
- Epidemiology Group, School of Biological Sciences, Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
| | - Barend M. de C. Bronsvoort
- Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Roslin, Midlothian, United Kingdom
| | - Ian G. Handel
- Epidemiology, Economics and Risk Assessment (EERA) Group, The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Roslin, Midlothian, United Kingdom
| | - Victoriya V. Volkova
- Epidemiology Group, School of Biological Sciences, Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
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Handel IG, de C Bronsvoort BM, Forbes JF, Woolhouse MEJ. Risk-targeted selection of agricultural holdings for post-epidemic surveillance: estimation of efficiency gains. PLoS One 2011; 6:e20064. [PMID: 21674022 PMCID: PMC3107858 DOI: 10.1371/journal.pone.0020064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 04/25/2011] [Indexed: 12/02/2022] Open
Abstract
Current post-epidemic sero-surveillance uses random selection of animal holdings. A better strategy may be to estimate the benefits gained by sampling each farm and use this to target selection. In this study we estimate the probability of undiscovered infection for sheep farms in Devon after the 2001 foot-and-mouth disease outbreak using the combination of a previously published model of daily infection risk and a simple model of probability of discovery of infection during the outbreak. This allows comparison of the system sensitivity (ability to detect infection in the area) of arbitrary, random sampling compared to risk-targeted selection across a full range of sampling budgets. We show that it is possible to achieve 95% system sensitivity by sampling, on average, 945 farms with random sampling and 184 farms with risk-targeted sampling. We also examine the effect of ordering samples by risk to expedite return to a disease-free status. Risk ordering the sampling process results in detection of positive farms, if present, 15.6 days sooner than with randomly ordered sampling, assuming 50 farms are tested per day.
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Affiliation(s)
- Ian G Handel
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, United Kingdom.
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Kovalik M, Thoday KL, Handel IG, de C. Bronsvoort BM, Evans H, van den Broek AHM, Mellanby RJ. Ciclosporin A therapy is associated with disturbances in glucose metabolism in dogs with atopic dermatitis. Vet Dermatol 2010; 22:173-80. [DOI: 10.1111/j.1365-3164.2010.00935.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bronsvoort BMDC, Parida S, Handel I, McFarland S, Fleming L, Hamblin P, Kock R. Serological survey for foot-and-mouth disease virus in wildlife in eastern Africa and estimation of test parameters of a nonstructural protein enzyme-linked immunosorbent assay for buffalo. Clin Vaccine Immunol 2008; 15:1003-11. [PMID: 18385460 PMCID: PMC2446625 DOI: 10.1128/cvi.00409-07] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 10/30/2007] [Accepted: 03/05/2008] [Indexed: 11/20/2022]
Abstract
In this study we estimate the seroprevalence of foot-and-mouth disease virus (FMDV) in wildlife from eastern and central Africa. Sera were sourced from between 1994 and 2002 from a rinderpest surveillance program. Our study compared a nonstructural protein enzyme-linked immunosorbent assay (Cedi test) with a virus neutralization test. The study shows that there is only a low seroprevalence of FMDV in sampled nonbuffalo species. The seroprevalence in the Cape buffalo was high for SAT2, lower for SAT1, and lowest for SAT3. As the SAT2 serotype was most prevalent, the Cedi test largely reflected the occurrence of SAT2-positive animals. The results also suggest that SAT2 became dominant around 1998, with a large increase in seroprevalence. The sensitivity and specificity of the Cedi test were estimated by comparison to the combined virus neutralization test results from all three SAT tests. A Bayesian implementation of the Hui-Walter latent class model was used to estimate the test parameters. The model permits estimation in the absence of a gold standard test. The final model, using noninformative priors and assuming conditional independence of test performance, estimated Cedi test sensitivity at 87.7% and specificity at 87.3%. These estimates are similar to those for domestic bovines; they suggest that the Cedi test is a useful tool for screening buffalo for infection with the various serotypes of FMDV.
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Affiliation(s)
- B M D C Bronsvoort
- University of Edinburgh, Centre for Tropical Veterinary Medicine, The Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, Roslin EH25 9RG, United Kingdom
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Halliday JEB, Meredith AL, Knobel DL, Shaw DJ, Bronsvoort BMDC, Cleaveland S. A framework for evaluating animals as sentinels for infectious disease surveillance. J R Soc Interface 2007; 4:973-84. [PMID: 17504735 PMCID: PMC2394544 DOI: 10.1098/rsif.2007.0237] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The dynamics of infectious diseases are highly variable. Host ranges, host responses to pathogens and the relationships between hosts are heterogeneous. Here, we argue that the use of animal sentinels has the potential to use this variation and enable the exploitation of a wide range of pathogen hosts for surveillance purposes. Animal sentinels may be used to address many surveillance questions, but they may currently be underused as a surveillance tool and there is a need for improved interdisciplinary collaboration and communication in order to fully explore the potential of animal sentinels. In different contexts, different animal hosts will themselves vary in their capacity to provide useful information. We describe a conceptual framework within which the characteristics of different host populations and their potential value as sentinels can be evaluated in a broad range of settings.
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Affiliation(s)
- Jo E B Halliday
- Wildlife and Emerging Diseases Section, R(D)SVS, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK.
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Fèvre EM, Bronsvoort BMDC, Hamilton KA, Cleaveland S. Animal movements and the spread of infectious diseases. Trends Microbiol 2006; 14:125-31. [PMID: 16460942 PMCID: PMC7119069 DOI: 10.1016/j.tim.2006.01.004] [Citation(s) in RCA: 258] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 11/21/2005] [Accepted: 01/20/2006] [Indexed: 11/28/2022]
Abstract
Domestic and wild animal population movements are important in the spread of disease. There are many recent examples of disease spread that have occurred as a result of intentional movements of livestock or wildlife. Understanding the volume of these movements and the risks associated with them is fundamental in elucidating the epidemiology of these diseases, some of which might entail zoonotic risks. The importance of the worldwide animal trade is reviewed and the role of the unregulated trade in animals is highlighted. A range of key examples are discussed in which animal movements have resulted in the introduction of pathogens to previously disease-free areas. Measures based on heightened surveillance are proposed that mitigate the risks of new pathogen introductions.
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Affiliation(s)
- Eric M Fèvre
- Centre for Infectious Diseases and Centre for Tropical Veterinary Medicine, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Roslin, Midlothian EH25 9RG, UK.
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