Development of Disease-specific, Context-specific Surveillance Models: Avian Influenza (H5N1)-Related Risks and Behaviours in African Countries.

Avian influenza virus (H5N1) is a rapidly disseminating infection that affects poultry and, potentially, humans. Because the avian virus has already adapted to several mammalian species, decreasing the rate of avian-mammalian contacts is critical to diminish the chances of a total adaptation of H5N1 to humans. To prevent the pandemic such adaptation could facilitate, a biology-specific disease surveillance model is needed, which should also consider geographical and socio-cultural factors. Here, we conceptualized a surveillance model meant to capture H5N1-related biological and cultural aspects, which included food processing, trade and cooking-related practices, as well as incentives (or disincentives) for desirable behaviours. This proof of concept was tested with data collected from 378 Egyptian and Nigerian sites (local [backyard] producers/live bird markets/village abattoirs/commercial abattoirs and veterinary agencies). Findings revealed numerous opportunities for pathogens to disseminate, as well as lack of incentives to adopt preventive measures, and factors that promoted epidemic dissemination. Supporting such observations, the estimated risk for H5N1-related human mortality was higher than previously reported. The need for multidimensional disease surveillance models, which may detect risks at higher levels than models that only measure one factor or outcome, was supported. To develop efficient surveillance systems, interactions should be captured, which include but exceed biological factors. This low-cost and easily implementable model, if conducted over time, may identify focal instances where tailored policies may diminish both endemicity and the total adaptation of H5N1 to the human species.

Satellite climatology and the environmental risk of Schistosoma mansoni in Ethiopia and east Africa.

Annual and seasonal composite maps prepared from the normalized difference vegetation index (NDVI) and earth surface maximum temperature (T(max)) satellite data from the archives of the Global land 1-km program of the United States Geological Survey (USGS) were studied for. their potential value, using geographic information system (GIS) methods, as surrogates of climate data in the development of environmental risk models for schistosomiasis in Ethiopia. Annual, wet season and dry season models were developed and iteratively analyzed for relationships with Schistosoma mansoni distribution and infection prevalence rates. Model-predicted endemic area overlays that best fit the distribution of sites with over 5% prevalence corresponded to values of NDVI 125-145 and T(max) 20-33 degrees C in the annual composite map, NDVI 125-145 and T(max) 18-29 degrees C for the wet season map, and NDVI 125-140 and T(max) 22-37 degrees C for the dry season map. The model-predicted endemic area was similar to that of a prior model developed using an independent agroecologic zone data set from the United Nations Food and Agriculture Organization (FAO). Results were consistent with field and laboratory data on the preferences and limits of tolerance of the S. mansoni-Biomphalaria pfeifferi system. Results suggest that Global 1-km NDVI and T(max), when used together, can be used as surrogate climate data for development of GIS risk assessment models for schistosomiasis. The model developed for Ethiopia based on global 1-km satellite data was extrapolated to a broader area of East Africa. When used with FAO agroecologic zone climate data limits of <27 degrees C for average annual mean temperature and annual moisture deficits (annual rain-annual potential evapotranspiration) of <-1300 mm, the model accurately represented the regional distribution of the S. mansoni-B. pfeifferi system in the East Africa extrapolation area.

A global network for the control of snail-borne disease using satellite surveillance and geographic information systems.

At a team residency sponsored by the Rockefeller Foundation in Bellagio, Italy, 10-14 April 2000 an organizational plan was conceived to create a global network of collaborating health workers and earth scientists dedicated to the development of computer-based models that can be used for improved control programs for schistosomiasis and other snail-borne diseases of medical and veterinary importance. The models will be assembled using GIS methods, global climate model data, sensor data from earth observing satellites, disease prevalence data, the distribution and abundance of snail hosts, and digital maps of key environmental factors that affect development and propagation of snail-borne disease agents. A work plan was developed for research collaboration and data sharing, recruitment of new contributing researchers, and means of access of other medical scientists and national control program managers to GIS models that may be used for more effective control of snail-borne disease. Agreement was reached on the use of compatible GIS formats, software, methods and data resources, including the definition of a 'minimum medical database' to enable seamless incorporation of results from each regional GIS project into a global model. The collaboration plan calls for linking a 'central resource group' at the World Health Organization, the Food and Agriculture Organization, Louisiana State University and the Danish Bilharziasis Laboratory with regional GIS networks to be initiated in Eastern Africa, Southern Africa, West Africa, Latin America and Southern Asia. An Internet site, www.gnosisGIS.org, (GIS Network On Snail-borne Infections with special reference to Schistosomiasis), has been initiated to allow interaction of team members as a 'virtual research group'. When completed, the site will point users to a toolbox of common resources resident on computers at member organizations, provide assistance on routine use of GIS health maps in selected national disease control programs and provide a forum for development of GIS models to predict the health impacts of water development projects and climate variation.

Epidemiology of Oestrus ovis in southwest France.

From July 1989 to June 1990, 555 heads of adult sheep obtained from Pamiers slaughterhouse (southwest France) were examined for infestation by Oestrus ovis. Infestation was present in 65% of the heads and the mean larval burden per positive case over the year was 24.8. The monthly prevalence rate varied from 44% in April to 88.2% in November. There are usually three generations of O. ovis each year: the first in March-April, the second in June-July and the last in September-October. There was no fly activity in winter and during the hottest months of summer. On the other hand, nearly all the larvae overwintered as the first stage. This study emphasizes the seriousness of the problem in the region and the authors recommend three strategic treatments per year during periods of high fly activity.

A geographic information system forecast model for strategic control of fasciolosis in Ethiopia.

A geographic information system (GIS) forecast model based on moisture and thermal regime was developed to assess the risk of Fasciola hepatica, a temperate species, and its tropical counterpart, Fasciola gigantica, in Ethiopia. Agroecological map zones and corresponding environmental features that control the distribution and abundance of the disease and its snail intermediate hosts were imported from the Food and Agriculture Organization (FAO) Crop Production System Zones (CPSZ) database on east Africa and used to construct a GIS using ATLAS GIS 3.0 software. Base temperatures of 10 degrees C and 16 degrees C were used for F. hepatica and F. gigantica, respectively, to calculate growing degree days in a previously developed climate forecast system that was modified to allow use of monthly climate data values. The model was validated by comparison of risk indices and environmental features to available survey data on fasciolosis. Monthly Fasciola risk indices of four climatic regions in Ethiopia were used to project infection transmission patterns under varying climatic conditions and strategic chemotherapeutic fasciolosis control schemes. Varying degrees of F. hepatica risk occurred in most parts of the country and distinct regional F. hepatica transmission patterns could be identified. In the humid west, cercariae-shedding was predicted to occur from May to October. In the south it occurred from April to May and September to October, depending on the annual abundance of rain. In the north-central and central regions, risk was highest during heavy summer rains and pasture contamination with metacercariae was predicted to occur during August-September, except in wet years, when it may start as early as July and extend up to October. At cooler sites above altitude of 2800 m, completion of an infection cycle may require more than a year. Fasciola gigantica risk was present in the western, southern and north-central regions of the country at altitudes of 1440-2560 m. However, a transmission cycle could be completed in a single year only at elevations below 1700 m. The greatest risk of F. gigantica infection was in the humid western region. Regional strategic chemotherapy schemes of two or three treatments per year were developed. Results suggest that the model can be extrapolated to all CPSZ in the country and adapted for use in control of other vector-borne diseases of economic and public health importance.

A geographic information system on the potential distribution and abundance of Fasciola hepatica and F. gigantica in east Africa based on Food and Agriculture Organization databases.

An adaptation of a previously developed climate forecast computer model and digital agroecologic database resources available from FAO for developing countries were used to develop a geographic information system risk assessment model for fasciolosis in East Africa, a region where both F. hepatica and F. gigantica occur as a cause of major economic losses in livestock. Regional F. hepatica and F. gigantica forecast index maps were created. Results were compared to environmental data parameters, known life cycle micro-environment requirements and to available Fasciola prevalence survey data and distribution patterns reported in the literature for each species (F. hepatica above 1200 m elevation, F. gigantica below 1800 m, both at 1200-1800 m). The greatest risk, for both species, occurred in areas of extended high annual rainfall associated with high soil moisture and surplus water, with risk diminishing in areas of shorter wet season and/or lower temperatures. Arid areas were generally unsuitable (except where irrigation, water bodies or floods occur) due to soil moisture deficit and/or, in the case of F. hepatica, high average annual mean temperature >23 degrees C. Regions in the highlands of Ethiopia and Kenya were identified as unsuitable for F. gigantica due to inadequate thermal regime, below the 600 growing degree days required for completion of the life cycle in a single year. The combined forecast index (F. hepatica+F. gigantica) was significantly correlated to prevalence data available for 260 of the 1220 agroecologic crop production system zones (CPSZ) and to average monthly normalized difference vegetation index (NDVI) values derived from the advanced very high resolution radiometer (AVHRR) sensor on board the NOAA polar-orbiting satellites. For use in Fasciola control programs, results indicate that monthly forecast parameters, developed in a GIS with digital agroecologic zone databases and monthly climate databases, can be used to define the distribution range of the two Fasciola species, regional variations in intensity and seasonal transmission patterns at different sites. Results further indicate that many of the methods used for crop productivity models can also be used to define the potential distribution and abundance of parasites.

The cost-benefit of biosecurity measures on infectious diseases in the Egyptian household poultry.

Increased animal intensification presents with increasing risks of animal diseases. The Egyptian household poultry is peculiar in its management style and housing and this present with particular challenges of risk of infection to both the flock and humans. Biosecurity remains one of the most important means of reducing risks of infection in the household poultry, however not much information is available to support its feasibility at the household level of production. In this study financial feasibilities of biosecurity were modeled and evaluated based on certain production parameters. Risks of particular importance to the household poultry were categorized and highly pathogenic avian influenza H5N1 was the most risky disease while people-related risk was the most important risk category. It was observed that basic biosecurity measures were applicable in the household poultry and it would be 8.45 times better to implement biosecurity than to do nothing against HPAI H5N1; 4.88 times better against Newcastle disease and 1.49 times better against coccidiosis. Sensitivity analyses proved that the household poultry project was robust and would withstand various uncertainties. An uptake pathway for basic biosecurity was suggested. The outcome of this work should support decisions to implement biosecurity at the household sector of poultry production.