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ILCA Manual No. 3 Veterinary Epidemiology and Econo-M.Cs In ILCA Manual No. 3 Veterinary epidemiology and econo-m.cs in Africa A manual for use in the design and appraisal of livestock health policy S.N.H. Putt, A. P. NI. Shaw, A.J. Woods, L. Tyler and A.D. James International Livestock Centre for Africa , , " " - .. ............ I/I 7FA ,, ,- • .,. ..IL+L'.. ; ­ ;Uj.r. ", I'+++ + :.. .,,+ _ . ­ + .......... ..::''!:l,-Flt+ -+,+,,,"S,+)"-'++-'-.+++ +fli..P ....".. .."' ':........; 'Is' I / +++ A+-' . +.- I, +-1 I_..+:-;: P4 AM ---+ +.__..__. " _.. -'//j.. Al = ­ "Up -­ Veterinary epidemiology and economics in Africa A manual for use in the design and appraisal of livestock health policy S.N.H. Putt, A.P.M. Shaw, A.J. Woods, L. Tyler and A.D. James Veterinary Epidemiology and Economics Research Unit, Department of Agriculture, University of Reading, Reading, Berkshire, England First published in January 1987 Original English Designed and printed at ILCA Typeset on Linotype CRTronic 200 in Baskerville I lpt and Helvetica ISBN 92-9053-076-6 Acknowledgements ACKNOWLEDG MENTS This manual was prepared largely from notes on lectures given by the authors. Many ofthe concepts introduced in the manual are not new and can be found in most standard textbooks on epidemiology, economics and statistics. The authors wish to acknowledge in particular the contribution of Schwabe, Riemann and Franti's "Epidemiology in Veterinaiy Practice", Leech and Sellers' "StatisticalEpidemiology in Ve*orinaryScience" and Gittinger's "EconomicAnal­ )sis ofAgriculturalProjects",which provided inspiration for certain parts of this manual. iiiU Foreword FOREWORD The value ofepidemiological investigation as a basis for the treatment and control of animal disease has been recognised for many decades, but the need to apply economic techniques to the formulation afd assessment of disease control activities only became apparent about 15 years ago. This arose in part from burgeoning veterinary expenditure demands associated with new, but costly, technology and in part from growing awareness of the significant influ­ ence of economic and social factors on patterns of ill-health and disease. FAO published a collation of disease losses in i 563, but it was concern in WHO over the zoonoses which led to the first international initiative, at Reading University in 1972, to develop new methods for the economic, as well as epidemiological, evaluation of animal health programmes. Since then many national and international agencies have become involved and re­ search and training units have sprung up at several universities around the world. An inter­ national society and various national societies have also been formed to provide forums for discussion of the more profound 1,nderstanding that is emerging of how to improve the health, welfare and productivity of animals. The team which has prepared this manual has demonstrated how representatives ofa wide variety ofdisciplines can, and should, work to­ gether not only to controi and avoid (he major disease hazards which can still decimate ani­ mal populations, but also to define how genetics, management, nutrition and environmental adjustment can complement specific veterinary measures. Each member has contributed to a wide variety of research projects and field investigations over the past decade and in so doing, has crystalised a contribution to the training of disease control planners and animal health advisers in Britain and overseas. Recognising the need to provide such material for reference purposes and a wider range of training activities in Africa, ILCA and VEERU decided to join forces in publishing this manual. While Africa is the main focus, we feel sure that this manual will prove usefui in other continents of the world and will further the long-term wellbeing of animals, in their many roles, as well as of people. P. R. ELLIS P.J. BRUMBY Director of VEERU, Director General, Department of International Agriculture and Livestock Centre Horticulture, for Africa, University of Reading, Addis Ababa, Great Britain Ethiopia V CONTENTS ACKNOW LEDGEMENTS ............................................................................... iii FOREW ORD .............................................................................................................. v 1. AN INTRODUCTION TO THE PLANNING AND EVALUATION OF DISEASE CONTROL POLICY ....................................................................... 1 1.1 Introduction ................................ ... ....................... ...1 . 1.2 The planning process ......................................................................................... 1 1.2.1 The systems approach to livestock development ........................................ 1 1.2.2 Stages in the planning process ................................................................ 2 1.2.3 The role of various disciplines in the planning process ............................ 3 2. EPIDEMIOLOGY: SOME BASIC CONCEPTS AND DEFINITIONS ................. 5 2.1 Introduction ................................................................................................... 5 2.2 Intrinsic determinants ofdisease ...................................................................... 6 2.2.1 Disease agents as determinants of disease ............................................... 6 2.2.2 Host determinants ................................................................................ 10 2.3 Extrinsic determinants ofdisease .................................................................... 11 2.3.1 Climate ................................................................................................ 12 2.3.2 Soils .................................................................................................... 12 2.3.3 Man ................................................................................................... .. 12 2.4 Describing disease events in populations ....................................................... 13 3. THE USE OF DESCRIPTIVE STATISTICS IN THE PRESENTATION OF EPIDEM IOLOGICAL DATA ...................................................................... 15 3.1 Introduction ................................................................................................. 15 vii 3.2 Tables and graphs ........................................................................................ 15 3.3 Bar and pie charts ......................................................................................... 17 3.4 Classification by variable .............................................................................. 18 3.5 Quantification ofdisease events in populations .............................................. 20 3.6 M ethods ofsummarising numerical data ........................................................ 24 4. THE EPIDEMIOLOGICAL APPROACH TO INVESTIGATING DISEASE PROBLEM S ....................................................................................... 27 4.1 Introduction ................................................................................................. 27 4.2 Types of epidemiological study ....................................................................... 28 4.2.1 Prospectiv" studies .............................................................................. 28 4.2.2 Retrospective studies ........................................................................... 28 4.2.3 Cross-sectional studies ........................................................................ 29 4.3 Sampling techniques in epiden' iological studies .............................................. 30 4.3.1 Random sampling ................................................................................ 30 4.3.2 M ulti-stage sampling .......................................................................... 31 4.3.3 Systematic sampling ............................................................................ 32 4.3.4 Purposive selection .............................................................................. 32 4.3.5 Stratification ........................................................................................ 33 4.3.6 Paired samples .................................................................................... 33 4.3.7 Sampling with and without replacement ............................................... 33 4.4 Sample sizes ................................................................................................. 34 4.4.1 Sample sizes for estimating ofdisease prevalence in large populations ...... 34 4.4.2 Sample sizes needed to detect the presence ofa disease in a population ..... 37 4.5 M ethods for obtaining data in epidemiological studies ................................... 37 4.5.1 Interviews and questionnaires .............................................................. 37 4.5.2 Procedures involving measurements ...................................................... 39 4.5.3 Errors due to observations and measurements ..................................... 39 4.6 Basic considerations in the design of epidemiological investigations ............... 42 4.6.1 Objectives and hypotheses ................................................................... 42 4.7 The use of existing data ................................................................................. 44 4.7.1 Advantages and disadvantages ............................................................ 44 4.7.2 Sources of data .................................................................................... 45 viii contmni 4.8 Monitoring and surveillance
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