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Towards One Health Disease Surveillance: the Southern African Centre for Infectious Disease Surveillance Approach

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Towards One Health Disease Surveillance: the Southern African Centre for Infectious Disease Surveillance Approach Page 1 of 7 Proceeding Towards One Health disease surveillance: The Southern African Centre for Infectious Disease Surveillance approach Authors: Africa has the highest burden of infectious diseases in the world and yet the least capacity 1 Esron D. Karimuribo for its risk management. It has therefore become increasingly important to search for ‘fit-for- Kuya Sayalel2,3 purpose’ approaches to infectious disease surveillance and thereby targeted disease control. Eric Beda1 Nick Short4 The fact that the majority of human infectious diseases are originally of animal origin means Philemon Wambura1 we have to consider One Health (OH) approaches which require inter-sectoral collaboration Leonard G. Mboera5 for custom-made infectious disease surveillance in the endemic settings of Africa. A baseline 3 Lughano J.M. Kusiluka survey was conducted to assess the current status and performance of human and animal Mark M. Rweyemamu1 health surveillance systems and subsequently a strategy towards OH surveillance system was Affiliations: developed. The strategy focused on assessing the combination of participatory epidemiological 1Southern African Centre approaches and the deployment of mobile technologies to enhance the effectiveness of disease for Infectious Disease alerts and surveillance at the point of occurrence, which often lies in remote areas. We selected Surveillance, Morogoro, Tanzania three study sites, namely the Ngorongoro, Kagera River basin and Zambezi River basin ecosystems. We have piloted and introduced the next-generation Android mobile phones 2Ngorongoro Conservation running the EpiCollect application developed by Imperial College to aid geo-spatial and Area Authority, Ngorongoro clinical data capture and transmission of this data from the field to the remote Information Arusha, Tanzania Technology (IT) servers at the research hubs for storage, analysis, feedback and reporting. We 3The Open University of expect that the combination of participatory epidemiology and technology will significantly Tanzania, Dar es Salaam, improve OH disease surveillance in southern Africa. Tanzania 4Royal Veterinary College, London, United Kingdom Introduction Although there have been some recent advances in the diagnosis and management of human 5 National Institute for infectious diseases, they still are a significant impact and burden on global economies and public Medical Research, Dar es Salaam, Tanzania health (Jones et al. 2008). Infectious diseases are responsible for a quarter of all human deaths worldwide (King et al. 2006). Most of these are as a result of emerging infectious diseases (EIDs), Correspondence to: defined as infections that have newly appeared in a population or have existed but are rapidly Esron Karimuribo increasing in incidence or geographic range (Morse 1995). There are various drivers for the Email: occurrence of EIDs including socio-economic, environmental and ecological factors. Analysis of [email protected] origins of EIDs for longer than six decades concluded that over 60% are zoonotic of which about 72% originate in wild animals (Jones et al. 1978). It has also been observed that when considering Postal address: spatial distribution of origins of infectious diseases, the majority are prevalent in and affect PO Box 3297, SUA Morogoro, Tanzania developing countries in the tropics, particularly in Africa and South-East Asia. How to cite this proceeding: Effective disease surveillance is required to ensure freedom from EIDs or else timely intervention Karimuribo, E.D., Sayalel, in order to reduce risks and impact on animal and human populations. Disease surveillance K., Beda, E., Short, N., is commonly defined as an ongoing systematic collection, analysis and interpretation of data Wambura, P., Mboera, L.G. et al., 2012, ‘Towards One essential to the planning, implementation and evaluation of disease management practice, closely Health disease surveillance: integrated with the timely dissemination of these data to those who need to know (Mboera, The Southern African Centre Rumisha & Kitua 2001; Thacker & Berkelman 1988). Although the purpose and objectives for Infectious Disease of disease surveillance may differ between different health sectors, it is generally agreed that Surveillance approach’, Onderstepoort Journal of surveillance is useful for rapid detection of new and/or foreign diseases, provides evidence of Veterinary Research 79(2), freedom from diseases within a defined geographic area or population, accurately delineates Art. #454, 7 pages. http:// the distribution and occurrence of diseases relevant to disease control and provides evidence dx.doi.org/10.4102/ojvr. required to assess progress and success of disease control or rededication (FAO 2004). v79i2.454 Note: Most developing countries have limited disease surveillance capacity and so need to ensure Proceedings of the optimal use of available resources. However, previous studies indicated that both animal and Conference of the Southern human health sectors are poorly resourced in terms of both clinical and public health service African Centre for Infectious provision (James & Muchiri 2006; Jones 2011; Karimuribo et al. 2011). Considering that most Disease Surveillance ‘One Health’ held at the National emerging infectious disease conditions in public health sectors, especially in tropical countries, Institute for Communicable are of animal (wildlife and domestic) origin (Jones et al. 2008; Wolfe, Dunavan & Diamond 2007), Diseases, Johannesburg, July 2011. Copyright: © 2012. The Authors. Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License. http://www.ojvr.org doi:10.4102/ojvr.v79i2.454 Page 2 of 7 Proceeding it is important to encourage collaboration between the completeness and accuracy of surveillance reports focusing animal and human health sectors in order to minimise risks on a period of five years (2005–2010) before the study. Other associated with such infections. The purpose of this work is factors that might have influenced the timely submission of to share findings based on our experience in southern Africa disease reports such as the distance from a health facility to focusing on the OH surveillance strategy developed by the the district headquarters were also recorded. Southern African Centre for Infectious Disease Surveillance (SACIDS). Design of Southern African Centre for Infectious Disease Surveillance One Health surveillance Materials and methods strategy in southern Africa One Health surveillance A participatory approach was used at an initial project inception workshop organised to agree on study sites In this paper, One Health (OH) surveillance is defined as and surveillance approaches. During the workshop, held collaborative efforts between the human and animal (wildlife in January 2010, it was agreed to develop and pilot OH and domestic) health sectors to conduct systematic collection surveillance in three ecosystems namely Ngorongoro, of disease event data, analysis of this data and a timely Kagera River basin and Zambezi River basin. The workshop dissemination of surveillance results to guide interventions recommended initial pilot activities to be carried out in one aimed to prevent or control disease in human and animal ecosystem (Ngorongoro) and then up-scaling the approach populations. to the other two project sites. Study design Implementation of the project activities in Ngorongoro This study involved two phases. Phase 1 involved conducting ecosystems required a collaborative approach coordinated a baseline survey to assess the performance of current by SACIDS and National Centre for Infectious Disease disease surveillance in animal and human health sectors. Surveillance (NatCIDS). Other key collaborators in the Lessons learnt from these exercises were used to improve development of the OH surveillance strategy in Tanzania the design of the OH surveillance system. The second phase were: the Ministry of Health and Social Welfare (Epidemiology involved designing an OH surveillance system suitable for unit), the Ministry of Livestock and Fisheries Development the southern African region. (Epidemiology section) and two academic institutions responsible for veterinary (Sokoine University of Agriculture) Baseline study on assessment of surveillance and medical (Muhimbili University of Health and Allied systems Sciences) training in the country. The project also partnered with collaborators from UK, namely the Royal Veterinary A rapid situation analysis was carried out in May 2010 to College (RVC) and Imperial College London, who assisted understand the structure and requirement of surveillance in sharing with the southern colleagues their experiences in systems in the animal and human health sectors in Tanzania. infectious disease surveillance and the use of appropriate This was followed by assessing the performance of the technologies and tools to support OH disease surveillance. disease surveillance systems in the two health sectors by Recommendations of the UK Foresight report on infectious visiting animal and human health facilities in Ngorongoro diseases (Brownlie et al. 2006) were also considered whilst district, carried out in November 2010. During field visits, devising OH surveillance strategy in southern Africa. individuals responsible for detection and reporting of disease events were interviewed using a structured questionnaire. A total number of 14 wards of Ngorongoro district were Study sites visited where all resident ward livestock field officers (LFO)
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