Dog rabies control in West and Central Africa: A review.

Rabies is a neglected but preventable zoonotic disease that predominantly affects the most vulnerable populations living in remote rural areas of resource-limited countries. To date, every country on the African mainland is considered endemic for dog-mediated rabies with an estimated 21'500 human rabies deaths occurring each year. In 2018, the United Against Rabies collaboration launched the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. The epidemiology of rabies from most Western and Central African countries remains poorly defined, making it difficult to assess the overall rabies situation and progress towards the 2030 goal. In this review, we attempt to provide an overview of the current rabies situation in 22 West and Central African countries based on published scientific literature and information obtained from rabies focal points. To this end, information was collected on i) established surveillance, ii) diagnostic capacity, iii) post-exposure prophylaxis (PEP) availability and coverage, iv) dog population estimates, v) dog vaccination campaigns, vi) animal and human health communication (One Health), vii) molecular studies, viii) Knowledge, Attitude and Practices (KAP), ix) cost estimates and x) national control strategies. Although rabies is a notifiable disease in the majority of the studied countries, national surveillance systems do not adequately capture the disease. A general lack of rabies diagnostic capacity has an additional negative impact on rabies surveillance and attempts to estimate rabies burden. Recurrent shortages of human rabies vaccine are reported by all of the countries, with vaccine availability usually limited to major urban centers but no country has yet adopted the new WHO-recommended 1-week intradermal vaccination regimen. Most countries carry out subsidized mass dog vaccination campaigns on World Rabies Day. Such activities are indispensable to keep rabies in the public consciousness but are not of the scale and intensity that is required to eliminate rabies from the dog population. Countries will need to scale up the intensity of their campaigns, if they are to progress towards the 2030 goal. But more than half of the countries do not yet have reliable figures on their dog populations. Only two countries reached stage 2 on the Stepwise Approach towards Rabies Elimination ladder - indicating that their national governments have truly prioritized rabies elimination and are thus providing the necessary support and political buy-in required to achieve success. In summary, the sub-region of West and Central Africa seems to be divided into countries which have accepted the challenge to eliminate rabies with governments committed to pushing forward rabies elimination, while other countries have achieved some progress, but elimination efforts remain stuck due to lacking government commitment and financial constraints. The possibility to meet the 2030 goal without international solidarity is low, because more than two-thirds of the countries rank in the low human development group (HDI ≤ 152). Leading countries should act as role models, sharing their experiences and capacities so that no country is left behind. Unified and with international support it is possible to reach the common goal of zero human rabies deaths by 2030.

"We never boil our milk, it will cause sore udders and mastitis in our cows"- consumption practices, knowledge and milk safety awareness in Senegal.

BACKGROUND: Milk is a nutrient-rich food that makes an important contribution to diets in several Low and Middle Income Countries such as Senegal. Milk can also harbour several pathogenic microorganisms. As in other low and middle income countries, the dairy industry in Senegal is growing, with an expansion of farms to meet rapidly growing demand in the cities. However, most of the production still happens in the informal sector, and little is known about consumption of milk and milk products, or knowledge, awareness and practices of actors in informal dairy supply chains. METHODS: We conducted structured focus group discussions with dairy farmers and milk processors in three selected regions (Dakar, Thies and Fatick) in Senegal to investigate the consumption practices, awareness of milk borne hazards, and practices relevant to the risk of milk contamination to gain a deeper understanding of drivers of milk-borne diseases. Data on the consumption of milk and milk products were also collected using a closed questionnaire. RESULTS: Results indicate that milk is an important part of the diet in the study regionsand raw milk consumption is very common. The most common milk product consumed was fermented milk. Awareness of milk borne hazards was limited. Several farmers and processors reported risky practices, despite being aware of better practices, due to cultural beliefs. In households, children, pregnant women and older people were prioritised when milk and milk products were distributed. Dairy farmers and milk processors were more concerned with the lack of food for animals, low production and seasonality of production than the safety of the milk and milk products. CONCLUSIONS: Lack of awareness of milk borne infections and some traditional practices put milk and milk product consumers in the study area at high risk of milk borne diseases.. Prioritising certain sub population at households (Pregnant women and children) makes then vulnerable to milk-borne hazards. It will be challenging to change the risky practices as they are motivated by cultural beliefs hence the best strategy to promote milk safety will be to encourage the boiling of milk by consumers.

Typology, technical efficiency and scale economy of dibiteries in Dakar, Senegal.

BACKGROUND: In recent years, a profound transformation has been observed in the eating habits of the populations of African cities, induced by accelerated socioeconomic and demographic growth. In Senegal, these changes have manifested in the proliferation of collective informal catering enterprises, such as the ' dibiteries', where the roasted meat of sheep is prepared and sold. The rise of the average household income has contributed substantially to increasing levels of meat consumption, leading to the expansion of the dibiteries. The purpose of the current work was to evaluate the managerial performance of these establishments in Dakar, Senegal. METHODS: To achieve this, a cross-sectional study was conducted among 163 dibiteries using a questionnaire. Efficiency scores were determined via the data envelopment analysis method. The pure technical scores thereby obtained were subsequently used as dependent variables in a Tobit model to identify the socioeconomic determinants of dibiterie efficiency. RESULTS: The resulting average score of the dibiteries suggests that the majority are operating inefficiently (79.6%). Moreover, it was demonstrated that this inefficiency seems to be related to scale rather than technical issues. However, few of the dibiteries assessed (20.4%) were nevertheless in a situation of constant scale economy. Among the socioeconomic variables tested, experience, leadership (family or individual-run), the ownership status of the restaurant building (own or lease) and the type of workforce (family, recruited, mixed or without) had a significant impact on the efficiency of the establishments. CONCLUSIONS: The scale economy and waste reduction in food production can result in economic gains that can in turn be used in the safety of finished products. Indeed, by following best practices, dibiteries can make gains which could be used to invest in good hygiene practices on handwashing, cleaning and disinfecting grilling tools, optimizing work space and training staff.

Where literature is scarce: observations and lessons learnt from four systematic reviews of zoonoses in African countries.

The success of a systematic review depends on the availability, accessibility and quality of literature related to the review question. This paper presents the literature found in four systematic reviews conducted for a selection of zoonotic hazards in four livestock value chains in Africa, as well as setting out the challenges in conducting the reviews. The protocol was designed following international standards, and addressed four questions around prevalence, risk factors, control options and impact of various hazards and populations. Searches were conducted in four online databases. Articles were screened for relevance, and quality was assessed before data extraction. Literature on zoonotic hazards was in general scarce and access to full articles was limited. Overall, 25-40% of papers were considered poor quality. The diversity of approaches and designs in the studies compromised the ability to generate summarized estimates. We found that the emphasis of veterinary research has been on livestock problems rather than public health issues, although this seems to be shifting in the last decade; we also found there are limited studies on impact and control. While increasing literature is being published around zoonoses in Africa, this is still inadequate to appropriately inform policy and guide research efforts.