Interventions to Support Children's Recovery From Neglect-A Systematic Review.

Earlier reviews to discover research on interventions for children after neglect have concluded little was available, despite the well-documented prevalence and harmful effects of neglect on children. We revisited this question through a systematic literature review to discover the state of research on interventions for children who have experienced neglect. We searched MEDLINE, PsycINFO, ERIC, Sociological Abstracts and EMBASE for studies published between 2003 and 2021. Studies were included if neglect could be distinguished, and child outcomes reported. Eight reports describing six studies about six interventions were identified. These studies differed in interventions, age-groups, definitions of neglect, and outcomes. Four studies reported positive child outcomes though with varying degree of quality. More research is needed to inform a coherent theory of change following neglect. There remains an urgent need for research on interventions to help children recover from neglect.

The Global Contributions of Working Equids to Sustainable Agriculture and Livelihoods in Agenda 2030.

Small farmers produce most food in low- and middle-income countries and most small farmers rely on directly or indirectly working equids (WE). The lack of methods and metrics for assessing the role of WE hampers realisation of WE contributions. Based on literature review and a survey of WE welfare experts, we propose a framework for optimising WE potential based on two axes of sustainable development goals (SDGs) and value chains. WE contribute especially to earning and sparing income (largely in food production) (SDG 1), but also have roles in accessing health and hygiene services and products (SDG 3 and 5), providing edible products (SDG 2), and benefiting women (SDG 6), with lesser contributions to other SDGs, notably climate action (SDG 13). Experts identified barriers to appropriate appreciation of WE contributions, in order to target actions to overcome them. They found WE are neglected because they belong to farmers who are themselves neglected; because information on WE is inadequate; and, because the unique nature and roles of WE means systems, policies, investors, markets and service providers struggle to cater for them. Harnessing WE to optimally contribute to sustainable development will require generating better evidence on their contributions to SDGs, ensuring better integration into ongoing efforts to attain SDGs, and building the WE capacity among development actors.

Livestock production systems, their responses to the demand for animal-source food, and the implications for animal health services.

This paper reviews the rapidly changing global demands for animal-source foods, examines the agri-food systems behind these changes, and discusses the potential responses required by public-sector Veterinary Services to meet these new demands.

Les auteurs examinent la demande mondiale en denrées alimentaires d'origine animale et ses évolutions extrêmement rapides, ainsi que les systèmes agroalimentaires qui sous-tendent ces changements ; ils abordent ensuite les différentes mesures que les Services vétérinaires du secteur public devraient envisager afin de répondre à ces nouvelles exigences.

Los autores examinan la demanda mundial de alimentos de origen animal, que cambia con gran rapidez, describen los sistemas agroalimentarios que se encuentran detrás de esta evolución y consideran las posibles respuestas de los Servicios Veterinarios del sector público que se requieren para atender esta nueva demanda.

Inactivity and exercise training differentially regulate abundance of Na+-K+-ATPase in human skeletal muscle.

Physical inactivity is a global health risk that can be addressed through application of exercise training suitable for an individual's health and age. People's willingness to participate in physical activity is often limited by an initially poor physical capability and early onset of fatigue. One factor associated with muscle fatigue during intense contractions is an inexcitability of skeletal muscle cells, reflecting impaired transmembrane Na+/K+ exchange and membrane depolarization, which are regulated via the transmembranous protein Na+-K+-ATPase (NKA). This short review focuses on the plasticity of NKA in skeletal muscle in humans after periods of altered usage, exploring NKA upregulation with exercise training and downregulation with physical inactivity. In human skeletal muscle, the NKA content quantified by [3H]ouabain binding site content shows robust, yet tightly constrained, upregulation of 8-22% with physical training, across a broad range of exercise training types. Muscle NKA content in humans undergoes extensive downregulation with injury that involves substantial muscular inactivity. Surprisingly, however, no reduction in NKA content was found in the single study that investigated short-term disuse. Despite clear findings that exercise training and injury modulate NKA content, the adaptability of the individual NKA isoforms in muscle (α1-3 and ß1-3) and of the accessory and regulatory protein FXYD1 are surprisingly inconsistent across studies, for exercise training as well as for injury/disuse. Potential reasons for this are explored. Finally, we provide suggestions for future studies to provide greater understanding of NKA regulation during exercise training and inactivity in humans.

Review: Animal health and sustainable global livestock systems.

This paper discusses the sustainability of livestock systems, emphasising bidirectional relations with animal health. We review conventional and contrarian thinking on sustainability and argue that in the most common approaches to understanding sustainability, health aspects have been under-examined. Literature review reveals deep concerns over the sustainability of livestock systems; we recognise that interventions are required to shift to more sustainable trajectories, and explore approaches to prioritising in different systems, focusing on interventions that lead to better health. A previously proposed three-tiered categorisation of 'hot spots', 'cold spots' and 'worried well' animal health trajectories provides a mental model that, by taking into consideration the different animal health status, animal health risks, service response needs and key drivers in each system, can help identify and implement interventions. Combining sustainability concepts with animal health trajectories allows for a richer analysis, and we apply this to three case studies drawn from North Africa and the Middle East; Bangladesh; and the Eastern Cape of South Africa. We conclude that the quest for sustainability of livestock production systems from the perspective of human and animal health is elusive and difficult to reconcile with the massive anticipated growth in demand for livestock products, mainly in low- and middle-income countries, as well as the aspirations of poor livestock keepers for better lives. Nevertheless, improving the health of livestock can contribute to health sustainability both through reducing negative health impacts of livestock and increasing efficiency of production. However, the choice of the most appropriate options must be under-pinned by an understanding of agro-ecology, economy and values. We argue that a new pillar of One Health should be added to the three traditional sustainability pillars of economics, society and environment when addressing livestock systems.

Effect of 23-day muscle disuse on sarcoplasmic reticulum Ca2+ properties and contractility in human type I and type II skeletal muscle fibers.

Inactivity negatively impacts on skeletal muscle function mainly through muscle atrophy. However, recent evidence suggests that the quality of individual muscle fibers is also altered. This study examined the effects of 23 days of unilateral lower limb suspension (ULLS) on specific force and sarcoplasmic reticulum (SR) Ca(2+) content in individual skinned muscle fibers. Muscle biopsies of the vastus lateralis were taken from six young healthy adults prior to and following ULLS. After disuse, the endogenous SR Ca(2+) content was ∼8% lower in type I fibers and maximal SR Ca(2+) capacity was lower in both type I and type II fibers (-11 and -5%, respectively). The specific force, measured in single skinned fibers from three subjects, decreased significantly after ULLS in type II fibers (-23%) but not in type I fibers (-9%). Western blot analyses showed no significant change in the amounts of myosin heavy chain (MHC) I and MHC IIa following the disuse, whereas the amounts of sarco(endo)plasmic reticulum Ca(2+)-ATPase 1 (SERCA1) and calsequestrin increased by ∼120 and ∼20%, respectively, and the amount of troponin I decreased by ∼21%. These findings suggest that the decline in force and power occurring with muscle disuse is likely to be exacerbated in part by reductions in maximum specific force in type II fibers, and in the amount of releasable SR Ca(2+) in both fiber types, the latter not being attributable to a reduced calsequestrin level. Furthermore, the ∼3-wk disuse in human elicits change in SR properties, in particular a more than twofold upregulation in SERCA1 density, before any fiber-type shift.

The control of East Coast fever of cattle by live parasite vaccination: A science-to-impact narrative.

There is an increasing interest in determining the impact of vaccine technologies developed using public funding targeted at international development, and understanding the factors and ingredients which contribute to the success and impacts of such vaccines. This paper chronicles the development of a live vaccine against East Coast fever, a tick-borne disease of cattle caused by Theileria parva. The paper describes the technological innovation, commonly known as infection-and-treatment, which was developed some 40 years ago, explores the institutional settings in which the vaccine was developed and refined, and discusses the political dynamics of both during the decades from first development to field deployment and impacts. The paper also analyses the direct and indirect indicators of success of ITM and the many qualifiers of these, the impacts that the emerging technology has had, both in positive and negative terms, and maps the key contributors and milestones on the research-to-impact pathway.

How Growing Complexity of Consumer Choices and Drivers of Consumption Behaviour Affect Demand for Animal Source Foods.

Many societies are spoiled for choice when they purchase meat and other livestock products, and around the globe food choice has grown dramatically in the last two decades. What is more, besides the cost and obvious health concerns influencing commodity section, an increasing proportion of choices is made to contribute to the achievement of certain ideals, such as natural resource management, climate change mitigation, animal welfare concerns and personal lifestyle. At the same time, human health considerations are becoming more important for consumption choices as richer societies, and increasingly the urban poor in low- and middle-income countries, face an unprecedented epidemic of over-consumption and associated diet-related non-communicable diseases. Animal source foods are considered significant contributors to this trend. This paper reviews this complicated arena, and explores the range of considerations that influence consumers' preferences for meat and other animal source foods. This paper also argues that deeper drivers of consumption behaviour of many foods may act in opposition to the articulated preferences for choices around animal source food consumption. We review how the returns to different causes are being valued, how emerging metrics are helping to manage and influence consumption behaviours, and draw conclusions regarding options which influence food choice.

Transmission rate and reproductive number of the H5N1 highly pathogenic avian influenza virus during the December 2005-July 2008 epidemic in Nigeria.

We quantified the between-village transmission rate, ß (the rate of transmission of H5N1 HPAI virus per effective contact), and the reproductive number, Re (the average number of outbreaks caused by one infectious village during its entire infectious period), of H5N1 highly pathogenic avian influenza (HPAI) virus in Nigeria using outbreak data collected between December 2005 and July 2008. We classified the outbreaks into two phases to assess the effectiveness of the control measures implemented. Phase 1 (December 2005-October 2006) represents the period when the Federal Government of Nigeria managed the HPAI surveillance and response measures, while Phase 2 (November 2006-July 2008) represents the time during which the Nigeria Avian Influenza Control and Human Pandemic Preparedness project (NAICP), funded by a World Bank credit of US$ 50 million, had taken over the management of most of the interventions. We used a total of 204 outbreaks from 176 villages that occurred in 78 local government areas of 25 states. The compartmental susceptible-infectious model was used as the analytical tool. Means and 95% percentile confidence intervals were obtained using bootstrapping techniques. The overall mean ß (assuming a duration of infectiousness, T, of 12 days) was 0.07/day (95% percentile confidence interval: 0.06-0.09). The first and second phases of the epidemic had comparable ß estimates of 0.06/day (0.04-0.09) and 0.08/day (0.06-0.10), respectively. The Re of the virus associated with these ß and T estimates was 0.9 (0.7-1.1); the first and second phases of the epidemic had Re of 0.84 (0.5-1.2) and 0.9 (0.6-1.2), respectively. We conclude that the intervention measures implemented in the second phase of the epidemic had comparable effects to those implemented during the first phase and that the Re of the epidemic was low, indicating that the Nigeria H5N1 HPAI epidemic was unstable.

Poverty impacts of foot-and-mouth disease and the poverty reduction implications of its control.

Foot-and-mouth disease (FMD) remains one of the most important livestock diseases of the world, given its highly infectious nature, its broad economic impacts on animal wellbeing and productivity, and its implications for successful access to domestic and export markets for livestock and products. The impacts of the disease vary markedly between developed and developing countries, and also within many developing countries. These differences in impact shape some markedly heterogeneous incentives for FMD control and eradication, which become of particular importance when setting priorities for poverty reduction in developing countries. Some consider that the benefits from FMD control accrue only to the better off in such societies and, as such, may not be a priority for investments targeted at poverty reduction. But is that view justified? Others see the control of FMD as a major development opportunity in a globalised environment. In this paper, Brian Perry and Karl Rich summarise the differential impacts of FMD and its control, and link these findings with the growing understanding of how the control of this globally important disease may contribute to the processes of pro-poor growth in certain countries of the developing world.

Certification for regional and international trade in livestock commodities: the need to balance credibility and enterprise.

The current system for the certification of internationally traded animal commodities can act as a barrier to developing countries accessing high-value international markets. In this Viewpoint article, Gavin Thomson and colleagues discuss the situation as it stands and identify inconsistencies with respect to the certification process. They suggest ways to address the lack of capacity for credible certification in some developing countries that will encourage market access for livestock commodities. They emphasise the role of mechanisms other than demonstrating that an area of production is free from a range of animal diseases, arguing that this could be of significant benefit to developing regions and countries, but that a reliable and independent system of certification based on international standards is essential.

Integrated epidemiology and economics modelling for the management of animal health.

This paper discusses the role of integrated epidemiology and economics modelling in animal health planning, with particular reference to the evaluation of national level interventions that involve the vaccination of livestock. Well-integrated epidemiology and economics is considered essential if model outputs are to be of value in national animal disease control planning. The different approaches to the use of modelling in priority setting and resource allocation in animal health are reviewed and discussed. The authors conclude that this particular application of modelling is poorly developed, due in part to the complexities involved. Much more has been done to develop models that evaluate the merits of different intervention scenarios for a given single disease, and examples of these are presented. However, the authors conclude that despite the widespread use of such models, there is still considerable scope for the development of a more standardised approach, incorporating consideration of both direct and indirect implications of intervention options. In discussing the changing demands on animal health economics modelling, the authors propose that increased attention should be given to the valuation of "externalities", the calculation and interpretation of the distribution of costs and benefits, the evaluation of the impact of disease control on poverty reduction, and the development of real-time economics modelling techniques, to assist particularly in the effective management of disease outbreaks.

The impact of tick control on the productivity of indigenous cattle under ranch conditions in Uganda.

The impact of tick control on the productivity of indigenous cattle was investigated in three herds of East African shorthorn Zebu and Zebu x Ankole (Nganda) breeds, maintained under three tick management systems practised under ranch conditions: twice-a-week dipping, once-a-month dipping, and no tick control. The milk production and the growth rates of pre-weaned and post-weaned calves were monitored once a month over a period of 34 months. Milk offtake was 23% higher during the heavy rainy seasons than in the long dry seasons. Twice-a-week dipping increased the milk offtake by 21% in the second year of study and prolonged the duration of lactation in cows. Similarly, twice-a-week dipping increased the pre-weaning growth rate by 39% in the second year of study, but had no significant effect on the post-weaning growth rate. Generally, the growth rate of calves were greatest during the heavy rainy seasons and least during the long dry seasons. These results provide a basis for assessing the losses under different tick management systems in the various production systems.

The economic impact of foot and mouth disease control and eradication in the Philippines.

The authors evaluate the impact of foot and mouth disease (FMD) and control of the disease in the Philippines using cost-benefit analysis. A scenario in which FMD control is maintained at recent levels with continued presence of the disease is compared to scenarios in which a publicly funded programme achieves eradication by 2005 (current policy objective), 2007 and 2010. Under varying assumptions regarding the development of exports of livestock products following eradication, estimated benefit-cost ratios for the investment in eradication range from 1.6 (2010, no exports) to 12.0 (2005, export of 5,000 tons each of low-value and high-value livestock products annually), indicating eradication to be an economically viable investment. The commercial swine sector is estimated to capture 84% of the benefits generated by the public investment in eradication, versus 4% by backyard swine producers. The implications of these results within the context of regional efforts to control FMD in South-East Asia are explored.

The dynamics and impact of foot and mouth disease in smallholder farming systems in South-East Asia: a case study in Laos.

There is a general lack of data on the different patterns of dynamics and impact of foot and mouth disease (FMD) in South-East Asia and the impact the disease has on different sectors, in particular the smallholder sector in which livestock play such an important role. A pilot study was conducted of a recent outbreak of FMD that swept across the southern part of Laos during the second half of 1999. The main objectives of the study were to investigate the possible routes of transmission of the disease and the impact of FMD on the predominantly smallholder rice/livestock production system of Savannakhet Province. The study was performed by group interviews of farmers in ten villages, located in five districts across the width of the Province, and of district and provincial veterinary officials. Results suggested that the infection had probably been introduced from the eastern border and had spread rapidly west, along a principal trading route of pigs, cattle and buffalo. In the process, many villages adjacent to this trading route became infected and the disease spread rapidly within infected villages. The disease had a significant impact on the agricultural system, but the impact would have been much greater had the epidemic occurred during the season of paddy field preparation. Mortality was observed in young buffalo, cattle and pigs, and long periods of morbidity were observed in buffalo, often requiring extended treatment. The sale of livestock for cash was severely restricted, creating additional repercussions on that sector. It was concluded that the most appropriate approach to FMD control would be to prevent infected animals from entering the principal trading routes for pigs, cattle and buffalo. This will require the involvement of all the stakeholders of the livestock industry, including traders and veterinary authorities. A further tactic to be considered would be to protect livestock systems adjacent to these trading routes by vaccination. An economic study of the market incentives of both traders and smallholders is recommended and this approach is advocated in other parts of South-East Asia where livestock trading routes present the major risk of FMD outbreaks.

The impact of Theileria parva infections and other factors on calf mean daily weight gains in smallholder dairy farms in Murang'a District, Kenya.

The association between mean daily weight gain, Theileria parva infections, clinical East Coast fever and other possible determinants of weight gain were examined in a longitudinal observational study that was conducted in cohorts of female calves from five agro-ecological zone (AEZ)-grazing strata. The strata were upper-midlands (UM) 1 zero-grazing, UM 1 open-grazing, UM 2 zero-grazing, UM 4 zero-grazing and UM 4 open-grazing. In total, 225 calves on 188 smallholder dairy farms were visited within the first 2 weeks of life and thereafter at biweekly intervals up to the age of 6 months between March 1995 and August 1996. During each visit, the calves were weighed and other calf-management practices in the farm during the visit such as housing, feeding and tick control also were recorded. Other events such as morbidity and mortality between or during the visits were also recorded. The overall mean daily weight gains were 0.24-0.29 kg (S.D.=0.17-0.22 kg) and were lower than the recommended targets for smallholder farms of 0.40-0.50 kg. The major tendency in variability of daily weight gains was due to visit-to-visit variation (especially in calves >3 months old). Differences in mean daily gains were associated with AEZ-grazing strata and calf-level factors that included breed of calf, calf sickness, incidence of ECF, feeding of milk, concentrate feeds and minerals and interaction between calf age and AEZ-grazing strata (P<0.05). ECF and other calf sicknesses exerted a temporal effect on calf-growth at the height of illness and immediately after; calves later recovered the lost growth except where other factors such as poor calf nutrition prevailed. Improvement in calf-growth in Murang'a District is achievable and extension services should continue to target individual-calf-level management practices.

Seroprevalences of vector-transmitted infections of small-holder dairy cattle in coastal Kenya.

A cross-sectional study was carried out from July to September 1989 in Kaloleni Division, Coast Province, Kenya to estimate the prevalence of vector-transmitted diseases in small-holder dairy cattle and to identify the risk factors associated with different management systems. One hundred and thirty of the 157 herds with dairy cattle in Kaloleni Division were surveyed. These were from three agro-ecological zones (coconut-cassava, cashew nut-cassava and livestock-millet), comprised two management systems (stall-feeding and herded grazing) and were herds with either dairy cattle only or with Zebu and dairy cattle. A formal questionnaire sought answers to questions on cattle health and management practices. A total of 734 dairy and 205 Zebu cattle in 78 dairy and 52 mixed (dairy and Zebu) herds were sampled and screened for haemoparasites (Trypanosoma, Anaplasma, Babesia, and Theileria infections). Sera were tested for antibodies to Theileria parva, using the schizonts-antigen indirect fluorescent-antibody (IFA) test and to antibodies for Babesia bigemina and antigens to Anaplasma marginale by enzyme-linked immunosorbent assay (ELISA). Packed-cell volume (PCV) also was measured. Tick-control measures were practised by all except three of the farmers. Despite this, overall seroprevalence to T. parva was >70%--suggesting either that control practices were not strictly implemented or they were ineffective. The seroprevalence of T. parva in adult cattle kept in stall-feeding systems in the coconut-cassava zone was significantly lower (57+/-8% (S.E.)) than in herded-grazing systems (79+/-3%) and there was no association between antibody prevalence and age of cattle in this zone. Antibody prevalences in cattle in the cashew nut-cassava and the drier livestock-millet zone increased with age. Cattle in herded-grazing systems had an overall lower seroprevalence of T. parva infection in the livestock-millet zone (45+/-6%) than in the other two zones. Analysis was confined to the coconut-cassava zone for B. bigemina and to the coconut-cassava and cashew nut-cassava zones for A. marginale. Mean prevalences of B. bigemina were 40.9+/-9 and 73+/-6% for dairy cattle under stall-feeding and herded-grazing systems, respectively, and increased with age. Antigen prevalences of A. marginale were over 80% in all age groups of cattle in the coconut-cassava and cashew nut-cassava zones. Overall trypanosome prevalence in cattle was <1%. Trypanocidal treatment was uncommon. The variations in antibody prevalence associated with risk factors such as feeding system, agro-ecological zone and age of animal suggest that management system influenced exposure to tick-borne infection (particularly, T. parva infections) in small-holder dairy cattle in coastal Kenya.

A longitudinal study of disease incidence and case-fatality risks on small-holder dairy farms in coastal Kenya.

A longitudinal study was carried out in the coastal lowlands coconut-cassava agro-ecological zone of Kaloleni Division, Coast Province, Kenya between June 1990 and December 1991 to estimate disease incidence and cause-specific case-fatality risk in an average of 120 cattle in 26 small-holder dairy herds kept in two grazing-management systems. East Coast fever (ECF) was the predominant disease diagnosed; the mean monthly incidence rate was 2.5 and 6.9% in animals < or = 18 months of age under stall-fed and herded-grazing systems, respectively. In cattle > 18 months of age, the monthly incidence rate was < 1%. The 6-month ECF incidence rate was 20+/-8% (S.E.) in the stall-feeding system compared with 39+/-7% in the herded-grazing systems. There was a gradual increase in antibody prevalence with age to over 90% in cattle over 18 months of age in herded-grazing systems, whilst less than a third of cattle in the stall-feeding systems were sero-positive at any age. Overall accumulated mortality to 18 months of age was estimated to be 56%. Annual mortality in cattle > 18 months averaged 9%. Cattle managed in the herded-grazing system had a 60% higher mortality, although not significantly so, than those fed in stalls. Deaths due to ECF accounted for over two-thirds of the deaths. ECF was then the major disease constraint to small-holder dairy production in the coconut zone of coastal Kenya. Clinical cases occur the whole year round (especially in young stock)--despite apparent tick control, and in both herded-grazing and stall-feeding system.

Identification of a target population for immunisation against East Coast fever in coastal Kenya.

Two experiments were carried out to identify the target population of cattle for immunisation against East Coast fever (ECF) using the infection-and-treatment method. Firstly, a sentinel-calf study was used to determine the age window for ECF immunisation by determining ages at clinical detection of infection with Theileria parva. Six groups of five naive cross-bred (Bos taurus/Bos indicus) male calves, introduced at intervals of 2 months at a mean age of 26 days, were exposed to natural tick challenge on a high ECF-risk, small-holder farm in the coastal lowland, coconut-cassava agro-ecological zone of coastal Kenya. Secondly, a challenge study evaluated the relationship between the presence of T. parva antibodies and immunity. Ten indigenous adult Zebu cattle and nine Zebu young stock purchased from farmers in the same zone, and eight cross-bred calves (survivors of the sentinel-calf study) were challenged with 10 times the immunising dose of T. parva Marikebuni stock. Twenty-four of these 27 cattle had high antibody titres before challenge. Two cross-bred calves, obtained from an ECF-free area and seronegative to T. parva schizont antigen, also were challenged and used as susceptible controls. Twenty-five (83%) of the 30 sentinel calves contracted ECF over an age range of 36-116 days (mean 72 days). The remaining five calves died of other causes within 2 months of arrival on the farm. Fourteen of the 25 calves survived the infection and developed antibodies to T. parva. Despite tick control, seven of these 14 calves had a second episode of ECF and two died. In total, 13 of the 25 calves that contracted ECF died. Only one of 19 indigenous Zebu animals developed clinical ECF when challenged with T. parva Marikebuni (mild clinical signs with spontaneous recovery). Of the eight cross-bred survivors from the first experiment, only one succumbed to ECF when challenged and it died. Both susceptible cross-bred calves developed severe clinical signs of ECF and one died. The experimental studies show that in the high ECF-risk areas of the coconut-cassava zone of coastal Kenya, immunisation against ECF in cross-bred (B. taurus/B. indicus) cattle should be targeted at an early age (preferably within 1-2 months of birth).

Endemic stability--a veterinary idea applied to human public health.

Endemic stability is an epidemiological state of a population, in which clinical disease is scarce despite high level of infection. The notion was developed to describe patterns of tick-borne disease in cattle. However, we propose a general model of endemic stability that is applicable to a broader range of diseases that are important in public health, including malaria, rubella, and mumps. We postulate that endemic stability requires only that (1) the probability, or severity, of clinical disease after infection increases with age, and (2) after one infection, the probability that subsequent infections result in disease is reduced. We present these criteria in simple mathematical terms. Our hypothesis predicts that partial disease control activities might, under certain circumstances, lead to an increase in disease incidence. We discuss the implications for public health interventions.