One Health in Indigenous Communities: A Critical Review of the Evidence.

Indigenous populations around the world face disproportionately high rates of disease related to the environment and animals. One Health is a concept that has been used effectively to understand and address these health risks. One Health refers to the relationships and interdependencies between animal, human, and environmental health and is an emerging research field that aligns with indigenous views of health. To understand the applicability of One Health in indigenous communities, a critical review was undertaken to investigate evidence of One Health research in indigenous communities internationally, assess the strength of evidence, and understand what gaps are present. This review included the appraisal of twenty-four studies based in five regions: Canada, Africa, Australia, South America, and Central America. The review found that there is a need for studies of high strength, with rigorous methods, local leadership, and active involvement of indigenous viewpoints, to be undertaken in indigenous communities internationally that focus on One Health. It highlights the need to further consider indigenous viewpoints in research to reduce limitations, increase effectiveness of findings, consider appropriateness of recommendations, and benefit communities.

Ecological Monitoring and Health Research in Luambe National Park, Zambia: Generation of Baseline Data Layers.

Classifying, describing and understanding the natural environment is an important element of studies of human, animal and ecosystem health, and baseline ecological data are commonly lacking in remote environments of the world. Human African trypanosomiasis is an important constraint on human well-being in sub-Saharan Africa, and spillover transmission occurs from the reservoir community of wild mammals. Here we use robust and repeatable methodology to generate baseline datasets on vegetation and mammal density to investigate the ecology of warthogs (Phacochoerus africanus) in the remote Luambe National Park in Zambia, in order to further our understanding of their interactions with tsetse (Glossina spp.) vectors of trypanosomiasis. Fuzzy set theory is used to produce an accurate landcover classification, and distance sampling techniques are applied to obtain species and habitat level density estimates for the most abundant wild mammals. The density of warthog burrows is also estimated and their spatial distribution mapped. The datasets generated provide an accurate baseline to further ecological and epidemiological understanding of disease systems such as trypanosomiasis. This study provides a reliable framework for ecological monitoring of wild mammal densities and vegetation composition in remote, relatively inaccessible environments.

Sleeping sickness and its relationship with development and biodiversity conservation in the Luangwa Valley, Zambia.

The Luangwa Valley has a long historical association with Human African Trypanosomiasis (HAT) and is a recognised geographical focus of this disease. It is also internationally acclaimed for its high biodiversity and contains many valuable habitats. Local inhabitants of the valley have developed sustainable land use systems in co-existence with wildlife over centuries, based on non-livestock keeping practices largely due to the threat from African Animal Trypanosomiasis. Historical epidemics of human sleeping sickness have influenced how and where communities have settled and have had a profound impact on development in the Valley. Historical attempts to control trypanosomiasis have also had a negative impact on conservation of biodiversity.Centralised control over wildlife utilisation has marginalised local communities from managing the wildlife resource. To some extent this has been reversed by the implementation of community based natural resource management programmes in the latter half of the 20(th) century and the Luangwa Valley provides some of the earliest examples of such programmes. More recently, there has been significant uncontrolled migration of people into the mid-Luangwa Valley driven by pressure on resources in the eastern plateau region, encouragement from local chiefs and economic development in the tourist centre of Mfuwe. This has brought changing land-use patterns, most notably agricultural development through livestock keeping and cotton production. These changes threaten to alter the endemically stable patterns of HAT transmission and could have significant impacts on ecosystem health and ecosystem services.In this paper we review the history of HAT in the context of conservation and development and consider the impacts current changes may have on this complex social-ecological system. We conclude that improved understanding is required to identify specific circumstances where win-win trade-offs can be achieved between the conservation of biodiversity and the reduction of disease in the human population.

The emerging role of induced hypothermia in the management of acute stroke.

Current treatment of acute stroke remains unsatisfactory. This review presents experimental and clinical data which suggest that mild induced hypothermia could be a potent and practicable neuroprotective treatment of acute ischaemic stroke and intracerebral haemorrhage. Hypothermia, if proven to be safe, effective and widely practicable in patients with acute stroke, could have an enormous positive impact on reducing the burden of stroke worldwide. Critical issues that will need to be considered in a well designed randomised controlled trial of induced hypothermia in acute stroke patients are discussed.