Assessment of the Impact of Zoonotic Infections (Bovine

DFID ANIMAL HEALTH PROGRAMME

Assessment of the impact of zoonotic infections (bovine tuberculosis and brucellosis) in selected regions of The Gambia, Senegal, Guinea, and Guinea Bissau - A Scoping study -

Fred Unger and Susanne Münstermann

International Trypanotolerance Centre

Banjul, The Gambia, May 2004 List of acronyms and abbreviations

BTB Bovine Tuberculosis B. abortus Brucella abortus BQ Black quarter C. bovis Cysticercus bovis CIDT Comparative Intradermal Tuberculin Test Cl. botulinum Clostridia botulinum CRD Central River Division DVO District Veterinary Officer FMD Food and mouth disease GB Guinea Bissau GBA Greater Banjul Area H.S. Haemorrhagic septicaemia ILRI International Trypanotolerance Centre LIPS Low input production system MOPS Market orientated production system M. bovis Mycobacterium bovis PH Public health p.m. post mortem PRA Participatory Rural Appraisal PPR Pest de Petite Ruminants PROCORDEL Program Concerté recherche-développement sur l’élevage en Afrique de l’Ouest SR Small ruminants SSA Sub-Saharan Africa TB Tuberculosis VH Veterinary health WA Weighted average WAS West African shorthorn

1 List of contents

SUMMARY ...... 6

1. BACKGROUND ...... 11

2. PURPOSE OF THE STUDY...... 13

3 PRODUCTION SYSTEMS AND COUNTRY CHARACTERISTICS IN THE STUDY AREA...... 13

3.1 Some country characteristics...... 16 3.1.1 The Gambia ...... 16 3.1.2 Guinea Bissau...... 17 3.1.3 Guinea ...... 18 3.1.4 Senegal ...... 19

4. MATERIALS AND METHODS...... 21

4.1 Study period...... 21

4.2 Study area ...... 21

4.3 Survey based on Participatory Rural Appraisal (PRA)...... 24 4.3.1 Team members for PRA sessions...... 25 4.3.2 Disease ranking...... 25

4.4 Survey based on semi-structured questionnaire...... 26

4.5 Survey based on serological sampling for brucellosis ...... 26

4.6. Data analysis ...... 26

5 RESULTS ...... 27

5.1 Study population...... 27

5.2 Farmers’ perceptions of animal diseases...... 29 5.2.1 Disease importance ranking...... 29 5.2.1.1 Results presented by country...... 29 5.2.1.2 Results presented by production system...... 31 5.2.2 Chronic diseases...... 33 5.2.2.1 Chronic diseases in cattle...... 33 5.2.2.2 Chronic diseases in small ruminants...... 35

5.3 Farmers perception on zoonoses ...... 36 5.3.1 Questionnaire results for zoonoses...... 36 5.3.1.1 Results by country ...... 36 5.3.1.2 Results by production system ...... 40 5.3.2 Group discussion results for zoonoses ...... 41

5.4 Specific observations on brucellosis...... 43 5.4.1 Symptoms of brucellosis ...... 43 5.4.1.1 Results by country for cattle...... 43 5.4.1.2 Results by country for small ruminants ...... 44

2 5.4.1.3 Results by production system ...... 45 5.4.2 Handling of aborted foetus...... 46 5.4.2.1 Results by country ...... 46 5.4.2.2 Results by production system ...... 47 5.4.3 Handling of milk from cows with previous history of abortion or observed hygromas ..47 5.4.3.1 Results by country ...... 47 5.4.3.2 Results by production system ...... 48

5.5 Attitudes to the importance of quality of livestock products...... 49 5.5.1 Observations on meat quality related to animal diseases ...... 49 5.5.2 Observations on milk related to animal diseases ...... 51 5.5.3 Handling of milk produced on farms...... 53

5.6 Observations on zoonoses by other groups involved...... 55 5.6.1 Butchers...... 55 5.6.1.1 Butchers’ knowledge of zoonoses ...... 56 5.6.1.2 Zoonotic diseases observed during the last 12 months...... 57 5.6.1.3 Knowledge of animal diseases which can influence meat quality...... 57 5.6.1.4 Health status of butchers...... 58 5.6.2 Veterinary health authorities...... 59 5.6.2.1 Observations on zoonotic infections in animals ...... 60 5.6.2.2 Animal diseases observed during the last year ...... 60 5.6.3 Public health sector...... 62 5.6.3.1 Observations of zoonotic infections during the last three years ...... 64 5.6.3.2 Diagnostic capacity of local health centres and hospitals with respect to brucellosis-like infections and tuberculosis ...... 64 5.6.3.3 Specific knowledge of brucellosis...... 66

5.7 Potential direct and indirect losses due to brucellosis...... 67 5.7.1 General herd parameters...... 67 5.7.2 Direct and indirect losses due to brucellosis (abortions and cow sterility) ...... 69

5.8 Serological sampling for brucellosis ...... 70 5.8.1 B. abortus in herd bulk milk samples ...... 70 5.8.2 B. abortus in man (volunteers) ...... 71

5.9 Differences in local perceptions of the impact of zoonoses on livestock and man in relation to present and previous serological findings in cattle ...... 71 5.9.1 Brucellosis ...... 71 5.9.2 Tuberculosis ...... 74

6 DISCUSSION ...... 75

7 CONCLUSIONS ...... 81

8 RECOMMENDATIONS ...... 82

8.1 Recommendations for the control of Bovine Brucellosis in the countries of this survey...... 82 8.1.1 Guinea ...... 82 8.1.2 Guinea Bissau...... 83 8.1.3 Gambia and Senegal...... 84

8.2 Recommendations for future research ...... 85

9 ACKNOWLEDGEMENT...... 86

3 10 REFERENCES ...... 88

11 ANNEX ...... 94

11.1 Results of this survey...... 94 11.1.1 Annex 1a: Guidelines for PRA sessions...... 94 11.1.2 Annex 1b: Tables 1 - 2 and Graphs 1 - 8 ...... 96

11.2 Results of previous ITC studies on bovine brucellosis and BTB...... 102

LIST OF TABLES

Table 1: Number of questionnaires administered per region and involved group...... 28 Table 2: Top-five diseases or symptoms in cattle as ranked by farmers´ in terms of importance by country...... 30 Table 3: Top-five diseases or symptoms in SR as ranked by farmers´ in terms of importance by country...... 31 Table 4: Top-five diseases or symptoms in cattle as ranked by farmers´ in The Gambia in terms of importance by production system...... 32 Table 5: Top-five diseases or symptoms in cattle as ranked by farmers´ in Senegal in terms of importance by production system...... 32 Table 6: Reports by farmers during group discussions of chronic (long lasting) diseases in cattle .34 Table 7: Consumption patterns (on farm) for meat and milk from chronic sick cattle related to production system...... 35 Table 8: Proportion of farmers by country with knowledge of unpecified zoonotic diseases...... 36 Table 9: Numbers of farmers identifying diseases with perceived zoonotic character (first mentioned disease)...... 37 Table 10: Farmers´ ranking of the importance of four given zoonoses by country...... 38 Table 11a: Specific knowledge of rabies and clinical observations in animals during the last three years by country (% of farmers) ...... 38 Table 11b: Specific knowledge of anthrax and clinical observations in animals during the last three years by country (% of farmers) ...... 39 Table 11c: Specific knowledge of BTB and clinical observations in animals during the last three years by country (% of farmers) ...... 39 Table 11d: Specific knowledge of bovine brucellosis and clinical observations in animals during the last three years by country (% of farmers)...... 40 Table 12: Clinical signs potentially indicative of brucellosis infection observed by farmers in their cattle (proportion of farmers by country) ...... 44 Table 13: Clinical signs potentially indicative of brucellosis infection observed by farmers in their small ruminants (proportion of farmers by country) ...... 45 Table 14: Abortions observed by farmers in their cattle or small ruminants (proportion of farmers by production system and country)...... 45 Table 15: Ways of handling aborted foetuses by country (proportion of farmers interviewed).....46 Table 16: Ways of handling aborted foetuses by production system and country (proportion of farmers interviewed)...... 47 Table 17 : Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by country (proportion of farmers)...... 48 Table 18: Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by production system and country (proportion of farmers)...... 48 Table 19: Processing of milk produced on-farm presented by country (% of farmers)...... 53 Table 20: Processing of milk produced on-farm presented by production system and country (% of farmers)...... 54 Table 21: General information on aspects related to slaughter and sale of cattle and small ruminants (number per butcher per week)...... 55 Table 22: Proportion of butchers with knowledge of unspecified zoonotic diseases by country...56

4 Table 23: List of suspected diseases with zoonotic importance observed by individual butchers during slaughter (last 12 months) ...... 57 Table 24: Butchers’ knowledge of symptoms and associated diseases which can influence meat quality...... 58 Table 25: Observations on health status of butchers ...... 59 Table 26: Information on the interviewed VH respondents...... 59 Table 27: Zoonotic infection in animals and humans reported by VH respondents in the study districts during the last 3 years ...... 60 Table 28: Diseases or symptoms in cattle ranked by DVOs according to their importance over the last 12 months by country...... 61 Table 29: Diseases or symptoms in SR ranked by DVOs according to their importance over the last 12 months by country...... 61 Table 30: Numbers of interviewed public health facilities in the study districts by country...... 62 Table 31: Exchange of information between PH and VH authorities...... 63 Table 32: Reports of zoonoses in humans over the last three years in the health centres and hospitals visited ...... 64 Table 33: Selected information on diagnostic procedures and prevalences related to flu-like infections and TB among patients that visited the health centre of this survey during the last year by country...... 65 Table 34: Knowledge of brucellosis symptoms in man and diagnostic procedures (number of hospitals or health centres by country) ...... 66 Table 35: Mean herd sizes and proportion of bulls, cows, heifers and calves based on questionnaires by country...... 67 Table 36: Cattle breeds in the study population (number of farms) ...... 68 Table 37: Selected herd fertility parameters ...... 69 Table 38: Serological results for B. abortus for herd bulk milk samples ...... 70 Table 39: Respondents’ perceptions of brucellosis and serological findings by country...... 72 Table 40: Respondents’ perceptions of BTB and serological findings by country...... 74

5 Summary

Introduction In order to evaluate the direct and indirect impact of brucellosis and bovine tuberculosis and other zoonoses on livestock and human health a scoping study was commissioned by DFID to ITC. The study was carried out in selected areas of The Gambia, Senegal, Guinea Bissau and Guinea Conakry during the period of March to August 2003. This survey expands on work already done at ITC investigating the distribution and prevalence of both diseases in different locations in all four countries, which focussed primarily on updating the limited existing information on the animal health aspects related to these diseases in the four countries.

Materials and methods The study was carried out in form of a Participatory Rural Appraisal (PRA). The PRA took place in 2 districts of The Gambia (Central River Division south, CRD and Greater Banjul Area, GBA), Senegal (Kaolack and Fatick), Guinea (Dubréka and Coyah) and in one district (Bafata) of Guinea Bissau. In each district three (GBA) up to four (all other) half-day PRA sessions in different, randomly selected locations were carried out. For each PRA session 10-24 respondents (on average 14) were selected consisting of farmers, herdsmen and milk vendors from one and up to 4 surrounding villages. The study population consisted in the Gambia of 115, in Senegal of 116, in Guinea of 100 and in Guinea Bissau of 58 respondents. Overall, 73% of the respondents were males and 27% females. The respondents were composed of 47% farmers, 26% herders and 27% milk vendors. The PRA team was composed of one national expert and two enumerators. One ITC scientist and a local veterinary officer joined the sessions as observers.

Besides gaining information during the PRA, a semi-structured questionnaire was applied in each district to farmers (n= 20), the Veterinary health authorities, local butchers/meat inspectors (up to five) and Public health authorities. Key issues such as observations on diseases transmissible to humans, observations after slaughter or at post mortem inspection and awareness of diseases that affect the quantity and quality of milk and meat were considered in these questionnaires.

6 To find correlations with results of already completed prevalence studies on brucellosis, bulk milk samples from each village/farm participating in the study were collected and tested for B. abortus. In addition serological sampling in man (farmers, veterinarians and herders) was carried out in Dubréka, a district known to have a high prevalence for brucellosis.

Results • Results for disease ranking Results from disease ranking for cattle differed between the countries, with high ranks for Haemorrhagic Septicaemia (H.S.) and the “diarrhoea complex” in all four countries. Reports on infections with zoonotic character varied widely between the four countries. Anthrax was number two in Guinea. Clinical hygromas (indicating brucellosis) were only mentioned by farmers in Guinea Bissau and Guinea and given rank number five.. In small ruminants PPR was the highest ranked disease in three of the four countries. In The Gambia, where unspecific diarrhoea and Pasteurellosis were ranked higher, PPR was number three among the “top five”. Anthrax was only among the top-five list in Guinea Bissau. • Observations on chronic diseases With regional variations brucellosis (only reported for Guinea and Guinea Bissau) and trypanosomosis were the most frequently observed chronic diseases in cattle. Chronic specific diseases in SR (n= 9) were less frequently reported than in cattle (35). Mange (n= 3) was recorded most often. • Farmers perceptions on zoonoses Farmers’ knowledge of zoonoses differed between the countries but was not related to the production system. Among four given zoonoses (rabies, anthrax, BTB and brucellosis) rabies was ranked highest by farmers in Guinea, Guinea Bissau and Senegal, followed by brucellosis in Guinea Bissau, Guinea and Senegal. The highest level of knowledge based on interviews and group discussions can be attested to farmers from Guinea Bissau. This includes the knowledge of symptoms and, with the exception of anthrax, also the transmission route and how to prevent transmission. Clinical cases of anthrax and brucellosis in cattle were more frequently reported by farmers in Guinea Bissau than in the other three countries. In addition, brucellosis was more often observed by farmers in Guinea than in Senegal and The Gambia,

7 where infections were not common. Results from group discussions on zoonoses showed that in particular the knowledge of the public health importance of anthrax was poor. The majority of participants in The Gambia, Senegal and Guinea indicated that meat from such animals is consumed after proper cooking or application of traditional treatment. Results of group discussions in Guinea indicate that cattle with hygroma are often not considered to be sick and milk is consumed without heat treatment. • Observations related to abortions The number of reported cases of abortions and hygromas in cattle were significantly higher in Guinea and Guinea Bissau. Abortions in SR were not influenced by country or production systems. The ways of handling of aborted foetuses and of milk from cows with abortion history or observed hygroma differed also between countries but not between production systems. • Observations related to meat and milk quality The main indicators for reduced meat quality mentioned by farmers in all four countries were bad smell, pale colour and higher water content. The handling of such meat and specific knowledge of the causing agent varies widely between the countries. Highest level of knowledge was found in Guinea Bissau followed by Guinea. Conversely, knowledge in The Gambia and Senegal was very limited. Accordingly meat of bad quality was also handled differently, i.e. usually consumed in Senegal and The Gambia while often discarded by farmers in Guinea Bissau. • Observations related to milk quality and processing During all group discussions it was agreed, that milk is a good source of energy and healthy but certain animal diseases can affect the quality of the product and may even transmit diseases to man. Changes in milk quality were generally characterized by higher water content, clotting and faster fermentation. Milk of reduced quality is usually not used for home consumption. Specific knowledge of the causative agent and how to prevent transmission differed between the regions and was found highest in Guinea Bissau. Milk in the region is usually consumed without treatment with the exception of Guinea Bissau.. Farmers and milk vendors clearly believe that milk, if boiled once, will not ferment, therefore milk is usually not heat treated because of customers’ preference for fermented milk. The use of starter cultures for fermentation after heating is not known. Moreover, a good number of farmers in Senegal and The

8 Gambia still believe that heating of milk may significantly reduce the milk yield of the producing cow. This traditional believes might limit the willingness of these farmers to accept pasteurisation as measure to prevent the transmission of zoonoses. • Observations on zoonoses by butchers The majority of butchers knew of at least one zoonotic infection. Their awareness of a second and third zoonosis was clearly reduced. The zoonoses most frequently observed by butchers were brucellosis, followed by anthrax. A higher frequency of this infection was reported for Guinea Bissau and Guinea. The execution of regular health checks of butchers varied between the countries. However, none of the check ups was documented by health certificates. • Observations by veterinary health authorities The most important zoonosis in respect to mortality in man was rabies followed by anthrax. The number of reported cases of rabies in animals (all of them dogs) was very similar in the four countries. Conversely more cases of anthrax and brucellosis were observed in Guinea and Guinea Bissau. The results for disease importance ranking obtained from veterinary authorities were consistent with those obtained from farmers • Observations on zoonoses by public health authorities Rabies was the highest ranked zoonosis by public health authorities followed by Salmonella infections. Patients with “brucellosis or flu -like” infections (fever and back/joint pain) are tested for malaria if laboratory facilities are available. If not, malaria treatment is administered symptomatically without differential diagnosis, e.g. for brucellosis. Knowledge of personnel on brucellosis (symptoms, transmission etc.) was very poor, laboratory tests were not performed in any of the locations visited. Strain identification for M. bovis in patients with symptoms of TB was not carried out in the health centres/hospitals visited in Guinea Bissau and Senegal and rarely undertaken in The Gambia and Guinea. • Potential losses due to brucellosis The number of cattle herds with reports on infertile cows or abortions was higher in Guinea and Guinea Bissau than in Senegal and The Gambia.

9 • Results of serological sampling for brucellosis B. abortus herd prevalence in bulk herd milk was significantly higher in Guinea and Guinea Bissau. Seven out of 20 volunteers tested positive for brucellosis in a high prevalence area for cattle (Dubréka, Guinea) . • Differences in local perception in relation to present and previous serological findings in cattle Differences observed in perception of farmers and other risk groups on brucellosis (i.e. knowledge and results of disease importance ranking) were in agreement with serological results for brucellosis in cattle. Brucellosis was ranked higher by farmers and veterinarians in the high-risk areas for cattle. The absence of BTB infection in cattle was confirmed by a general low importance assigned to this disease by farmers and veterinary health authorities (i.e. it was not considered as an important disease in the disease ranking).

10 1. BACKGROUND

The expansion of poverty and food insecurity is a cause of major concern in sub- Saharan Africa (SSA). It is estimated that between 40 to 45% of the African continent’s 730 million people live in absolute poverty with 30% classified as extremely poor. West Africa has the highest population growth (3% p.a.) and urbanisation (6 % p.a.) rates in SSA and one of the highest in the world. By 2050, the human density of much of West Africa will be similar to present day Nigeria (114 persons/sq km). People’s attempts to secure livelihoods include diversification of income with a significant increase in the share of the overall household income coming from livestock production. In general, the livestock sector is intensifying in response to population and urbanisation increase.

In rural areas, but also in peri-urban livestock production centres, a close relationship between the people and their animals exists, often coupled with very poor hygienic conditions. Livestock diseases are controlled only to a limited extent as veterinary services are defunct and drugs neither readily available nor easily affordable for the rural and urban poor farmers. Under these circumstances, zoonotic diseases, easily transmissible from livestock to man and, in the case of tuberculosis also vice-versa, can play an important role as a contributing factor to poor human health and poverty. In a recent study commissioned by DFID on prioritising animal health research for poverty reduction (PERRY et al, 2002), a strong link between poor human health and low income and zoonotic diseases was stated. Zoonoses can be fatal and disabling diseases, the prevention of which is usually through control in animals. For this reason, their control is often left to veterinary services, with human health services showing only a limited interest or awareness of them. For two classical animal diseases transmissible to men through infection by contact or consumption of contaminated animal products, brucellosis (B. abortus and B. melitensis) and tuberculosis (M. bovis), farmers, herders and butchers have been considered to be the main groups at risk (ADAMS & MAEGRAITH, 1984). A key risk factor is the widespread consumption of raw milk in West Africa; which earlier studies at ITC have shown to be highly contaminated with pathogens that pose a public health risk to the consumer (HEMPEN et al., 2002, UNGER et al. 2003).

11 Human brucellosis is known as a disease presenting a variety of symptoms, affecting multiple systems and causing different forms of localised infection. It is characterised by a febrile reaction and usually associated with enlarged spleen (splenomegalie) and osteoarticular manifestations (BATHKE, 1987; SEWELL and BROCKLESBY 1990). Further complications are hepatitis, endocarditis, orchitis and meningo- encephalitis (BATHKE, 1987; DJORDJEVIC, et. al 2003; MASOURIDOU et. al 2003). The classical signs (fever and back/joint pain) are therefore easily confused with other more common ailments, e.g. malaria and hence often wrongly treated. These diagnostic difficulties are characteristic for developing countries since specific tests for brucellosis are usually not available. Tuberculosis comes in the wake of poverty, war, and immunosuppressive diseases, such as HIV and is on the increase in most developing countries. In sub-Saharan Africa nearly 2 million TB cases per year occur and the Genus Mycobacteria has pathogenetic and zoonotic importance (DABORN et al., 1996). The presence of both diseases in livestock therefore represents a significant public health risk.

In recent work to establish the geographic distribution and prevalence of both infections in cattle carried out by ITC (2000 – 2003), various surveys were carried out in The Gambia, Guinea, Guinea Bissau and Senegal. Brucellosis was diagnosed in cattle with high variability in the prevalences between different locations within and between countries. To be more specific, herd prevalences for bovine brucellosis as high as 61 - 100 % were reported for selected districts in Guinea Bissau and Guinea whereas in The Gambia and Senegal infections are not common. In contrast to this, for bovine tuberculosis an unexpected absence of the infection was reported for all four countries.

These studies focussed primarily on updating the lack of information on the animal health aspects of brucellosis and tuberculosis in these four countries. In order to fully understand the impact and importance of these diseases on livestock and people, the perception of livestock owners and other people in close contact with animals of the human health aspect needs also to be investigated in order to complement the information obtained in livestock. Furthermore, information on the economic

12 importance (direct and indirect losses) of zoonotic diseases in livestock is required. The latter investigations have rarely been addressed in these countries in the past. It was therefore proposed to carry out a scoping study on the importance of those zoonotic diseases for people in livestock environments.

2. PURPOSE OF THE STUDY

This study was undertaken to evaluate the direct and indirect impact of zoonoses, with special emphasis on brucellosis and bovine tuberculosis on livestock and human health in selected areas of The Gambia, Senegal, Guinea Bissau and Guinea Conakry. The study expands on work already done at ITC investigating the prevalence of both diseases in different locations in all four countries.

3 PRODUCTION SYSTEMS AND COUNTRY CHARACTERISTICS IN THE STUDY AREA

In the study region two livestock production systems have been identified:: the predominant low-input system and the Market-oriented system. The low-input production system (LIPS) operates at subsistence or semi-subsistence level with farmers growing crops and keeping livestock. They are smallholder farmers who rely mainly on family labour inputs for cropping and livestock related activities. Because of the scarcity of resources, farmers in LIPS adopt a risk aversion strategy which entails limited use of externally purchased inputs that in turn is not conducive to adoption of new technologies. Livestock is kept for multiple objectives: subsistence (milk, milk products), sales or exchange, inputs to agriculture (power, manure), transportation and insurance against crop failure. The study region is characterised by large areas of medium to high livestock disease risk due to ecto- and endoparasites, vector- and vector borne diseases. LIPS farmers consequently use indigenous breeds that are adapted to the feeding, health and climatic environment, but that have limitations in their productivity.

13

Traditional N’Dama herd in Keneba, The Gambia

LIPS is also characterised by an extensive land use system, animals are fed on natural pastures and crop residues, with feed supplementation limited to selected groups of animals during the dry season. Consequently body weight and milk yield decline during the long dry seasons (particularly in The Gambia and Senegal) to such low productivity levels that leave limited surplus for marketing. The vast majority of poor farmers in the study region are found in LIPS. The farmers are unlikely to engage in innovative production processes in the absence of infrastructure, easy access to markets and high costs of transportation. However, LIPS has proven to be dynamic also and respond to new challenges like increased demand for livestock products. For instance, farmers have changed species composition due to drought and they are moving to more intensified and integrated mixed farming systems. (Fall, 2003). The LIPS is predominant in The Gambia, Guinea Bissau, Guinea and in large parts of Senegal. It is estimated that 95% of the milk production in this region is produced by the LIPS (Mbogoh, 1984).

14

Traditional way of milking N’Dama herd in Guinea

A transition process towards intensification has taken place in those areas where policies are conducive, inputs available and the agro-ecological environment suitable. It is shown in Nicholson et al. (1999) that West Africa as a region has not only one of the highest urbanisation and population growth rates, but also harbours the emerging markets in the coastal cities (Dreschel et al., 1998) that will make the region a major consumption centre of livestock products in general and dairy products in particular. This transition to the market-oriented production (MOPS) has often been induced by urbanisation and the establishment of peri-urban integrated agricultural enterprises. The systems have developed prominently in the Greater Banjul Area, peri-urban Dakar, the Nieyes and in the Bassin Arachidier of Senegal and have been studied in the framework of PROCORDEL (Somda et al., 2003, Somda et al, 2004, Dia et al, 2004)

15

F1 crossbred (Holstein Frisian x N’Dama) with dam in Greater Banjul Area, The Gambia

The MOPS is geared towards income generation and the maximization of profit. It entails the introduction of new breeds (cross-bred or purebreds), feed supplementation, resource inputs such as labour, drugs, feeds. The system is usually established near marketing structures, existing infrastructure and service providers. Management strategies need to take into consideration the major challenges: provision of animal feeds in sufficient quantities year round, processing and conservation of products (meat and milk) and marketing of products. (Akinbamijo, 2003).

3.1 Some country characteristics

3.1.1 The Gambia

The Gambia, with 11,300 km2 one of the smallest African countries, is completely surrounded by Senegal, except for the Western Coast line. It has a population of 1,36 Million with 90% Muslim and 9% Christian. It is administratively divided in 5 Divisions and Banjul city. English is the official language, but Mandinka, Wolof and Fula are widely spoken. Population density is one of the highest in West Africa and can be compared with Nigeria. The drift to move to growing urban centres is increasing with presently 40% of the population living in towns. Agriculture

16 contributes 23% to the GDP (1997 estimates) with the main products groundnuts, millet, sorghum, rice, corn, cassava and palm kernels. A mixed, crop-livestock farming system is practised throughout the country. The pattern of rural settlement in The Gambia is described by villages surrounded by areas of regularly cultivated fields and fallows with, at increasing ranges, long-term fallows merging into woodland. The cattle population is estimated at 360,000, sheep at 190,000, goats at 265,000, equines at 51,000 (livestock census, 1993). More than 90% of ruminants in The Gambia are trypanotolerant breeds, namely N’Dama cattle, Djallonke sheep and West African Dwarf goats. The recent introduction of cross-bred cattle for the evolving dairy sector is limited to the Greater Banjul Area. The climate is characterised by a uni-modal rainfall pattern with a long dry season (November to June). Characteristics of the livestock sector, principal constraints and counter strategies are well described by Snow in Bourn et al., 2001.

3.1.2 Guinea Bissau

Guinea Bissau covers an area of 36,120 km2, is neighbour to Senegal in the north and Guinea in the south and east and the Atlantic coast line in the west. It is a low-lying coastal region of swamps, rain forests, and mangrove, coastal wetlands, with about 25 islands off the coast. The Bijagos archipelago extends 48 km out to sea. The population is estimated at 1,38 Mill with a growth rate of 2% and 45% Muslims, 5% Christians and 50% animists. The official language is Portuguese, but Creole is the language spoken most widely. The country is administratively divided into nine regions where the population is unevenly distributed. Likewise, the regional density of the livestock population and specifically cattle is unequal. The Eastern zone (regions of Bafata and Gabu) has the highest livestock density accounting for 74% of cattle (MDRA/DGP, 1991). The Northern zone (regions of Cacheu and Oio) follows the east in terms of livestock numbers, particularly the Oio region with 13% of cattle. Cattle belong exclusively to the N’Dama breed (FAO, 1980) and are extensively managed in relation with the socio-economic background of the livestock owners (Gonçalves, 1995).

17

N’Dama herd at watering point and nearby rice fields in Guinea Bissau

Recent political developments have seen a coup d’état in September 2003 by General Correia Seabra who later handed over to an interim government led by President Henrique Rosa. Legislative elections took place in March 2004 and a new government is expected to be formed in the coming weeks. Presidential elections are scheduled to take place early 2005. International disputes exist over the separatist war in Senegal’s Casamance region which results in refugees and cross-border raids, arms smuggling and other illegal activities, and political instability in Guinea- Bissau.

3.1.3 Guinea

Guinea covers an area of 245,857 km2, is bordered by Guinea-Bissau, Senegal, Mali, Côte D’Ivore, Liberia and Sierra Leone and has a coast line in the west. The country consists of a coastal plain, a mountainous region, a savannah interior and forest areas in the Guinea Highlands with the highest peak of Mount Nimba (1,752 m).It has a population of 9,25 Million with a relatively low density (19 inhabitants/km2 as compared to 122/km2 in The Gambia). The growth rate is 2.4% and religion is 85% Muslim, 8% Christian and 7% animists. Official language is French, but Malinké, Susu and Fulani are widely spoken. The country possesses enormous agricultural potential, which varies according to the four natural agro-ecological zones: Guinée Maritime, Moyenne Guinée, Haute Guinée and Guinée Forestière. Livestock numbers are 2,5 Mill cattle, 1,5 Mill small ruminants, 55,000 pigs and 9 Mill poultry (livestock census 1995).. The livestock

18 sector contributes 16% to the agricultural segment of the GDP. The predominant dairy cattle breed is the N’Dama, which is managed under the low-input system. However, few crosses (N’Dama x zebu cattle) are found in Haute Guinea. The regional distribution of cattle from the census conducted in 1995, is as follows: Maritime (17%), Moyenne (41%), Haute (34%) and Forestière (8%). The Haute Guinea thus represents the second most important region in terms of livestock production. Furthermore, several projects, including the ITC led PROCORDEL, are being implemented with a dairy component and the introduction of crossbreds. International disputes arise over domestic fighting among disparate rebel groups in Guinea, Liberia, and Sierra Leone. They have created skirmishes, deaths and refugees in border areas.

Nature’s beauty after the first rains in Guinea

3.1.4 Senegal

Senegal covers an area of 196,190 km2 and is bordered by Mauritania in the north, Mali in the east, Guinea and Guinea Bissau in the south and it encloses The Gambia. The Atlantic coast line forms the western limit. It has a population of 10,59 Mill with 94% Muslim and 5% Christian. The official language is French, Wolof is widely spoken, other languages are Pular, Serr, Joal, Malinke and Soninke. Agriculture, which employs more than half the working population, represents 20% of GDP. Fishing is the country’s primary source of income. Exports are concentrated in the areas of groundnuts, fishing, tourism and phosphates. The country has a per capita

19 GSP of $459. According to recent surveys, 65% of households consider themselves poor. (The Courier, 2003). The Casamance conflict is still not fully resolved.

The subdivision of the country into ecological zones relates well to the distribution of livestock species. The trypanosusceptible Zebu, Sahelian sheep and goats and horses occupy the Sahelian region, devoid of tsetse, while the south is inhabited mainly by trypanotolerant N’Dama cattle, Djallonké sheep and dwarf goats and donkeys.

Diakore cattle in Senegal

The sudano-sahelian and north Sudan zones (middle part of the country) have mixed populations including the Diakore (Zebu x N’Dama cross), which has an intermediate level of trypanotolerance. The Diakore is a popular draught animal in this region because it is larger than the N’Dama. The southern soudanian and north Guinean vegetation zones (Casamance region) are the most important areas of Senegal for rearing trypanotolerant N’Dama cattle.

At the national level, a period of stable cattle population is seen in the 1980s probably associated with droughts that occurred during this period. There is however a trend of a steady increase since the early 1990s. This trend is also seen in the Kolda and Ziguinchor regions where the majority of trypanotolerant livestock are found.

Three main livestock production systems are described in Senegal. These are (1) the pastoral system in the Sahel zone with limited rainfall (300-500mm) and therefore scarce feed and water resources that drive people and livestock to great mobility

20 according to seasons, (2) the peri-urban production system in the Niayes area with appr. 1000 exotic dairy cattle and in the surroundings of large cities like Kaolack and Fatick where crossbred dairy cattle have been introduced since the mid 1990s and (3) the agro-pastoral system with the integration of crop and livestock enterprises.

4. MATERIALS AND METHODS

4.1 Study period

The study was carried out in form of a Participatory Rural Appraisal (PRA) for a period of 6 months, starting in March 2003. March 2003 was considered as the Preparation Period for the main study. During this period the national PRA teams, local authorities, villages and all target groups were identified and sensitised for the study. The PRA sessions were carried out in April and May in the chosen districts of The Gambia and Senegal, in June in Guinea and in July in Guinea Bissau.

4.2 Study area

The PRA took place in two districts of The Gambia, Senegal, Guinea and one district of Guinea Bissau. All chosen districts are known for their high cattle density. Another criterion for the selection of a district was the involvement in previous ITC disease prevalence studies on bovine tuberculosis and brucellosis, since useful background information was already available. For Senegal and The Gambia the locations represented also different production systems (low input and market- orientated systems).

In The Gambia the Central River Division south (CRD) and the Greater Banjul Area (GBA) were selected. The CRD is a rural area and located in the eastern part of The Gambia. The distance to Banjul is around 300 km. The cattle population consists of trypanotolerant N´Dama kept on natural pasture under traditional husbandry. The GBA is a peri-urban area located around Banjul, the capital of The Gambia. The area is characterised by its current transition from the low-input to the market-orientated system. The cattle population consists of N´Dama and few crossbred cattle which

21 where recently introduced by ITC. Milk is usually sold to markets in Banjul and the GBA.

Map of Senegal and The Gambia

In Senegal the districts of Kaolack and Fatick were identified, located in the Bassin Arachidier (groundnut production basin) southwest of Dakar. The distance to Dakar is 220 km from Kaolack and 190 km from Fatick. Programmes for intensification of the existing livestock system are already on-going in the Bassin Arachidier. The cattle population consists mainly of Zebu type cattle and crossbreds. The proportion of crossbreds is continuously increasing due to a national artificial insemination programme.

In Guinea the Districts of Dubréka and Coyah were selected. Dubréka and Coyah are rural areas. Coyah District is located in the close vicinity of Conakry; the District capital is 60km away from Conakry. Dubréka District is also situated close to Conakry. The distance from Dubréka town to Conakry is around 70 km. Milk produced in the Dubréka and Coyah District is therefore sold also at Conakry markets. The cattle population consists of pure N´Dama kept on natural pasture under traditional husbandry. The majority of cattle herds in both districts are on transhumance during March to June and thereafter move to communal pastures.

22

Map of Guinea

The district of Bafata was selected in Guinea Bissau which is situated in the centre of Guinea Bissau, bordering Guinea. The distance from Bafata to Bissau is 120 km. Milk produced in Bafata is sold also at Bissau markets. Bafata holds 40% of the cattle population of the country and the predominant breed is the N´Dama.

23

Map of Guinea Bissau

4.3 Survey based on Participatory Rural Appraisal (PRA)

Four half day PRA sessions were held in all selected districts, except for the GBA, were only three sessions were carried out. In total 27 PRA sessions formed the basis for this study. Sessions were set to be attended by a minimum of 10 and a maximum of 15 people with 5 to 8 farmers (owners of cattle and small ruminants), 2 to 4 herders (being family members or labourers often paid with milk) and 2 to 4 milk vendors as participants. Four to 12 villages in each district were randomly chosen by the District Veterinary Officers (DVO). Hence, 40 to 60 respondents were expected per district.

Before performing a PRA exercise in a selected location, the village chief was identified by the DVO, the aims of the study were explained and permission was sought to carry out the study in the village. The participants from each village were chosen by the DVO, often in agreement with the local chief, on the basis of willingness to participate.

24 The PRAs were carried out as group discussions. However, for specific questions, quantification of group answers was achieved by randomly selecting five individuals amongst the group of farmers.

The structure of the PRA sessions is listed in Annex 1a.

PRA during the rain in Guinea Bissau and in the open in Guinea

4.3.1 Team members for PRA sessions

The PRA team consisted of 6 individuals, with a variety of skills encompassing veterinary knowledge, PRA experience, local knowledge of the area and livestock systems, and fluency in the local languages, and was led by a national PRA expert. More specifically the team consisted of a PRA expert, 2 enumerators (one of them socio-economist), the project co-ordinator, the local DVO and one translator. In The Gambia, Guinea and Guinea Bissau a national PRA team was recruited for the study, while in Senegal the team consisted of 2 Gambian and one Senegalese enumerator.

4.3.2 Disease ranking

This method was used to obtain perceptions about the differences in disease importance ranking within and between the countries. In a first step all clinical symptoms observed by respondents during the last 12 months were recorded. These clinical symptoms were then related to specific diseases whenever possible. Five

25 farmers (owners of cattle and of small ruminants) were randomly selected among the group and asked to rank the 5 most important diseases.

4.4 Survey based on semi-structured questionnaire

In addition to the information obtained during the PRA, a semi-structured questionnaire was administered in each district to randomly selected farmers (n= 20), Veterinary health authorities, local butchers/meat inspectors (up to five) and Public health authorities. Key issues like the reproduction status of herds, observations on diseases transmissible to humans, observations after slaughter or in post mortem and awareness of diseases that affect the quality and quantity of milk and meat were considered in these questionnaires.

4.5 Survey based on serological sampling for brucellosis

To find correlations with results of previous prevalence studies on brucellosis, bulk milk samples from the majority of farms participating in the study were collected and tested for the presence of B. abortus antibodies using Milk ELISA (Bommeli®).

In addition, to obtain some base line information on brucellosis in man in a known high risk area for cattle, serological sampling in potential risk groups (farmers, veterinarians and herders) was carried out in Dubréka (Guinea). According to the recommendation of the German Reference Laboratory for brucellosis in Berlin these sera were tested for B. abortus antibodies using Rose Bengal Plate Test followed by Complement Fixation Test.

4.6. Data analysis

For entry of data, descriptive and quantitative analysis and for graphical presentation Microsoft Excel, Statgraphics Plus and EPI-Info 5.2 software was used. For comparison of means simple t-test was applied. To find likely associations between observations (e.g. abortion occurrence and management) Yates-corrected chi-square test or Fisher exact test were performed. Significantly differences were expressed as

26 differences between categories marked with different superscripts. The level of significance is given separate.

5 RESULTS

5.1 Study population

A total of 389 people participated in the PRA sessions, composed of 115 in the Gambia, 116 in Senegal, 100 in Guinea and 58 participants in Guinea Bissau. The average number of participants in each PRA session was 14.4 (13.19,15.61).

On average, in each PRA session per location 64.9 to 82.1% (overall mean 72.6%) were male respondents and 17.5 to 35.1% (overall mean: 27.4%) were females. The highest proportion of women was found in Dubréka, Guinea (35.1%), the lowest during group discussions in the LIPS in the Bassin Arachidier of Senegal (17.9%). In general the gender distribution was quite homogenous for each district and country (Graph 1).

Graph 1: Gender distribution during group discussion by region and country

male female 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% GBA CRD MOS LIS Dubreka Coyah Bafata (MOS) (LIS)

The Gambia Senegal (Bassin Guinea Guinea Overall Arachidier) Bissau

The respondents were composed of 39.7 to 54.8% (overall mean: 47.1%) farmers, 18.7 to 37.9% herders (overall mean: 25.9%) and 19.3 to 33.3% milk vendors (overall mean: 27.0%). The specific distributions for each region are presented in

27 Graph 2. The proportion of herders was slightly lower in both districts of Guinea whereas the proportion of milk vendors was a bit higher. Graph 2: Composition of respondents in group discussions by region and country

farmer herder milk vendors 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% GBA CRD (LIS) MOS LIS Dubreka Coyah Bafata (MOS)

The Gambia Senegal (Bassin Guinea Guinea Overall Arachidier) Bissau

The number of respondents in the semi-structured questionnaires is summarized in Table 1. The reduced amount of farmers selected for The Gambia results from the limited number of farmers representing the market-orientated system in the GBA (n= 15).

Table 1: Number of questionnaires administered per region and involved group

Farmers Veterinary Public health Butchers Total health authorities authorities The Gambia 35 8 5 8 56 (GBA and CRD) Senegal 40 6 4 9 59 (Kaolack and Fatick) Guinea 40 3 4 7 54 (Dubréka and Coyah) Guinea Bissau 20 3 3 5 31 (Bafata) Total 135 20 16 29 200

28 5.2 Farmers’ perceptions of animal diseases

5.2.1 Disease importance ranking

5.2.1.1 Results presented by country

In order to obtain information on the importance of diseases/symptoms as perceived by the PRA participants a ranking was applied during the group discussions. Results for ranks are based on scoring for the 5 highest ranked diseases/symptoms in all countries and expressed as weighted average.

Results for cattle are shown in Table 2. Potential zoonoses or clinical symptoms, which could indicate zoonotic infections, are shaded in grey. In addition results including the top-ten list of diseases/symptoms are presented graphically by country in Annex 1b (Graphs 1-4).

The ranking for the five most important diseases/symptoms indicated always in all countries “unspecific diarrhoea” and H.S. (pasteurellosis). With the exception of Guinea, also Black quarter was ranked high, even number one in Guinea Bissau.

Symptoms/diseases with likely zoonotic implications were reported in all countries with regional variations. Anthrax was considered as the second most important disease in Guinea Bissau. Abortions and hygromas (local name “bakale”) were ranked as number four and five respectively in Guinea and Guinea Bissau but not mentioned by farmers in Senegal and The Gambia.

29 Table 2: Top-five diseases or symptoms in cattle as ranked by farmers´ in terms of importance by country

Symptoms/ Gambia Guinea Guinea Senegal diseases Bissau Total no. of farmers 35 40 20 40 Ranking WA* Ranking WA* Ranking WA* Ranking WA* Abortion - - 4 1.3 4 1.4 - - Anthrax - - 5 1.1 2 1.9 - - BQ 4 1.1 - - 1 2.7 4 1.3 Diarrhoea (unspecific) 1 2.8 1 1.9 3 1.6 5 0.9 FMD 5 1.0 ------H.S. 3 1.4 5 1.1 4 1.4 1 2.6 Hygroma - - 5 1.1 5 1.3 - - Foot problems - - 3 1.5 - - - - (unspecific) Lumpy skin - - 2 1.6 - - - - Tick damage/fly sore ------2 2.3 Trypanosomosis 2 1.8 - - - - 3 1.6 * Weighted average (WA) of scores

The results for disease ranking for the five most important diseases/symptoms for small ruminants are presented in Table 3. Potentially zoonotic diseases or associated symptoms are shaded grey. In addition, the results for the ten highest ranked diseases/symptoms are presented graphically by country in the Annex 1b (Graph 5- 8).

PPR was considered in three countries as the “number-one” disease and in one country number three. All other diseases/symptoms including likely zoonoses varied widely between the countries. With the exception of Guinea Bissau abortions were always within the top-five list. As stated already for cattle in Guinea Bissau anthrax was highly ranked also in SR in this country.

30 Table 3: Top-five diseases or symptoms in SR as ranked by farmers´ in terms of importance by country

Symptoms Gambia Guinea Guinea Bissau Senegal

Total no. of farmers 35 40 20 40 Ranking WA* Ranking WA* Ranking WA* Ranking WA*

Abortion 4 1.0 2 0.9 2 2.0

Anthrax 2 2.3

BQ 4 1.0

Diarrhoea (unspecific) 1 2.7 4 0.6

Foot problems 3 5 (unspecific) 0.8 0.8 Mange 3 1.3

Nervous symptoms 5 0,4

Pasteurellosis 3 1.1 3 1.4

PPR 2 1.2 1 3.7 1 4.3 1 2.6

Tick damage/fly sore 4 1.3

Trypanosomosis 5 0.5 5 0.8 * Weighted average (WA) of scores

5.2.1.2 Results presented by production system

In The Gambia and in Senegal the PRA was carried out on farms characterised by different production systems. Results for the five most important diseases/symptoms in cattle according to the production system are shown in Table 4 for The Gambia and Table 5 for Senegal.

In The Gambia differences in disease ranking between the production systems were observed. Trypanosomosis was ranked highest in the MOPS, but only given 5th rank in the LIPS. In addition, more importance was attributed to tick infestations in the MOPS, wherever BQ, FMD and constipation were more frequent in the LIPS.

31 Table 4: Top-five diseases or symptoms in cattle as ranked by farmers´ in The Gambia in terms of importance by production system

Symptoms/diseases GBA (MOPS) CRD (LIPS) Total no. of farmers 15 20 Ranking WA* Ranking WA*

BQ - - 2 1.7 Constipation (unspecific) - - 3 1.1 Diarrhoea (unspecific) 2 2.9 1 2.8 FMD 5 0.7 3 1.1 H.S. - - 2 2.2 Lumpy skin 4 0.5 4 0.8 Tick damage/fly sore 3 1.9 - - Trypanosomosis 1 3.3 5 0.7 * Weighted average (WA) of scores

Results for disease ranking according to production systems were more homogeneous in Senegal (Bassin Arachidier) than in The Gambia. The five most important diseases/symptoms were nearly equally ranked with the exception of diarrhoea, FMD and poisoning (Table 5). Diarrhoea and poisoning were ranked more highly in the MOPS, FMD higher in the LIPS.

Table 5: Top-five diseases or symptoms in cattle as ranked by farmers´ in Senegal in terms of importance by production system

Symptoms MOPS LIPS

Total no. of farmers 20 20 Ranking WA* Ranking WA*

BQ 4 1.2 4 1.3 Diarrhoea 3 1.3 - - FMD - 5 0.9 H.S. 2 2.0 1 3.3 Poisoning 5 1.0 - - Tick damage/fly sore 1 2.4 2 2.3

32 Trypanosomosis 3 1.3 3 1.9 * Weighted average (WA) of scores

Summary: • Results from disease ranking from cattle differed between the countries. However, H.S. and symptoms of diarrhoea were always among the top-five in all four countries. • Reports on infections with zoonotic character varied widely between the four countries. Anthrax was number two in Guinea. Clinical hygromas (indicating brucellosis) were only mentioned by farmers in Guinea Bissau and Guinea and ranked as number 5. • In small ruminants PPR was the highest ranked disease in three of the four countries. In The Gambia, where unspecific diarrhoea and Pasteurellosis were ranked higher, PPR was number three among the “top five”. • Potential zoonotic infections such as anthrax were only among the top-five list in Guinea Bissau. • Differences in disease importance ranking according to the production system were observed for The Gambia while in Senegal responses were more similar.

5.2.2 Chronic diseases

During group discussions information was collected on chronic diseases in cattle and small ruminants. Results for cattle are shown in Table 6 and for small ruminants in Table 7. Five farmers amongst the PRA groups were selected randomly in each location to quantify responses (see 4.3). A chronic disease was defined as an illness, which lasted more than four weeks.

5.2.2.1 Chronic diseases in cattle

During group discussions a total of 68 cases of long lasting diseases in cattle were reported by respondents. In 21 cattle the cause of the disease was unknown. The 68 cases were observed on 60 different farms.

33 Among the chronic diseases reported in cattle, brucellosis (14/47) and trypanosomosis (10/47) were most frequently reported. The latter disease was noted by participants in all four countries, whereas brucellosis was only reported in Guinea and Guinea Bissau. The differences observations of brucellosis between countries were significant.

Table 6: Reports by farmers during group discussions of chronic (long lasting) diseases in cattle

Guinea Disease suspected Overall Gambia Guinea Senegal Bissau Total no of farmers 185 35 40 20 40 No. of farmers with cattle 47 19 25 13 7 suffering from chronic diseases Brucellosis (Hygroma) 14 0 a 10 b 4 b 0 a BQ 3 0 3 0 0 Diarrhoea (unspecific) 1 0 1 0 0 Endoparasites 3 0 2 1 0 H.S. 3 3 0 0 0 Poisoning (plastic bag) 2 0 2 0 0 Lumpy skin 4 1 0 3 0 Mange 3 0 0 3 0 Mastitis 1 0 0 1 0 Pasteurellosis 3 0 0 1 2 Trypanosomosis 10 4 3 0 3

Unknown (unspecific symptoms) 15 9 4 0 2 a:b (p<0.05)

When asking farmers on their consumption habit of meat and milk of chronically sick cattle, the majority (34/60) reported that they always consume such meat and milk. Among the observed chronic diseases in cattle brucellosis (n= 14) and mastitis (n= 1) have relevant importance as milk-borne infection for man, yet milk was always consumed from diseased animals.

34 Differences in milk consumption patterns related to the production system were observed (Table 7). A significantly higher proportion of farmers in the LIPS consumed meat from sick cattle. The difference in milk consumption practices was significant (p= 0,06) although not at the p=0.05 level.

Table 7: Consumption patterns (on farm) for meat and milk from chronic sick cattle related to production system

MOPS LIPS No. of farmers who reported having chronically sick cattle 14 46 No. of farmers consuming raw/fermented milk from sick animals 3 * 25 * No. of farmers consuming meat from sick animals 1 a 33 b a:b (p<0.05) * (p= 0.06)

5.2.2.2 Chronic diseases in small ruminants

A total of 22 chronic cases of diseases in SR was reported by 22 farmers (Annex 1b, Table 1). Only in nine of these cases were the symptoms described sufficientsly by respondents to identify the disease. Mange was reported most frequently (3/9), followed by one case each of arthritis, BQ, heartwater, lumpy skin, metritis and orf.

Differences in the consumption practices according to production system were also observed for small ruminants. None of the farmers reporting chronically sick animals in the MOPS (n= 4) consumed meat from such animals whereas 13 of 18 did it in the LIPS. Milk from small ruminants is usually not consumed at all.

Summary: • With regional variations, brucellosis and trypanosomosis were the most frequently observed chronic diseases in cattle. Cases of brucellosis were only observed by farmers in Guinea and Guinea Bissau. • Specific chronic diseases in SR (n= 9) were less frequently reported than in cattle (35). Mange (n= 3) was recorded most often. • The practice of consuming milk and/or meat from chronically ill animals clearly differed between the production systems. The majority of farmers in the LIPS

35 system still consume meat and/or milk from chronic sick cattle or SR, while this was done only exceptionally by farmers from the MOPS.

5.3 Farmers perception on zoonoses

5.3.1 Questionnaire results for zoonoses

5.3.1.1 Results by country

In the semi-structured questionnaires farmers were asked to name at least three animal diseases, which might cause also infection in man. Results are presented in Table 8.

Compared to Senegal a significantly higher proportion of farmers in The Gambia, Guinea and Guinea Bissau had knowledge of at least one zoonotic infection. With the exception of Guinea Bissau the knowledge of second or third zoonoses was weak in all other countries. The difference was significant.

Table 8: Proportion of farmers by country with knowledge of unspecified zoonotic diseases

Guinea Overall Gambia Guinea Senegal Bissau No. of farmers interviewed 135 35 40 20 40 Farmers knowing of one disease a a a b likely to be zoonotic (%) 53 51 58 65 20 Farmers knowing of two diseases a a b a likely to be zoonotic (%) 18 6 10 65 13 Farmers knowing of three diseases a b a likely to be zoonotic (%) 12 0 a 5 55 8 a:b (p<0.05)

Thereafter, farmers were asked to list these zoonotic infections. Table 9 gives a list by country of the first disease mentioned by farmers as likely to be zoonotic.

36 Brucellosis was reported most frequently, followed by anthrax, rabies and bovine tuberculosis. All these infections were reported by farmers in each of the four countries, however with regional variations. Brucellosis was again more frequently reported in Guinea and Guinea Bissau (p= 0.06) than in Senegal and The Gambia. Less frequently reported in some of the countries were Cl. butolinum and FMD. One farmer in Senegal believed that HIV and BQ were zoonotic infections.

Table 9: Numbers of farmers identifying diseases with perceived zoonotic character (first mentioned disease)

Overall Gambia Guinea Guinea Senegal Bissau Total no of farmers 135 35 40 20 40 Brucellosis 26 3 a 15 b 7 b 1 a Anthrax 20 7 4 6 7 Rabies 19 7 4 6 2 BTB 7 2 1 1 3 Cl. botulinum 2 - - - 2 FMD 1 - - - 1 HIV 1 - - - 1 BQ 1 - - - 1 a:b (p<0.05)

In the next step farmers were asked to rank four given selected zoonoses (rabies, anthrax, BTB and brucellosis) according to their importance. The aggregate ranks were calculated based on scorings as follows: the first zoonotic disease mentioned was assigned a score of 4, the second 3 etc. Then the total scores were calculated. Results are presented in Table 10 by country.

Among these four zoonoses, rabies was ranked highest in three of the four countries. In Guinea anthrax was graded as the most important zoonotic disease. In three of the four countries, brucellosis was believed to be the second most important zoonosis. Less importance was accorded to BTB.

37 Table 10: Farmers´ ranking of the importance of four given zoonoses by country

Gambia Guinea Guinea Bissau Senegal Total no of farmers 35 40 20 40 Rabies 1 3 1 1 Anthrax 2 1 3 4 BTB 4 4 4 3 Brucellosis 3 2 2 2

Information was also collected on farmers’ specific knowledge for each of these four zoonoses. Results are presented in Table 11a – d. The following topics were discussed: • Knowledge of the disease and key symptoms in cattle • Modes of transmission • Preventive measures • Cases in animals observed by farmers (during the last three years).

For rabies (Table 11a) regional differences in farmers’ level of knowledge were observed, this being significantly higher in Guinea Bissau followed by Senegal. Measures to prevent transmission (i.e. vaccination) were known by 100% of farmers in Guinea Bissau and 83% of farmers in Senegal, but only by a minority of respondents in The Gambia and Guinea. Suspected cases of rabies, all of them observed in dogs, were reported by farmers in all countries.

Table 11a: Specific knowledge of rabies and clinical observations in animals during the last three years by country (% of farmers)

Rabies Gambia Guinea Guinea Senegal Bissau Total no of farmers 35 40 20 40

38 Disease & symptoms in animals 69 a 65 a 100 b 93 b Modes of transmission 54 a 38 a 100 b 90 b Preventive measures 43 a 28 a 100 b 83 b Observed in animals* 14 a 3 a 5 a 10 a a:b (p<0.05) * dogs

Similar differences in farmers’ knowledge of anthrax were observed. Symptoms in cattle were best known in Guinea Bissau. However, knowledge about transmission and prevention was generally poor in all countries. Clinical cases of anthrax in cattle and small ruminants were most frequently observed in Guinea Bissau.

Table 11b: Specific knowledge of anthrax and clinical observations in animals during the last three years by country (% of farmers)

Anthrax Gambia Guinea Guinea Senegal Bissau Total no farmers 35 40 20 40 Disease & symptoms in animals 40 a 50 a 75 b 10 b Modes of transmission 20 a 33 a 25 a 0 c Preventive measures 17 a 28 a 25 a 0 b Observed in animals* 9 a 5 a 25 b 0 a a:b:c (p<0.05) *cattle or small ruminants

Symptoms, transmission and prevention of BTB were well known by farmers in Guinea Bissau, whereas it was very poor in the other three countries. Suspected clinical cases of BTB (described as a vasting disease and characterised by loss of weight and chronic pulmonary symptoms) were only observed by farmers in Guinea Bissau.

Table 11c: Specific knowledge of BTB and clinical observations in animals during the last three years by country (% of farmers)

BTB Gambia Guinea Guinea Senegal Bissau Total no farmers 35 40 20 40

Disease & symptoms in animals 20 a 50 b 75 b 15 a

39 Modes of transmission 9 a 15 a 75 b 13 a Preventive measures 6 a 3 a 75 b 10 a Observed in animals* 0 0 10 0 a:b (p<0.05) *cattle

The differences in reports of bovine brucellosis between the countries were significant. More farmers had specific knowledge of all aspects in Guinea Bissau. Though the symptoms of the disease are better known by farmers in Guinea, the knowledge of transmission and prevention was poor, likewise in The Gambia and Senegal. Suspected brucellosis-like symptoms in cattle were most frequently observed in Guinea Bissau, followed by Guinea (see also 5.9.1).

Table 11d: Specific knowledge of bovine brucellosis and clinical observations in animals during the last three years by country (% of farmers)

Brucellosis Gambia Guinea Guinea Senegal Bissau Total no farmers 35 40 20 40 Disease & symptoms in animals 23 a 75 b 100 c 55 b Modes of transmission 11 a 28 a 100 b 23 a Preventive measures 6 a 3 a 65 b 18 a Observed in animals* 3 a 30 b 80 c 8 a a:b:c (p<0.05) * cattle

5.3.1.2 Results by production system

Farmers’ knowledge about these four zoonoses (rabies, anthrax, BTB and brucellosis) was not significantly influenced by the production system. The results are presented in Annex 1b (Tables 2a-d).

Summary: • Farmers’ knowledge of zoonoses differed between countries but not by the production system. • Among the four given zoonoses (rabies, anthrax, BTB and brucellosis) rabies was ranked highest by farmers in Guinea Bissau, The Gambia and Senegal while in

40 Guinea anthrax was ranked highest. Number two zoonosis was brucellosis (Guinea, Guinea Bissau and Senegal) and anthrax respectively in The Gambia. • The highest level of knowledge about these zoonoses was found in farmers from Guinea Bissau. This includes the knowledge of symptoms and, with the exception of anthrax, also the transmission route and how to prevent transmission. • Clinical cases of anthrax and brucellosis in cattle were more frequently reported by farmers in Guinea Bissau than in the other three countries. In addition, brucellosis in cattle was more often observed by farmers in Guinea than in Senegal and The Gambia, where infections were not common as evidenced by the ITC prevalence study (see 5.9.1).

5.3.2 Group discussion results for zoonoses

Farmers’ knowledge about zoonoses in The Gambia was very limited. There was a general understanding that some animal diseases can be transmitted to people but the respondents could not be more specific. Anthrax was mentioned as a zoonosis by four respondents in two of the seven locations. However, the high risk of transmission to man was unknown. It was actually reported that meat of suspected anthrax cases is consumed after a specific local treatment (adding of thorns of a local plant called “sumpo” when cooking). Another disease of zoonotic importance mentioned was lumpy skin disease in cattle. One respondent pointed out that human TB can be transmitted via sputum from man to cattle; another farmer suffered from serious diarrhoea in the last year and related it to the consumption of meat from a chronically sick and emaciated bovine. In seven of the eight selected locations in Guinea farmers had some knowledge of animal diseases, which can also affect man. Anthrax was always cited. Some respondents believed the steam during cooking to be a likely source of infection for man. Only in two locations were animals, suspected to have died from anthrax, burned and buried. In particular if veterinary services are not available, e.g. when an animal died “far away in the bush” during transhumance, only the spleen is discarded but the meat is consumed after proper cooking. Recent outbreaks of anthrax in cattle were reported from two locations. In addition 10-15 cases of anthrax in cattle were observed in 2001 in a cattle herd from Tambaya when on transhumance in

41 Forehcariah. Furthermore rabies, brucellosis, BQ, lumpy skin and tuberculosis were mentioned. However, the modes of transmission were often not known. Related to brucellosis the majority of farmers pointed out that cattle with hygromas are not considered to be sick. Therefore the milk of those cattle is consumed. However, there was a consensus that they would never buy such an animal from markets or neighbours. In three of the eight locations respondents mentioned BQ as a zoonotic infection. Only in one location are such carcasses burned, otherwise the meat is consumed, with the exception of the affected parts.

The majority of participants in the group discussions in Senegal believed that some animal diseases can be transmitted to humans through milk and meat. However, they were usually not able to specify any such disease. Only in two locations was anthrax cited as a zoonosis. When observed, meat is not consumed and the carcass needs to be burned and buried. Other diseases, thought to be zoonotic, which were mentioned only in one location each, were mastitis, BTB, FMD and rabies. Respondents related some experiences of similar disease symptoms observed in livestock and people, but these were of anecdotal value only. With respect to the handling of an aborted foetus (see below) there is a traditional belief in one location that hanging it on a tree might reduce the occurrence of abortion in the herd.

As was the case with the replies to the questionnaire, the level of knowledge emerging from the group discussions was found to be higher in Guinea Bissau than in the other three countries. In all locations participants had specific knowledge of rabies, brucellosis, BTB and anthrax. The transmission routes and preventive measures were usually clearly known. Only in two locations no knowledge of the measures for avoiding anthrax infection in man was established.

Summary: • Farmers in Guinea Bissau appear to have a higher level of knowledge about zoonotic diseases. This includes knowledge of the symptoms, transmission routes and how to avoid transmission. • In particular, knowledge of the public health importance of anthrax was generally poor. The majority of participants in The Gambia, Senegal and Guinea

42 indicated that meat of such animals is consumed after proper cooking or application of traditional treatment. • The results of group discussions in Guinea indicated that cattle with hygroma are often not considered to be sick and their milk is consumed unpasteurised.

5.4 Specific observations on brucellosis

5.4.1 Symptoms of brucellosis

Information on the pathognomic symptoms of brucellosis in cattle (hygroma) and potentially linked symptoms like abortions (cattle and SR) and sterility (cattle) were collected during interviews and in group discussions. For quantification of results obtained from group discussions, five farmers with cattle and/or SR were selected randomly during each group session (see 4.3).

Cow with hygroma in Guinea Bissau

5.4.1.1 Results by country for cattle

Results from questionnaires and group discussions are consistent regarding reports of clinical hygromas and abortions in cattle (Table 12). The frequency of abortions was higher in cattle on farms in Guinea Bissau and Guinea than in The Gambia and Senegal. The differences are significant.

43 Table 12: Clinical signs potentially indicative of brucellosis infection observed by farmers in their cattle (proportion of farmers by country)

Gambia Guinea Guinea Bissau Senegal Questionnaire results

No. of farmers interviewed 35 40 20 40

% observing abortions in their cattle (during last 12 months) 23 a 53 b 70 b 33 a

% observing hygromas in their cattle 3 a 65 b 75 b 5 a % observing infertile cows in their cattle a a b a (>2 years without calf) 6 45 60 25 Group discussion results No. of respondents 1 35 40 20 40 % observing abortions in their 29 a 6% b 95 c 43 a cattle (during last 12 months) % observing hygromas in 0 a 60 b 75 b 0 a their cattle 1 Five randomly selected farmers per group discussion a:b:c (p<0.05)

5.4.1.2 Results by country for small ruminants

Results from interviews and group discussions on abortions observed in SR both indicate that there is no significant difference between countries (Table 13).

44 Table 13: Clinical signs potentially indicative of brucellosis infection observed by farmers in their small ruminants (proportion of farmers by country)

Guinea Gambia Guinea Senegal Bissau Questionnaire results

No. of farmers interviewed 35 40 20 40 % observing abortions in their small ruminants (during last 12 months) 34 20 15 35 Group discussion results No. of respondents 1 35 40 20 40 % observing abortions in their small ruminants (during last 12 months) 57 53 35 65 1 Five randomly selected farmers per group discussion

5.4.1.3 Results by production system

The number of abortions reported during the last 12 months did not differ significantly between the production systems within the same country as shown in Table 14.

Table 14: Abortions observed by farmers in their cattle or small ruminants (proportion of farmers by production system and country)

Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed 15 20 20 20

45 % observing abortions in their 20 35 60 55 cattle (during last 12 months) % observing abortions in their 40 70 75 60 small ruminants (during last 12 months) 1 Five randomly selected farmers per group discussion

5.4.2 Handling of aborted foetus

5.4.2.1 Results by country

Information was collected during the interviews on how aborted foetuses are handled. Farmers’answers were categorised as follows: • Definite destruction (foetus are buried or cremated) • Partial destruction o Thrown away o Fed to dogs o Hanging on a tree • Seasonal (dry season) definite or partial (rainy season) destruction (same subcategories as described above)

Results from the questionnaire indicate regional differences in handling of aborted foetuses. A significantly higher proportion of farmers in Guinea Bissau (13/20) and in Guinea (16/40), bury the aborted foetuses. This proportion is even higher in the rainy season as some farmers practise this method only during this period. The majority of farmers in The Gambia (29/35) and Senegal (28/40) simply throw away the foetuses (Table 15).

Table 15: Ways of handling aborted foetuses by country (proportion of farmers interviewed)

Questionnaire Results Guinea Gambia Guinea Bissau Senegal No. of farmers interviewed 35 40 20 40 % burying or cremating (definite destruction) 9 a 40 b 65 b 20 a

46 % throwing away (partial destruction) 82 a 20 b - b 70 a % hanging on a tree (partial destruction) - - - 5 % feeding to dogs (partial destruction) 9 - - 5 % throwing away or burying according to season - a 38 b 25 a - a % didn’t know 0 2 15 - a:b (p<0.05)

5.4.2.2 Results by production system

No differences in the handling of aborted foetuses on farm according to the production system were found. Results are nearly similar as presented in Table 16.

Table 16: Ways of handling aborted foetuses by production system and country (proportion of farmers interviewed)

Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed 15 20 20 20 % burying or cremating (definite 7 10 15 20 destruction) % hanging on a tree (partial destruction) - - - 10 % feeding to dogs (partial destruction) 13 7 5 5 % throwing away or burying according to season 80 83 80 65

5.4.3 Handling of milk from cows with previous history of abortion or observed hygromas

5.4.3.1 Results by country

Farmers were asked what they do with milk from cows with an history of abortion (last 12 months) or with clinical hygromas. As shown in Table 17, the majority of

47 farmers still consume milk from such cattle. However, fewer farmers do it in Guinea Bissau (11/20) and nine of twenty farmers indicated that this milk is fed to dogs, a habit which was more common in Guinea Bissau than in the other three countries.

Table 17 : Farmers’ ways of dealing with milk from cows with a history of abortion or observed hygroma by country (proportion of farmers)

Questionnaire Results Guinea Gambia Guinea Bissau Senegal No. of farmers interviewed 35 40 20 40 % throwing milk away 23 a 23 a 0 b 13 ab % feeding milk to dogs 0 a 3 a 45 b 8 a % consuming milk 77 73 55 80 a:b (p<0.05)

5.4.3.2 Results by production system

The handling of milk from cows with a history of abortion or observed hygromas did not differ significantly between the production systems (Table 18).

Table 18: Farmers’ ways of dealing with milk from cows with a history of abortion or observed hygroma by production system and country (proportion of farmers)

Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed 15 20 20 20 % throwing milk away 26 10 10 15 % feeding milk to dogs - - - 15 % consuming milk 74 90 90 70

Summary:

48 • The number of reports of abortions and hygromas in cattle was significantly higher in Guinea and Guinea Bissau. Reports of sterile cows were more frequent in Guinea Bissau. • The occurrence of abortions and hygromas in cattle was similarly distributed in both production system • Abortions in SR were not influenced by country or production systems • Handling of aborted foetuses differed between countries but not between production systems • Handling of milk produced from cows with abortion history or observed hygroma differed also between countries but not between production systems

5.5 Attitudes to the importance of quality of livestock products

During group discussions farmers’ perceptions of the importance of meat and milk- quality produced on-farm was discussed. This included the following key issues: • diseases which can influence the quality of milk and meat, • changes related to animal diseases observed in meat and milk, • handling of affected milk and meat. Information from the questionnaire on handling of milk produced on-farm was also included (5.4.3).

5.5.1 Observations on meat quality related to animal diseases

In all group discussions participants agreed that livestock diseases can affect the quality of meat. The main indicators for reduced meat quality mentioned were bad smell, pale colour, and higher water content. The handling of such meat and specific knowledge of the causes varied widely between the countries.

Participants in The Gambia noted the following changes in meat quality from sick animals: slimy, higher water content, black spots on meat and intestines, pale colour and hardening of the liver. The causes were usually not known. In two locations participants were able to relate changes in meat, such as black colour of meat and blood to anthrax infection. As mentioned above, some participants had some

49 knowledge about the zoonotic character of this disease. Meat from animals thought to be diseased or meat of bad quality is usually consumed after proper cooking or sometimes washed with vinegar before cooking. No differences in perceptions related to meat quality were observed in the different production systems.

The main changes in meat of bad quality reported by respondents in Senegal were: black spots on the meat, pale, containing less blood/anaemic, higher water content, tasteless, bad smell and spots on the liver. The causes were usually not known. Some participants in one location related bad smell and taste of meat, slimy and pale colour to emaciation and pulmo-nasal symptoms in cattle, yet they consumed this meat. There was a general consensus that such affected meat can still be consumed after proper cooking. Differences in perception related to the production systems were not observed.

The observations of participants in Guinea regarding meat quality were in general similar to the observations made in Senegal and The Gambia. In addition, respondents were able to relate some changes to animal diseases. Farmers’ knowledge was better than in Senegal and The Gambia. In six of the eight locations, participants were able to describe clearly the changes in meat due to anthrax: enlarged spleen, black colour of meat and blood and rapid rotting. However, there was little awareness of the related high risk to humans. As mentioned earlier (see 5.3.2) meat is often consumed in particular when animals died “far way in the bush”. Other diseases causing changes in meat quality were BQ and lumpy skin. Oedematous swelling of muscles was related to BQ. The affected part is discarded but the remaining carcass usually consumed after proper cooking. Bad odour and blood spots in meat, was linked to lumpy skin disease in cattle by some participants.

Participants in Guinea Bissau considered anthrax, BQ, pasteurellosis and trypanosomosis as animal diseases, which reduce the quality of meat. Furthermore, chronic diseases, which were not further specified, might lead to watery and anaemic meat. The general changes in meat of bad quality were the same as listed for The Gambia and Senegal. The changes in anthrax-infected animals were well known. Only in one of the four locations did respondents state that such meat should be

50 consumed only after proper cooking and discarding of the spleen. Oedema in meat was related to BQ; in this case the affected parts are discarded and the remaining carcass is consumed.

Summary: • The main indicators for reduced meat quality mentioned by farmers in all four countries were bad smell, pale colour, and higher water content. • The handling of such meat and specific knowledge of the causative agent varies widely between the countries. The highest level of knowledge was found in Guinea Bissau followed by Guinea. Comparatively, knowledge in The Gambia and Senegal was poor. Accordingly meat of bad quality was also handled differently, i.e. usually consumed in Senegal and The Gambia while often discarded by farmers in Guinea Bissau.

5.5.2 Observations on milk related to animal diseases

There was a general agreement in all group discussions that milk is an excellent source of energy and healthy but that certain animal diseases can affect the quality of the product and may even be transmissible to man. Changes in milk quality were generally characterized by a higher water content, clotting and faster fermentation. Some respondents (Senegal and The Gambia) mentioned also slower fermentation as a sign of reduced quality. This observation was mainly made by milk vendors.

The main indicators for milk of bad quality noted during group discussions in The Gambia were as described above, plus discolouring, bad smell and presence of blood spots. Participants agreed that such milk is not sold or consumed because it can pose a health risk for the consumer. However, the nature of this risk could not be specified by any of the respondents (milk vendors). Despite the general agreement that milk can transmit diseases to man, it is usually not pasteurised. There is a traditional belief of farmers that boiling of milk might reduce the milk yield of the lactating cow. Only

51 two farmers in one location (Sareh-Ngai, LIPS) pointed out that women after delivery should only drink pasteurised milk to avoid the risk of transmission of disease.

During group discussions in Senegal milk of bad quality was characterized as described above. Such milk is not sold and discarded by the farmers or vendors. In Kaolack (a location representing the market-orientated system), some farmers related reduced milk quality and changes in consistency to mastitis in F1 cattle. In the same location milk vendors have heard about the advantages of boiling but they do not do this because of the difficulty of selling such a milk product. However, some farmers pasteurise their milk for home consumption. In two more locations, one representing the MOPS (Fatick) and one the LIPS (Koutal), milk vendors and farmers boil their milk when used for home consumption in particular when used for pregnant women and young children. Milk is usually not heated due to the local belief that boiling of milk over fire may result in sores on the udder of the cow which produced the milk.

Participants in Guinea described the same changes as mentioned above for reduced milk quality. This milk is generally discarded. Respondents were usually not able to relate changes in milk quality to animal diseases. Only in Tambaya one respondent related lumpy skin disease to reduced quality of milk. The zoonotic importance of brucellosis was only mentioned by farmers in Tanene and Tambaya. Farmers do not boil milk in any of these locations. The highest level of knowledge was again found in Guinea Bissau. Milk of poor quality was characterized in group discussions by higher water content, faster fermentation and clotting. If this is observed such milk will be discarded. The diseases mentioned as influencing the quality of milk were brucellosis (mentioned in 3 locations) and TB (mentioned in one location). In three of the four chosen locations (Sintuna Mamodou, Aguira and Buntusso) farmers boil milk for home consumption so as to avoid the transmission of animal diseases. Fermented milk is never boiled.

Summary • During all group discussions it was agreed, that milk is a good source of energy and healthy but certain animal diseases can affect the quality of the product and may even be transmissible to man.

52 • Poor quality milk was generally characterized by higher water content, clotting and faster fermentation. • Milk of reduced quality is usually not used for home consumption. • Specific knowledge of the causative agents and of how to prevent transmission varied between regions and was found to be best in Guinea Bissau. • Milk in the region is usually consumed without heat treatment. However, most of the respondents in Guinea Bissau heated their milk when used unfermented for home consumption.

5.5.3 Handling of milk produced on farms

During the interviews, information was collected on the handling of milk produced on farm. Results are given in Table 19.

All farmers filtered their milk before home consumption or sale. How the milk was handled depended on the final product desired. In the case of sour milk production, none of the farmers in the regions heated the milk. However, when consumed as raw (unfermented) milk at home, regional differences were observed regarding boiling of milk. Milk was boiled by the majority of farmers in Guinea Bissau (15/20). Conversely in Senegal (9/40) and The Gambia (4/35) heat treatment was rarely undertaken and in Guinea not at all.

Table 19: Processing of milk produced on-farm presented by country (% of farmers)

Guinea Gambia Guinea Senegal Bissau No. of farmers interviewed 35 40 20 40 % filtering 100 100 100 100

53 Raw milk % not heating 88 a 100 a 15 b 78 a % heating if used at home 9 a 0 a 85 b 22 a % heating 3 - - - (only for pregnant woman) Sour milk

% not pasteurising 100 100 100 100 a:b (p<0.05)

Farms in the MOPS showed a higher acceptance of pasteurisation (Table 20). However, the differences were not significant.

Table 20: Processing of milk produced on-farm presented by production system and country (% of farmers)

Gambia Senegal

MOPS LIPS MOPS LIPS No of farmers interviewed 15 20 20 20 % filtering 100 100 100 100 Raw milk

% not heating 87 90 65 90 % heating if used at home

13 5 35 10 Pasteurised (only for pregnant woman) in % - 5 - - Sour milk

Not pasteurised in % 100 100 100 100 Summary • Milk produced on-farm was always filtered. • Only raw milk was pasteurised. • Acceptance of pasteurisation differed between the countries and was more common on farms in Guinea Bissau.

54 • Use of pasteurisation was not significantly influenced by different production systems.

5.6 Observations on zoonoses by other groups involved

5.6.1 Butchers

An overview of selected aspects of the slaughter process, such as number of animals slaughtered per week, place of slaughter, time of slaughter etc. is given in Table 21.

The average number of animals slaughtered per week, location and butcher varied between the countries. Generally fewer cattle (range 4.7 – 11.4) were slaughtered than SR (6.8 – 24). With the exception of some butchers in Guinea (n= 2) slaughtering was carried out at the local abattoirs and mainly between 6.00 and 10.00 in the morning. Meat was sold by the majority of butchers on the same day. Some (7/28) sold their meat also on the following day. With few exceptions no records on disease observations were kept by butchers. However, all butchers indicated that the local veterinarian will be informed in case of any suspicion of epidemic diseases.

Table 21: General information on aspects related to slaughter and sale of cattle and small ruminants (number per butcher per week)

Gambia Guinea Guinea Bissau Senegal Slaughter animals per butcher/week

55 Cattle (mean) 11.4 (4.9,17.9) 4,7 (2.7, 6.7) 7.0 (6.3, 7.7) 4,9 (3.2, 6.6) SR (mean) 24.0 (8.5, 39.5) 7,3 (1.2, 13.4) 17.5 (7.9, 27.1) 6,8 (2.7, 10.9)

No of butchers 8 7 6 9 interviewed Place of slaughter

Farm - 2 - - abattoir 8 5 5 9 Time of slaughter

6-10 AM 6 5 5 8 other 2 2 - 1 Time of sale

Same day 7 6 4 5 Same & next day 1 1 1 4 Records on observations during slaughter do exist

yes 2 1 - - Contacts to VH do exist yes 8 7 5 9 In brackets CI for the mean

5.6.1.1 Butchers’ knowledge of zoonoses

Butchers were asked to list at least three zoonotic animal diseases. The knowledge of butchers was found broadly similar in all locations and differences were not significant (Table 22). The majority of butchers did know of at least one zoonotic infection. Their knowledge of a second and third zoonosis was clearly limited. It appears that butchers in The Gambia were better informed.

Table 22: Proportion of butchers with knowledge of unspecified zoonotic diseases by country

Gambia Guinea Guinea Senegal Bissau No. of butchers interviewed 8 7 5 9 Butchers knowing of one disease 87 85 80 55

56 likely to be zoonotic (%) Butchers knowing of two diseases likely to be zoonotic (%) 50 28 40 22 Butchers knowing of three diseases likely to be zoonotic (%) 25 14 - 11

5.6.1.2 Zoonotic diseases observed during the last 12 months

The observations of zoonotic infections made by butchers during slaughter are shown in Table 23. As most of the butchers did not record their observations it was usually not possible to exactly quantify the number of cases observed. Therefore, the numbers in Table 23 should be interpreted as recall data rather than as indicating the exact number of cases. The most frequently observed zoonosis was brucellosis, followed by anthrax and cysticercosis. A higher frequency of anthrax and brucellosis were found in Guinea Bissau and Guinea and of C. bovis infections in The Gambia.

Table 23: List of suspected diseases with zoonotic importance observed by individual butchers during slaughter (last 12 months)

Symptoms Suspected Gambia Guinea Guinea Senegal disease Bissau No. of butchers 8 7 5 9 interviewed Enlarged spleen Anthrax 1/8 3/7 3/5 - Hygroma Brucellosis 1/8 4/7 3/5 - Oedema (muscle) BQ 1/8 - - 1/9 Aphthae FMD - - - 1/9 Cysts C. bovis 4/8 - - 1/9 TB like lesions TB (M. bovis)* 1/9 - 1/5 1/9 * not confirmed

5.6.1.3 Knowledge of animal diseases which can influence meat quality

Butchers were asked to list diseases or to describe clinical symptoms, which can influence the quality of meat (Table 24). The only symptom, which was known by the majority of butchers, was liver indurations due to fasciolosis. Eight out of thirty

57 butchers indicated that symptoms related to anthrax and BTB can reduce meat quality. Other diseases mentioned were trypanosomosis, cysticercosis and BQ.

Table 24: Butchers’ knowledge of symptoms and associated diseases which can influence meat quality

Symptom Related Gambia Guinea GB Senegal observed disease (No.) (No.) (No.) (No.)

No. butchers 8 7 5 9 Dark blood, Anthrax 3/8 2/7 3/5 1/9 enlarged spleen Liver Fasciolosis 4/8 4/7 3/5 5/9 indurations Pneumonia Pasteurellosis - 2/7 - - Emaciation/ BTB 2/8 2/7 3/5 1/9 caseatic lesions Watery/ Trypanosomosis 3/8 - - 3/9 pale meat Cyst Cysticercosis 4/8 - 1/5 1/9 Oedema BQ - - - 4/9

5.6.1.4 Health status of butchers

Information was collected on the health status of butchers, including their regular health check ups. Special emphasis was given on the occurrence of symptoms likely related to TB infections and/or brucellosis, such as: arthritis and orchitis for possible brucellosis infections and chronic coughing for TB. Regular health checks and examination of faecal samples was noted when carried out at least once during the last year. As shown in Table 25 the execution of regular health checks of butchers varied between the countries. All butchers in The Gambia confirmed having had such an investigation during the last year, a minority in Senegal and Guinea and none of the butchers in Guinea Bissau. However, we could not verify these health checks by a medical statement. No significantly differences between countries were observed for brucellosis-like symptoms. Chronic cough, a

58 clinical symptom that could be related to TB in man, had a similar distribution in the countries.

Table 25: Observations on health status of butchers

Total Gambia Guinea GB (No.) Senegal (No.) (No.) (No.) (No.) Total no. of butchers 28 8 5 7 9 Regular medical check-up 13 8 2 0 4 Self observation of selected symptoms possible related to brucellosis or TB: Arthritis 18 5 5 4 3 Orchitis 5 1 0 3 1 Cough (chronic) 12 5 2 2 4

Summary • The majority of butchers knew of at least one zoonotic infection. Their knowledge of a second and third zoonosis was clearly reduced. • The zoonosis most frequently observed by butchers was brucellosis, followed by anthrax. A higher frequency of these infections was reported for Guinea Bissau and Guinea. • 8 of 30 butchers indicated that symptoms related to anthrax and BTB can reduce meat quality • The extent to which butchers had regular health checks varied between countries, None of these check-ups were documented by health certificates.

5.6.2 Veterinary health authorities

The veterinary authorities consulted were veterinarians and veterinary technicians as shown in Table 26. The District Veterinary Officer (DVO) was always among the respondents in each location.

Table 26: Information on the interviewed VH respondents

59 Gambia Guinea GB Senegal Total Total respondents 8 3 3 6 20 Veterinarian 5 2 1 2 10 Veterinary technician 3 1 2 4 10

5.6.2.1 Observations on zoonotic infections in animals

This information was obtained from records of DVO´s for the last three years. The most serious zoonosis was rabies followed by anthrax (Table 27). The number of reported cases of rabies in animals (all of them dogs) was broadly similar in the four countries. Conversely anthrax seems to occur more frequently in Guinea and Guinea Bissau. The same applies for brucellosis in cattle. Infections due to C. bovis in cattle were reported for Senegal and The Gambia. Rift Valley Fever (RVF) was only observed in The Gambia were people also died. However, there was no proof of a direct relationship between observed cases in animals and man in this outbreak.

Table 27: Zoonotic infection in animals and humans reported by VH respondents in the study districts during the last 3 years

Symptoms How Gambia Guinea GB. (No.) Senegal (No.) diagnosed (No.) (No.) animals humans animals humans animals humans animals humans Anthrax p.m. 2 - 6 1 4 - 2 - Clinical & - - 9 - 6 - 1 - Brucellosis p.m. C. bovis p.m. 3 - - - - - 2 - Rabies RL* 3 2 5 - 2 2 5 - RVF RL* 3 3 ------* Reference laboratory p. m. post mortem 5.6.2.2 Animal diseases observed during the last year

Veterinary services were asked to list the most common animal diseases observed in the last year and to rank them according to their importance. Results are presented in Table 28 for cattle and Table 29 for SR. Zoonotic diseases are shaded grey. For comparison the results from group discussions (see 5.2.1.1) are also included in the Table.

60 Trypanosomosis was ranked highest in The Gambia, anthrax in Guinea and Guinea Bissau and H.S. in Senegal. Brucellosis and anthrax were indicated as important diseases only in Guinea and Guinea Bissau. With some exceptions there was a good agreement between results obtained from veterinarians and farmers.

Table 28: Diseases or symptoms in cattle ranked by DVOs according to their importance over the last 12 months by country

Gambia Guinea Guinea Bissau Senegal Ranking Ranking Ranking Ranking (*) (*) (*) (*) Abortions - 5 (4) - - Anthrax - 1 (5) 1 (2) - BQ 4 (4) 4 (9) 3 (1) 3 (4) Brucellosis - 3 (5) 4 (7) -

Endoparasites 3 (-) - - - FMD 5 (5) - - - H. S. 2 (3) 2 (5) 2 (5) 1 (1)

Lumpy skin - 5 (2) - 5 (-) Pasteurellosis

Red water - - - 4 (-) Trypanosomosis 1 (2) 4 (-) - 2 (3) (*) Results of disease ranking by farmer (see 5.2.1.1)

In SR the highest ranked disease was PPR, followed by abortions (The Gambia) and pasteurellosis (Guinea and Guinea Bissau). With one exception (Pasteurellosis in Guinea was ranked lower by farmers than veterinarians) the results were broadly similar to the rankings made by the farmers during the group discussions.

Table 29: Diseases or symptoms in SR ranked by DVOs according to their importance over the last 12 months by country

Symptoms Gambia Guinea Guinea Bissau Senegal

61 Ranking Ranking Ranking Ranking (*) (*) (*) (*) Abortions 2 (4) - - - Orf - 5 - - Diarrhoea (unspecific) 4 (1) 4 (4) - 3 (6)

Pasteurellosis 3 (3) 2 (8) 2 (3) Cowdryosis 3 (5) 5 (8) PPR 1 (2) 1 (1) 1 (1) 1 (1)

Ticks 5 (7) - - - Trypanosomosis - 2 - 4 (*) Results of disease ranking by farmer (see 5.2.1.1)

Summary • The most important zoonosis in terms of mortality in man was rabies followed by anthrax. The number of reported rabies cases in animals (all of them dogs) was much the same in the four countries. However, more cases of anthrax and brucellosis were observed in Guinea and Guinea Bissau than in the other countries. • The ranking of diseases by veterinarians was broadly similar to that done by the farmers (see 5.2.1.1).

5.6.3 Public health sector

Hospitals and local health centres were visited in each country and a questionnaire was administered (Table 30). Whenever possible the central hospital for the region was contacted. In addition, local health centres were visited. The respondents consisted of physicians, PH-officers and laboratory technicians.

Table 30: Numbers of interviewed public health facilities in the study districts by country

Gambia GB Guinea Senegal Location Hospital 3 1 1 2 Health centre 2 2 3 2

62 Respondent’s jobs Physician 2 2 1 2 PH officer 2 1 3 2 Laboratory technician 1 - - -

When asked about exchange of information with veterinary health authorities, differences between countries were observed as shown in Table 31. All respondents in Guinea Bissau (3/3) and the majority in Guinea (3/4) indicated that there is a regular exchange of data related to zoonoses.

Health Centres in Guinea Bissau (left) and Guinea (right)

Table 31: Exchange of information between PH and VH authorities

Gambia Guinea Guinea Bissau Senegal Number of respondents 5 4 3 4 Number exchanging information with VH authorities on a regular basis 2 3 3 1

63

5.6.3.1 Observations of zoonotic infections during the last three years

Information about zoonotic infections reported during the last three years was collected from PH authorities. The results are based only on reports made by the personnel interviewed in hospitals or health centres and might be not representative for the country. Cases of rabies in humans were observed in all countries and in each location (Table 32), Rift Valley Fever (RVF) only in the CRD of the Gambia. Salmonellosis infections in man were reported in all hospitals where the capacity for microbiological investigations existed.

Table 32: Reports of zoonoses in humans over the last three years in the health centres and hospitals visited

How Guinea Gambia Guinea Senegal diagnosed Bissau Bassin GBA CRD Coyah Dubréka Bafata Arachidier Rabies RL yes yes yes yes yes yes Rift Valley RL - yes - - - - Fever (RVF) Salmonellosis Bacteriology yes yes yes ? N.A. yes * Reference Laboratory N.A: Data not available

5.6.3.2 Diagnostic capacity of local health centres and hospitals with respect to brucellosis-like infections and tuberculosis

Human brucellosis is characterised by a febrile reaction and usually associated with osteoarticular manifestations (BATHKE, 1987, SEWELL and BROCKLESBY 1990). Diagnostic difficulties exist due to the similarity of these key symptoms (fever and back/joint pain) with other widespread diseases such as malaria or flu-like infections. Table 33 is an attempt to obtain information on the diagnosis and

64 prevalence of “flu-like infections” as well as TB in man covering the period of 12 months..

If laboratory facilities exist a malaria test is usually carried out in patients with such “flu-like” infections. Otherwise malaria treatment is administered symptomatically. The interviews in health centres and hospitals revealed that 1-5% (Senegal and The Gambia) and 1-10% (Guinea and Guinea Bissau) of patients who test negative for malaria still receive anti-malaria drugs without any differential diagnosis. Thus such patients, could well be infected with brucellosis or other diseases with similar symptoms. The prevalence of TB-infections in man was found in the majority of locations in The Gambia, Senegal and Guinea to be less than one percent. However, in Guinea Bissau prevalences were higher and ranged between 6 and 10%. In most of the hospitals or health centres visited no strain identification or transfer of samples to the National Reference Laboratories was done. Hence the possible role and importance of M. bovis in the epidemiology of human TB in these countries could not be assessed. Samples are only occasionally sent for further identification to the National Reference Laboratories from few of the locations in Guinea and The Gambia.

Table 33: Selected information on diagnostic procedures and prevalences related to flu-like infections and TB among patients that visited the health centres of this survey during the last year by country

Gambia GB Guinea Senegal Location GBA CRD Bafata Coyah Dubréka Bassin Arachidier Number of health 2 3 3 2 2 4 centres / hospitals

65 visited Standard procedure for patients with “flu-like symptoms” (i.e. malaria, flu, brucellosis) Malaria test done if available 2 2 2 2 0 2 If test unavailable malaria treatment given without test 0 1 1 0 0 2 Proportions of malaria test negative patients reported (No. of PH facilities) 1-5% 2 2 1 1 0 4 6-10% 0 0 2 1 0 0 Test not applied 0 1 0 0 2 0 Proportions of TB patients reported in the last year (No. of PH facilities)

<1% 2 3 0 2 1 3 1-5% 0 0 0 1 0 1 6-10% 0 0 3 0 0 0 Strain identification for M. bovis undertaken (No. of PH facilities)

Not performed at all 1 2 3 1 0 4 Applied but not regularly 1 1 0 2 1 0

5.6.3.3 Specific knowledge of brucellosis

The specific knowledge of personnel interviewed in the hospitals or health centres was found to be very limited (Table 34). Only in five of the 16 locations visited were the disease and symptoms in man known. The diagnostic capacity to apply brucellosis specific tests did not exist in any of the locations. Moreover, only one physician from Senegal had knowledge of the diagnostic procedures.

Table 34: Knowledge of brucellosis symptoms in man and diagnostic procedures (number of hospitals or health centres by country)

Gambia GB Guinea Senegal Location GBA CRD Bafata Coyah Dubréka Bassin Arachidier

66 Health centre/hospitals 2 3 3 2 2 4 visited Number with knowledge of: Brucellosis infection and symptoms in man 1 0 1 1 0 2 Diagnostic procedures 0 0 0 0 0 1 Number where test is applied if the disease is suspected 0 0 0 0 0 0

Summary • Rabies was the zoonosis ranked highest by public health authorities followed by Salmonella infections. • Patients with “brucellosis or flu -like” infections (fever and back/joint pain) are tested for malaria where laboratory facilities are available. If not, malaria treatment is administered symptomatically without differential diagnosis, e.g. for brucellosis. • The personnel’s knowledge of brucellosis (symptoms, transmission etc.) was very limited, laboratory tests were not undertaken in any of the visited locations. • Strain identification for M. bovis in patients with symptoms of TB was not carried out in any of the health centres/hospitals visited in Guinea Bissau and Senegal and rarely performed in The Gambia and Guinea.

5.7 Potential direct and indirect losses due to brucellosis

5.7.1 General herd parameters The herd structure is presented in Table 35. Herd sizes differed significantly between the regions with larger average herd sizes in Guinea Bissau (159) and Guinea (136) than in Senegal (81) and The Gambia (61).

Table 35: Mean herd sizes and proportion of bulls, cows, heifers and calves based on questionnaires by country

Herd size/ Gambia Guinea Guinea Senegal

67 composition Bissau Overall mean size 61a 136 b 159 b 81a (100%) (46.6,74,6) (108.7,162.9) (92.1,218.7) (62.8,98.6) % Bulls (not castrated >3 yrs) 2,3% 6,7% 2,2% 3,6% % Cows (after calving) 43,6% 44,3% 53,3% 54,7% % Heifers (>1 year until calving) 23,1% 22,0% 25,3% 19,0% % Calves (0 – 1yr.) 24,1% 19,6% 18,9% 13,6% a:b (<0.05) In brackets: CI

The predominant cattle breed in Guinea, The Gambia and Guinea Bissau is the trypanotolerant N´Dama and in Senegal the Zebu type of cattle. F1 cattle (crosses with exotic breeds) were only present in Senegal and The Gambia on farms representing the MOPS (Table 36).

Table 36: Cattle breeds in the study population (number of farms)

Gambia Guinea Guinea Bissau Senegal* Breed/Location GBA CRD Coyah Dubréka Bafata MOPS LIPS (MOPS) (LIPS) No of farms 15 20 20 20 20 20 20 N´Dama - 20 20 20 20 - 1 N´Dama & F1 14 ------N´Dama & WAS* ------2 F1 1 - - - - 1 -

68 Zebu ------11 Zebu & F1 - - - - - 14 - Zebu & N´Dama ------5 Zebu & N´Dama & - - - - - 5 - F1 Zebu & WAS* - - - - - 4 * West African shorthorn

5.7.2 Direct and indirect losses due to brucellosis (abortions and cow sterility)

To get some information on the direct and indirect losses potentially attributable to brucellosis, observations on infertile cows and cases of abortions in cattle and SR on herd level were recorded. A cow was considered to be sterile if it had not produced a calf during the last three years. Observations on sterile cows and cases of abortions were more frequent in herds from Guinea Bissau and Guinea (Table 37). In SR no significant differences between the countries were detected.

Table 37: Selected herd fertility parameters

Gambia Guinea Guinea Senegal Bissau Location CRD Dubréka Bafata LIPS No of farmers interviewed 35 40 20 40 Observations in cattle % observing abortions in their cattle (obtained from group a b c a discussion) 10 27 19 17 % observing abortions in their 8 a 21 b 6 a

69 cattle * 14 b

% observing infertile cows in their cattle (>2 years without calf) * 2 a 18 b 12 b 10 a Observations in SR

% observing abortions in their SR (obtained from group discussion) 20 21 7 26 % observing abortions in their SR

* 12 8 3 14 * Obtained from questionnaires a:b (p<0.05)

Summary: • The number of cattle herds with infertile cows or abortions was higher in Guinea and Guinea Bissau than in Senegal and The Gambia

5.8 Serological sampling for brucellosis

5.8.1 B. abortus in herd bulk milk samples

On some farms herd bulk milk samples were taken and tested for B. abortus using milk-ELISA (Table 38). Bulk milk samples were not collected in the GBA (The Gambia) and Coyah (Guinea) as most of the herds were on transhumance.during the time of the study Significantly higher herd prevalences for bovine brucellosis were found on farms from Guinea and Guinea Bissau confirming previous observations in serological surveys (see 5.9.1 and Annex 2, Table 1).

Table 38: Serological results for B. abortus for herd bulk milk samples

Gambia Guinea Guinea Bissau Senegal* Location GBA CRD Bafata Coyah Dubréka MOPS LIPS No of herds sampled - 20 20 - 12 20 20 % Herds with positive bulk - 15 a 75 b - 83 b 10 a 5 a milk for B. abortus (3/20) (15/20) (10/12) (2/20) (1/20) a:b (p<0.05)

70

5.8.2 B. abortus in man (volunteers)

In a local health centre in Dubréka (Guinea), identified as a high brucellosis prevalence area for cattle in previous ITC studies (see 5.9.1 and Annex 2, Table 1), some individuals in the potential risk groups (eight herders, seven farmers, three milk vendors and two veterinary technicians) were tested for the presence of brucella abortus antibodies. Out of 20 volunteers seven reacted positive, all of them herders (n= 4) or farmers (n= 3).

Summary • B. abortus herd prevalence in bulk herd milk was significantly higher in Guinea and Guinea Bissau. • Seven out of 20 volunteers tested positive for brucellosis in a high prevalence area for cattle (Dubréka, Guinea).

5.9 Differences in local perceptions of the impact of zoonoses on livestock and man in relation to present and previous serological findings in cattle

Since 2000 ITC has undertaken several studies to get base line information on the distribution of bovine brucellosis and tuberculosis in cattle in The Gambia, Senegal, Guinea and Guinea Bissau. The studies were carried out in the form of abattoir (BTB) and herd screening surveys (BTB and brucellosis).

5.9.1 Brucellosis

Results of previous serological studies are summarized in Table 1 of Annex 2 and indicate different epidemiological situations in the four countries. Highest mean

71 prevalences for bovine brucellosis were found in Guinea Bissau (Bafata: 18.6%) and Guinea with 9.2% (Dubréka and Coyah). These values were considerably lower in the surveyed districts of The Gambia (CRD: 1.1 %) and Senegal (Bassin Arachidier. 0.6 %). No samples were taken in the GBA of The Gambia. During the course of this study, herd bulk milk samples were collected from participating farmers. The results are presented in Section 5.8.1. and are consistent with previous serological findings. It was expected that differences in farmers’ and risk groups’ perception of the impact of brucellosis would be related to the distribution of the infection in cattle. Therefore the results of the PRA and semi-structured questionnaires were compared with previous and actual (herd bulk milk) serological findings. As shown in Table 39, brucellosis was ranked high as a disease by farmers and local veterinarians in the high prevalence areas of Guinea and Guinea Bissau. Also, in these countries, clinical symptoms of brucellosis in cattle were more frequently observed and there was greater familiarity with the disease and its modes of transmission. However, farmers’ knowledge about the prevention of infection did not necessarily correlate with serological findings e.g. high herd prevalences were found in areas with high (Guinea Bissau) as well as in areas with low knowledge (Guinea).. Despite the different epidemiological situations for brucellosis in cattle and the observed differences in perception of farmers and veterinary health services, the awareness of the public health sector for this zoonosis was very low in all four countries. Currently, no diagnostic tests on patients with brucellosis-like-symptoms were either performed or available in any of the health centres visited.

Table 39: Respondents’ perceptions of brucellosis and serological findings by country

Gambia Guinea Guinea Senegal (CRD) Bissau Farmers perceptions (see 5.2.1.1) Ranking of brucellosis among 5 Not among Rank No. Rank No. Not among Most important diseases first 5 5 5 first 5 Ranking of brucellosis among Not Rank No. 1 Rank No. 1 Not chronic infections mentioned mentioned Farmers observation on brucellosis (see 5.4.1)

72 No. of farmers knowing the symptoms 4/15 30/40 20/20 23/40 No. of farmers knowing the modes of transmission 3/15 11/40 20/20 22/40 No. of farmers knowing the preventive measures 2/15 1/40 13/20 9/40 VH authorities’ perceptions (see 5.6.2.2)

Ranking of brucellosis among 5 Not among Rank No. Rank No. Not among Most important diseases first 5 3 4 first 5 PH authorities, perceptions (see 5.6.3.3) No. of officers knowing the zoonotic character 0/3 1/4 1/3 2/4 No. of officers knowing the diagnostic procedures in man No knowledge 1/4 Serological survey (previous studies, see Annex 2, Table 1) Mean animal prevalence 1.1 a 9.2 b 18.6 c 0.6 a (0,1.3) (0.2,2.0) (7.8,10.6) (15.3,21.9) Mean herd prevalence 15 a 88.6 b 100 b 10 a (0,30.6) (78.1,99.0) (0,20.7) Serological screening of bulk milk (present study, see 5.8.1) Mean herd prevalence 15 a - 83 b 7.5 a In brackets: CI for the mean

73 5.9.2 Tuberculosis

Findings obtained from previous on-farm and abattoir ITC investigations into bovine tuberculosis are summarized in Table 2 of Annex 2. No confirmed cases of M. bovis were found in any of the countries. Results are consistent with observations obtained from the PRA and questionnaires (Table 40) administered in this study. Farmers as well as veterinarians did not consider BTB to be an important disease. However, farmers’ knowledge of symptoms in cattle and how to prevent transmission to man was significantly better in Guinea Bissau. There were no differences in perception of PH authorities. No confirmed case of BTB was reported in any of the health centres or hospitals visited.

Table 40: Respondents’ perceptions of BTB and serological findings by country

Gambia Guinea Guinea Senegal Bissau Farmers’ perceptions (see 5.2.1.1) Ranking of BTB among 5 most Not mentioned important diseases Ranking of BTB among chronic Not mentioned infections Farmers observation on BTB (see 5.3.1.1 ) No. of farmers knowing the symptoms 7/35 a 20/40 b 15/20 b 6/40 a No. of farmers knowing the preventive measures 2/35 a 1/40 a 15/20 b 4/40 a VH authorities’ perceptions (see 5.6.2.2) Ranking of BTB among 5 most important diseases Not mentioned PH authorities perception (see 5.6.3.3) Isolation of M. bovis applied Not applied regularly Not applied Reports in man No knowledge Previous surveys – tuberculinization & meat inspection - (see Annex 2, Table 2) Mean animal prevalence 0 0 0 0 a:b (p< 0.05)

74 Summary: • Differences observed in perception of farmers and other risk groups concerning brucellosis (i.e. knowledge and results of disease importance ranking) were in agreement with serological results for brucellosis in cattle. Brucellosis was ranked high by farmers and veterinarians in the high risk areas for cattle. • The absence of BTB infection in cattle was confirmed by a general low perception of farmers and veterinary health authorities related to this diseases (i.e. not considered as an important disease in disease ranking)

6 DISCUSSION

This study was the first attempt in each of the four countries to get information on the impact of zoonoses by obtaining and comparing information from different stakeholder groups: farmers, milk vendors, butchers, veterinarians, public health authorities. Information was collected using group discussions and interviews. The results obtained were compared to previous prevalence studies for selected zoonoses.

Discussion of methodology

The study chose a step-wise approach, starting with group discussions in form of PRAs with groups of up to 15 people, composed of the key persons dealing with the animals either directly (farmers and herders) or indirectly (milk vendors). A local veterinary person (veterinarian or livestock assistant) was also invited to verify observations and to assist in clarifying local descriptions for ultimate definition of the most important diseases. It showed that “unspecific symptoms” were difficult to allocate to individual diseases. We therefore gave specific disease descriptions as guidelines for the discussion. With this assistance, the PRA group discussions were able to reach a consensus as to which were the most important diseases, although some groups of symptoms were retained as such in the ranking (foot problems and diarrhoea).

75 As would be expected, participants tended to remember recent outbreaks more easily than events in the past, so questions covered the last 12 months. Replies may also have been influenced by the lack of knowledge of specific diseases and better knowledge of disease syndromes such as diarrhoea, constipation, foot problem, abortions, respiratory problems. It was observed that farmers were not clear about the difference between anthrax and BQ, particularly in the francophone countries where their French names are similar (charbon bacterienne and charbon symptomatique). The moderators of the PRAs attempted to clarify some of the uncertain answers by additional questioning and further discussions. This led to allocation of some of these descriptions to groups of diseases, e.g. respiratory disease allocated to PPR and pasteurellosis.

The main objective of this study, the importance of zoonoses, was not directly communicated to the farmers while carrying out the exercise of definition of most important diseases, in order to assess their appreciation by farmers amongst all other diseases. One of the PRA discussion points was the knowledge of chronic diseases. This question was asked with a view to bringing out the mention of brucellosis and tuberculosis-like disease occurrences. Answers were clearly referring to brucellosis in Guinea and Guinea Bissau, whereas no reference was made in Gambia and Senegal. No reference was made to tuberculosis in any of the four countries. In general, chronic diseases were even less specifically described by farmers than acute diseases and were difficult to allocate.

Thereafter questions were directed more specifically to zoonotic diseases also in a step-wise approach: “name up to three zoonotic diseases”; “discuss the top zoonotic diseases”; “specify your knowledge of these diseases”. It was particularly noticeable in this discussion that some participants easily dominated others, which could be explained by the general lack of awareness of what zoonosis, as a concept of a disease, which people could get from animals, means.

76 Thereafter five farmers from the PRA group were invited to look at the list of important diseases, including the identified zoonoses and were asked to select the top five diseases and to rank them (separately for cattle and small ruminants).

In a second step the group of informants was expanded to include selected farmers/herders, veterinarians, butchers and medical health authorities. The method used was semi-structured questionnaires. It was observed that willingness of farmers/herders to go into exhaustive discussions particularly on disease reporting over the last 12 months was less than during group discussions (PRA), which made it more difficult e.g. to reach at disease ranking. On the other hand, answers to specific questions, e.g. on symptoms, mode of transmission of zoonotic diseases, were more differentiated and more quantitative. The use of questionnaires with the group of veterinary and medical health personnel posed no problems and revealed clear results. Interviewing butchers revealed that their record keeping was poor, therefore answers could not be confirmed by documentation.

In conclusion, this study tried to make use of different approaches so as to compensate for deficits that may be inbuilt in one method by using additional methods. However, a certain degree of interpretation by the moderators (PRA) and interviewers (questionnaires) influenced the final presentation of results. This aspect has been offset by a multi-facetted presentation of the results that span all approaches and questions asked. This shows particularly when comparing results of PRA and individual interviews on brucellosis or farmers’ knowledge of zoonotic diseases in different countries, where similar results were obtained by both methods.

Zoonoses

This discussion does not attempt to repeat the results reported in each chapter.

Farmers’ perception of zoonoses clearly differed between the countries, with a better level of knowledge in Guinea Bissau. This observation was initially made during group discussions and later confirmed in the interviews. The greater knowledge covered symptoms in animals, mode of transmission and preventive measures, the

77 latter two only for certain zoonoses. Moreover, changes in meat quality due to animal disease were also better known in Guinea Bissau than in the other three countries. The differing levels of knowledge seem to be related to how common the disease is within a country (e.g. prevalence of brucellosis highest in Guinea Bissau, followed by Guinea). However, this does not fully explain the varying levels of knowledge of rabies or BTB as the distribution of these diseases is similar in the four countries.

With the exceptions mentioned above for Guinea Bissau, the PRA has clearly demonstrated that farmers are not aware of the potential risks of consuming meat from animals suffering from acute or chronic diseases such as anthrax or BTB. In particular, their knowledge of the public health risk of anthrax was poor. The majority of respondents in group discussions in The Gambia, Senegal and Guinea indicated that meat of such animals is consumed after proper cooking or traditional treatment.

Milk in the region is consumed as fresh and or sour milk. SOMDA et al. (2003) have shown in a recent survey on the consumption pattern of milk in The Gambia that local fresh milk is the most preferred (35%) followed by sour milk (33%). Moreover 81% of respondents preferred local dairy products to imported ones Results have clearly shown that processing of raw milk differs between countries. Milk, if consumed fresh on farm, was boiled by the majority of farmers in Guinea Bissau, while in all other countries this is the exception. Although this is applied traditionally in Guinea Bissau it might be also related to the high prevalence of brucellosis, which is locally known as “bakale” and related by some farmers to malaria-like symptoms in man. Conversely a good number of farmers in The Gambia and Senegal still believe that heating of milk may significantly reduce the yield of the producing cow. This traditional belief might limit the willingness of these farmers to accept pasteurisation as measure to prevent the transmission of zoonoses. However, because of customer preferences, milk is often sold fermented and therefore never boiled. Farmers and milk vendors clearly believe that milk, if boiled once, will not ferment. The use of starter cultures for fermentation after heating, was not known to the milk vendors. Some vendors related faster fermentation to improved quality of milk, an observation, which might reflect their interest in selling as much as possible sour

78 milk. The same observation was made by HEMPEN (2003). These vendors were thus not aware of the fact that faster fermentation indicates higher bacterial contamination.

Bovine brucellosis

The key symptoms of bovine brucellosis such as the occurrence of abortions, hygromas and infertility in cows were more frequently observed in Guinea and Guinea Bissau. In addition, farmers’ knowledge was better in these two countries. However, there are important public health implications attached to the observations made, particularly during group discussions in Guinea, that farmers do not consider cows with hygroma as sick and their milk is still consumed.

It is well known for brucellosis that seropositivity is strongly related to the occurrence of this clinical symptom (AKAKPO et al., 1987, OLOFFS 1996, OLOFFS et al. 1998, UNGER et al, 2003). Therefore it was expected that these differences in reports of clinical observations may coincide with previous results from serological surveys. When comparing PRA results and serological findings this assumption was confirmed. Significantly higher prevalences for bovine brucellosis based on serology in serum (previous surveys) and herd bulk milk (see 5.8.1) were found in Guinea Bissau and Guinea as compared to The Gambia and Senegal.

The high prevalences in reported herd bulk milk samples in Guinea and Guinea Bissau and the volunteers testing serologically positive in Dubréka in Guinea are also indicative of a high public health risk. However, this high risk was not at all reflected in any awareness of this disease by the public health authorities. The majority of public health persons interviewed were not aware of brucellosis as a zoonosis. Moreover, the capacity to diagnose infections in man was not available in any of the health centres visited. As confirmed in our investigations in volunteers and also reported by PERRY et al. (2002) prevalences for brucellosis in risk groups in high prevalence areas for cattle are likely to be high.

79 It has to be noted that a moderate number of abortions in cattle was also reported by farmers in The Gambia and Senegal. This indicates that there are other causes than brucellosis for abortions. In contrast to cattle the occurrence of abortions in small ruminants did not differ significantly between the countries.

BTB

In contrast to bovine brucellosis, farmers’ awareness of this zoonosis was generally low in all countries surveyed. This was also confirmed by the veterinary and public health authorities. The results of group discussions and interviews are in agreement with previous findings of ITC studies. As no confirmed case of M. bovis was found in the cattle population in large scale abattoir and on-farm surveys it was concluded that the risk posed by this zoonosis to the consumer is very low (UNGER et al. 2003).

Although the interviews in hospitals and health centres have shown that M. tuberculosis is widespread in the region the diagnostic capacity to isolate M. bovis in human sputum samples is restricted to the National Reference Laboratories (Senegal and Guinea) and the Medical Research Council (The Gambia). However, the standard procedure for investigating cases of suspected tuberculosis usually stops after the Ziehl Neelsen stain without further culturing and can only confirm Mycobacteria spp.

Production system

Results from interviews and group discussions indicated that farmers’ knowledge of zoonoses was not related to production systems. A possible explanation for this unexpected result might be that the introduction of the MOPS in the GBA of The Gambia and the Bassin Arachidier of Senegal is not yet fully established and is an on-going process. It is better characterised as a transitional phase from LIPS to MOPS. Therefore, farmers’ knowledge might not yet be significantly different between the two systems.

80 Results show the urgent need for an improvement of knowledge of farmers representing the MOPS, as it is well known that the incidence of certain zoonoses (diseases of intensification) might increase drastically with intensification. However, some differences in disease ranking were observed between the production systems for The Gambia. The ecological and endemic situation differs between the GBA and CRDsouth. Therefore the level of challenge from certain diseases (e.g. tick- borne diseases or trypanosomosis) varies and could explain the different rankings. 7 CONCLUSIONS

Comparing results obtained from various groups of respondents (farmers, herders, butchers, milk vendors, veterinarians and public health facilities) and using different methods of collection of information (interviews and group discussions) this scoping study was able to collect a significant amount of information on all aspects of zoonoses. All the potential risk groups (farmers, herders, butchers, milk vendors, butchers and veterinarians) and health authorities (veterinary and public health) were involved in the study. This broad-spectrum approach has not been applied before and can be considered unique.

Furthermore, this scoping study linked results from questionnaires and group discussions obtained from different groups of respondents with data from epidemiological studies on the distribution and prevalence of selected zoonoses. It was clearly shown that serological prevalences of selected zoonoses (bovine brucellosis and BTB) were reflected in farmers’ perceptions.

For brucellosis, it was shown for two countries of the study region (Guinea and Guinea Bissau) that the perception of interviewed groups did correspond well with the prevalence of this zoonosis in cattle, but it did not correlate to the potential impact in man. Based on results of herd screenings and clinical observations, brucellosis is considered to be a serious human health hazard in the surveyed districts in those countries. Although the symptoms of brucellosis in cattle and the possible modes of transmission to man, were best known by farmers in the high cattle prevalence area of Guinea Bissau, this improved knowledge did not result in the

81 application of any meaningful control measures, thus it may not contribute to reduced prevalences in cattle and consequently in man. In particular the perception of the public health authorities was exceptionally low in areas with high prevalence in cattle, and equally so in the low prevalence areas of Guinea and Guinea Bissau.

Livestock offers both a major contribution to the livelihood of producers but also a risk to consumers´ health and performance. The control of zoonotic diseases such as brucellosis will require a coordinated effort of medical and veterinary research, the provision of veterinary services and the reinforcement of disease control regulations.

8 RECOMMENDATIONS

8.1 Recommendations for the control of Bovine Brucellosis in the countries of this survey

Based on the results of the prevalence studies and perceptions of farmers, the approach in the fours countries to control of bovine brucellosis differs. Recommendations are made by country and include the technical options as well as human resource development options.

8.1.1 Guinea

The scoping study together with the animal prevalence studies revealed the existence of areas of high within-herd prevalence (up to 13.2, CI: 10.8, 15.6), well above the limit of 10% recommended by OIE for vaccination. However, areas where no brucellosis was found were also detected (e.g. Labe) during the prevalence studies. Given the infrastructure and poor financial situation of public services in Guinea, a country wide serological survey, though appropriate, can not be recommended. However, our results give enough evidence to justify intervention. We therefore recommend that Guinea seeks external donor funding support to carry out surveys in other Provinces with high cattle densities in form of bulk milk sample testing. Herds found positive in bulk milk sample tests should then be retested serologically. This approach is fast, easy to apply and cheaper than large scale serological surveys.

82 Based on the results already available from our studies and the recommended additional study, the appropriate application of the control option vaccination and test and slaughter can be made. We recommend for the areas covered by our studies, vaccination of herds with an within-herd prevalence >10% following OIE procedures to reduce prevalence to levels that are appropriate for test and slaughter policy. Similar control attempts in other developing countries (e.g.Malaysia) have not fully succeeded because between herd movement in high prevalence areas could not be controlled (Palamisany et al. 2003). An individual animal registration system exists in Guinea, that could be used to enhance this type of movement control. Additional measures to break the chain of infection within and between herds are an increased level of hygienic handling of infectious material (aborted foetus, milk of positive animals). Our studies showed that these measures are usually not known and are not applied.

8.1.2 Guinea Bissau

The areas covered in Guinea Bissau by the scoping study and the animal prevalence study cover more than 50% of the National herd. In all areas surveyed brucellosis was found to exist with maximum within-herd prevalence of 19.4% (CI: 16.1, 22.7). It can therefore be concluded that a countrywide effort to control brucellosis is indicated without necessity for further herd testing. Given the limited number of the national herd (~ 300.000 cattle) a nationwide vaccination campaign can be recommended to reduce prevalence to levels appropriate for test and slaughter. Application of hygienic measures and animal movement control as described for Guinea apply. However, our study found a significantly higher knowledge by farmers on possible preventive measure (e.g. discarding of milk from animals with hygroma or abortion history; destruction of aborted foetus).

Technical control options recommended for both countries include the test and slaughter option as per recommendation by OIE. In both countries cattle represent living capital for herd owners and their agreement to slaughter animals in case of detected brucellosis may be difficult to obtain unless

83 compensation is offered. This attitude is the major obstacle to implementation of this control option and Governments should consider to request external financial assistance not only for the vaccination campaign but also for the creation of a compensation fund.

8.1.3 Gambia and Senegal

Compared to the findings in Guinea and Guinea Bissau the within-herd prevalence in the areas surveyed were well below 10% (Senegal: 0.9%; CI: 0; 1.1; Gambia: 0.8; CI: 0;2.)

Gambia: though our study surveyed the District with the highest animal density (40% of the national herd) we recommend extending the survey to include the other districts to consolidate our findings using the approach as described above (screening of bulk milk samples followed by serological tests of positive herds), Given the low animal prevalence (5 animals out of 465) the test and slaughter policy is recommended and Government authorities should be encouraged to reinforce this policy, bearing in mind the necessity to compensate farmers.

Senegal: Contrary to the other countries, the area surveyed in Senegal is not representative in terms of highest cattle numbers, but represents an area in transition from traditional to intensified cattle husbandry, where cross bred dairy animals have been introduced since the 1990s. As brucellosis has often been described as a disease of intensification, it was seen important to characterise the disease situation in this region. Other areas with high local cattle densities and small numbers of crossbreds, e.g.. Casamance, have not been covered by our study and herd testing using bulk milk samples is recommended. The same recommendation concerning the test and slaughter policy as described for Gambia applies.

84 In addition to the above technical control policy option, the study revealed different, but generally very poor levels of knowledge on zoonoses, their spread, symptoms and control by the investigated risk groups (farmers, butcher, milk vendors, herders, public health authorities). We recommend sensitisation and awareness campaigns and training targeted at the different groups. Farmers and herders in Guinea Bissau had the highest level of knowledge. Practical training in disease control and prevention appears appropriate, whereas for all other countries sensitisation and awareness campaigns have to precede training. The group of butchers had the same low level of knowledge in all countries; training on diseases that affect quality of meat is recommended. People handling milk (herders, milk vendors) would benefit from training on milk hygiene and awareness on risk associated with consumption of raw milk. Public health authorities in all countries had a very low awareness of the importance of zoonotic diseases, with the exception of rabies. The link between Veterinary health and Public Health authorities is generally weak, better communication and exchange of health statistics is recommended.

The recommendations for sensitisation and training should be supported by the production of leaflets for distribution to livestock assistants and other veterinary and public health personnel, training manuals to be used for training of farmers and multimedia campaigns.

8.2 Recommendations for future research

The most surprising finding in the prevalence studies was the apparent non-existence of BTB in the four countries under investigation. This finding was well reflected in the perception of livestock stakeholders, who did not attribute any major importance to BTB. As much as human tuberculosis is on the increase, also in the context of the AIDS pandemic, there is no apparent zoonotic link to cattle.

During the tuberculinisation tests in Guinea, The Gambia, Guinea Bissau and Senegal, more than 50% of cattle reacted positive for PPD M. avium. Recent findings

85 have shown that environmental infections with other mycobacteria can influence the immune response to M. bovis to an unknown extend (BUDDLE et al., 2002; VORDERMEIER et al., 2001). It is therefore assumed, that the unexpected absence of M. bovis in the study population may not reflect the true epidemiological picture. The phenomenon of interference of environmental infections with the classical infection pathway, explained by cross-immunity mechanism, has been reported in humans (BLACK et al., 2002). The observed variation in immuno-response to M. tuberculosis in man may reflect geographic variations in the exposure to environmental mycobacteria, as it was reported recently by BLACK et al. (2002) comparing vaccinated populations in Malawi and UK. When tested with the specific antigen for M. tuberculosis (ESAT -6) in comparison with the PDD, a larger proportion of patients reacted positively to the PDD, a clear indication for exposure to environmental mycobacteria. The role of the unspecific, non-pathogenic mycobacterial infections in the epidemiology of M. bovis is not known and may be very specific for West Africa. As described for M. tuberculosis (BLACK et al., 2002) and in consideration of the very close genetic similarity between M. bovis and M. tuberculosis, potential candidates for protective cross-immunity for M .bovis could be M. avium. M. intracellulare and M. marinum.

Further investigations using more sensitive diagnostic methods to clarify the role of possible cross-immunity induced by environmental mycobacteria in the epidemiology of BTB as well as human tuberculosis are recommended. Results could provide more differentiated information on the role of mycobacteria infections in cattle and the role of environmental versus pathogen mycobacteria.

9 ACKNOWLEDGEMENT

The authors would like to thank all the people who actively participated in the implementation of this study, too many to be named here. Particular thanks go to Dr Boye Diallo and Dr Alphonse Goumou of Guinea (DNE), Dr Mamadou Diop and Mr Douda Deh of Senegal (ISRA), Dr Hipolito Djata and Dr Ivo Mendez of Guinea Bissau (DGP) and Mr Jabel Sowe and Dr Demba Jallow of The Gambia (DLS), who assisted in the identification of experienced PRA staff, suitable areas to carry out the

86 study and general organisation of this study. The PRA experts, namely Omar Ngom, Louis Beavogui, Filomeno Barbosa deserve our sincere thanks for their devotion to this work, even under difficult local circumstances and working conditions. Support with sample size determination and choice of statistical methods was given by Dr Moses Kyule, FU Berlin, Germany and Dr Mulumba Kamuanga of ILRI/CIRDES. No results could have been presented here without the wholehearted support and willingness to participate of the farmers that shared their opinions, time and enthusiasm about livestock keeping with us. The International Trypanotolerance Centre provided its facilities, infrastructure and the support by the Director General to this study is acknowledged. Our colleagues Michaela Hempen and Penda Kane need to be thanked for their assistance in the milk sample testing. The assistance of Dr Karsten Nöckler (Reference Laboratory for brucellosis at the Institute for Risk Assessment, BfR, Berlin, Germany) and Dr Jakob Zinsstag, (Swiss Tropical Institute, Basel, Swizerland) in providing the antigen and reagents for the serological tests for brucellosis is greatly appreciated.

We gratefully acknowledge the funding of this study by DFID’s Animal Health Programme.

87

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88 J.M., BRANSON, D., CHAGULUKA, S.D., DONOVAN, L., JARME N, E., KING, E., FINE, P.E.M., DOCKRELL, H.M. (2002): BCG induced increase in interferon-gamma response to mycobacgterial antigens and efficacy of BCG vaccination in Malawi and the UK: two randomised controlled studies. The Lancet. Vol 359. April 20, 2002.

DABORN, C.J., GRANGE, J.M., KAZWALA, R.R. (1996): The bovine tuberculosis cycle – an African perspective. Soc Appl Bacteriol Symp. 1996, 25, 27-32.

DJORDJEVIC, M., LAKO, B., RISTANOVIC, E. (2003): The significance of serological tests in diagnosis and following up of neurobrucellosis: case report. Poster, Brucellosis 2003 International Research Conference. Sept 15-17, 2003, University of Navarra, Pamplona, Spain.

DRESCHEL, P., QUANSAH, C. AND PENNING DE VRIES, F. (1998): Stimulation of urban and peri-urban agriculture in West Africa - Characteristics, challenges, and need for action. Paper delivered at IDRC workshop on Urban Agriculture, 15-18 June 1998, Ouagadougou, International Board for Soil Research and Management and University of Science and Technology, Kumasi, Ghana, and Bangkok, Thailand, 21 pp. (June)

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89 Proceedings, of the Procordel National Conference, 13-14 November 2003, The Gambia. International Trypanotolerance Centre, Banjul, The Gambia .ISBN 9983 9910 39, 104 pp.

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90 Inquerito sobre os efectivos de gado nas regiões de Oio, Bafata et Gabu. Direcção Geral da Pecuaria, Ministério do Desenvolvimento Rural e Agricultura, Bissau.

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93 11 ANNEX

11.1 Results of this survey 11.1.1 Annex 1a: Guidelines for PRA sessions

1. General information’s (Table) Village/District/Division Number of participants (male/female and list where they are from) Which livestock management do they undertake? What are the different types of livestock rearing?

2. Which kind of animal health services is available in the area? How does the service response to your requests (timely, delayed, no response)?

3. Clinical signs/diseases • What kind of clinical signs do you observe in your cattle? Briefly list and describe them • What kind of livestock diseases do you know? Briefly list and describe them • Has there been any outbreak of livestock diseases in the area? (last 3 years) Cattle/small ruminants and number affected? Which disease did you assume or describe symptoms if you do not know the disease? At what time of the year was it?

4. Long lasting (chronic) diseases • Do you had/have any cattle in your herd, which suffered for a long time (more than one month) of any disease? Cattle/small ruminants and number affected? Which disease did you assume or describe symptoms? What do you do with the milk of such an animal? What do you do if such an animal dies?

94

5. Do you have any animal, which aborted? What do you do with the aborted foetus?

6. Zoonotic aspects • Do you know any of diseases, which could be transmitted to human beings? If yes how is it transmitted and do you know how to avoid transmission? • Do you know in your family or on your farm any case of disease, which could be originated in animals of your farm? • How do you consume the milk produced at your farm?? How do you sell the milk? Do you know that some infections are transmitted by milk? • Do you know that some animal diseases can affect the quality of meat? If yes which and what did you observe? What do you think is it possible, that animal diseases can be transmitted via the meat through man? If yes, do you now any disease or symptom of such disease? • Do you visit a doctor when you feel sick or do you use your own treatment?

7. Selling/buying animals and slaughter management • Where do you sell or buy your animals? • What do you do if you slaughter an animal? Where and how do you slaughter these animals? Which kind of veterinary services do you use

8. Disease importance ranking: Depending on the group discussion: - Information on disease (including wasting diseases)

95 11.1.2 Annex 1b: Tables 1 - 2 and Graphs 1 - 8

Graph 1: Top-ten diseases or symptoms in cattle as ranked by farmers´ in The Gambia in terms of importance

3,0 2,8

2,5

2,0 1,8

1,5 1,4 1,1 1,0

Weighted average 1,0 0,8 0,7 0,7

0,5 0,3 0,2

0,0

a Q re in n s e o k o m ms o H.S. B s ti e o h FMD a bl fly o stip r Diarr o-somosis e/ mpy s n p n g u t a L Co oo ama F d Tryp k Nerveous sympt Tic

Graph 2: Top-ten diseases or symptoms in cattle as ranked by farmers´ in Guinea in terms of importance

3,0

2,5

2,0 1,9 1,6 1,5 1,5 1,3 1,1 1,1 1,1 Weighted average 1,0 0,8 0,7 0,5 0,5

0,0

a on rax ula hoea ems ti H.S. BQ o bl ly sore W Anth Diarr Abor Hygrom Lumpy skin age/ f Foot pro m

ick da T

96 Graph 3: Top-ten diseases or symptoms in cattle as ranked by farmers´ in Guinea Bissau in terms of importance

3,0 2,7

2,5

2,0 1,9 1,6 1,5 1,4 1,4 1,3 1,1 Weighted average 1,0 0,8 0,6 0,5 0,4

0,0

a . a e n s e .S m g ki e BQ hrax ho H o s it t rr gr as An y Man ar Dia Abortion H p Lumpy Endo Trypano-somosis

Graph 4: Top-ten diseases or symptoms in cattle as ranked by farmers´ in Senegal in terms of importance

3,0 2,6 2,5 2,3

2,0 1,6 1,5 1,3

0,9

Weighted average 1,0 0,8 0,8 0,8 0,5 0,5 0,5

0,0

. re is a n n is .S o s e o ion H s o BQ o tio t m rrh cia FMD so ia a Mastit D Abor Em Intoxicati pano- damage/ fly k Try ic T

97 Graph 5: Top-ten diseases or symptoms in SR as ranked by farmers´ in The Gambia in terms of importance

4,5

4

3,5

3 2,7 2,5

2

Weighted average 1,5 1,2 1,1 1,0 1 0,5 0,4 0,5 0,3 0,3 0,3 0,3

0

R is re t sis oo PP los anie r p d rel omo Mange o s fly so oo Diarrhoea t Abortion - / F s no Tym ge Pa a a yp am Skin infection Tr d Tick

Graph 6: Top-ten diseases or symptoms in SR as ranked by farmers´ in Guinea in terms of importance

4,5

4 3,7 3,5

3 2,5

2

Weighted average 1,5 0,9 0,8 1 0,6 0,5 0,4 0,3 0,3 0,2 0,2 0,1 0

s lk ion ms ites PPR rt e losi s o bl el a b r ar A pro o ced mi Diarrhoea symptoms ast u ot s P ndop ed Intoxication o E R F eou Nerv Tick damage/ fly sore

98 Graph 7: Top-ten diseases or symptoms in SR as ranked by farmers´ in Guinea Bissau in terms of importance

4,5 4,3

4

3,5

3

2,5 2,3

2

Weighted average 1,5 1,3 1,0 1 0,8 0,7 0,6 0,6 0,4 0,5 0,3

0

s x e Q is re ea n ra g B s o si o PPR an o so o rti nth m y rh ell o A M so fl iar r b - / D to A no ge s Tympanie a a Pa m ryp a T d ck Ti

Graph 8: Top-ten diseases or symptoms in SR as ranked by farmers´ in Senegal in terms of importance

4,5

4

3,5

3 2,6 2,5 2,0 2 1,4 1,3

Weighted average 1,5

1 0,8 0,5 0,5 0,4 0,5 0,2 0,1 0

n re s f oea ms PPR rtio so h to Or ange o blem fection M orellosis fly o mp Ab t e/ Diarr in y in s s Pas ag ot pr u Fo Sk eo dam ick Nerv T

99

Table 1: Reports by farmers during group discussions of chronic (long lasting) diseases in SR Disease suspected Overall Gambia Guinea Guinea Senegal Bissau Total no of farmers No. of farmers with SR 22 5 8 4 5 suffering from chronic diseases Arthritis 1 1 BQ 1 1 Heart water 1 1 Lumpy skin 1 1 Mange 3 1 2 Metritis 1 1 Orf 1 1 Unknown (unspecific symptoms) 13 3 6 - 4

Table 2a: Specific knowledge of rabies and clinical observations in animals during the last three years by production system and country (% of farmers) Rabies Gambia Senegal F1 local F1 local Total no farmers 15 20 20 20 Disease & symptoms in animals 67 70 90 95 Modes of transmission 67 45 85 95 Preventive measures 53 35 85 80 Observed in animals* 13 15 10 10 * dogs

100 Table 2b: Specific knowledge of anthrax and clinical observations in animals during the last three years by production system and country (% of farmers) Anthrax Gambia Senegal F1 local F1 local Total no farmers 15 20 20 20 Disease & symptoms in animals 40 40 5 15 Modes of transmission 13 25 0 0 Preventive measures 7 25 0 0 Observed in animals* 0 15 0 0 * cattle

Table 2c: Specific knowledge of BTB and clinical observations in animals during the last three years by production system and country (% of farmers) BTB Gambia Senegal F1 local F1 local Total no farmers 15 20 20 20 Disease & symptoms in animals 13 25 10 20 Modes of transmission 0 15 10 15 Preventive measures 0 10 10 10 Observed in animals* 0 0 0 0

Table 2d: Specific knowledge of bovine brucellosis and clinical observations in animals during the last three years by production system and country (% of farmers) Brucellosis Gambia Senegal F1 local F1 local Total no farmers 15 20 20 20 Disease & symptoms in animals 27 20 40 35 Modes of transmission 7 15 10 35 Preventive measures 0 10 10 15 Observed in cattle 0 5 0 0

101 11.2 Results of previous ITC studies on bovine brucellosis and BTB

Table 1: Results of previous serological studies of ITC on bovine brucellosis carried out in the region

Region Area Cattle Individual Individual Herds Herds Herd sampled +ve reactors animal sampled +ve prevalence prevalence rate in % in % (CI) (CI) Guinea Dubréka 749 95/749 12.7 a 17 16 94.1 a (10.2,15.2) (82.9,100) Coyah 810 48/810 5.9 b 18 15 83.3 a (4.3,7.5) (62.6,100) Guinea Bissau Bafata 539 100/539 18.6 c 15 15 100 a (15.3,21.9) The Gambia CRD south 465 5 1.1d 20 3 15 b (0.2,2.0) (0,30.6) Senegal Bassin 479 3 0.6 d 30 3 10 b Arachidier (0,1.3) (0,20.7) Superscript letters: Significantly differences between districts

102 Table 2: Results of previous serological studies of ITC on bovine tuberculosis carried out in the region

Results for The Gambia Guinea Guinea Bissau Senegal M. bovis Single meat 1595 cattle in Not applied Not applied Not applied the GBA inspection Suspected 1 Not applied Not applied Not applied positive cases in meat inspection Confirmed cases of 0 0 0 Not applied infection* CIDT/meat Not applied 933 cattle 450 cattle in Not applied inspection* in Kankan Bissau Total suspected Not applied 0 2 Not applied positive cattle in CIDT** Confirmed in meat Not applied 0 0 Not applied inspection CIDT on-farm 465 cattle from Not applied Not applied 479 F1 and local screening 20 farms in cattle from 30 farms the CRD in Bassin Arachidier Herds with suspected 3 Not applied Not applied 3 positive cattle in CIDT*** Total suspected 5 Not applied Not applied 5 positive cattle in CIDT*** Confirmed positive 0 Not applied Not applied 0 reactor in CIDT (after retest) * Positive in Ziehl Nelson and specific culturing for M. bovis ** Meat inspection of suspected positive reactors to PPD-M. bovis in the CIDT *** Doubtful reaction in skin test

103