Participatory appraisal of the impact of epizootic lymphangitis in Ethiopia.

Epizootic lymphangitis (EZL) is reported to have a significant impact upon livelihoods within resource-poor settings. This study used a participatory approach to explore peoples' experiences of EZL and examine the perceived impact of disease, owner knowledge and understanding of EZL, lay management of disease and, attitudes and strategies towards disease prevention. Focus-group discussions were held with 358 cart-horse owners and drivers recruited from 7 towns attended by SPANA (Society for the protection of animals abroad) mobile veterinary clinics and 2 unexposed towns where no SPANA clinics were available. Focus group discussions explored four main research questions: (1) Is EZL recognised by animal owners, and is this considered an important disease in equids? (2) What factors do animal owners associate with the development of disease? (3) What happens to an animal with clinical disease and how does this impact upon the owner/community? (4) Are measures taken to reduce disease occurrence? These key areas were explored using photographs, disease ranking, matrices and open discussion. Data were analysed using descriptive statistics and thematic analysis. The results are presented thematically and include: recognition and descriptions of EZL, treatment strategies used, disease priorities and ranking, impact of disease, disease transmission and attitudes and approaches to disease prevention. EZL was widely recognised and ranked highly as an important disease of equids. However, there was uncertainty around identifying early cases of EZL, and this could impact upon the timing of initiating treatment and separating potentially infectious animals. People had varying knowledge of effective methods for disease prevention and reported particular difficulties with isolating infected animals. The impact of EZL was multi-dimensional and encompassed effects upon the horse, the individual owner and the wider society. Working equids provide a vital utility and source of income to many people in resource-poor settings. Often, infection with EZL resulted in a reduction in working ability which had a direct impact upon the livelihoods of owners and their dependent family members. EZL also impacted upon the welfare of the horse as sick animals continued to be worked and, in advanced cases, horses were abandoned due to ineffective or unavailable treatment. This study conceptualises the importance of EZL due to the effects of the disease on the horse and its impact upon human livelihoods. Epizootic lymphangitis is a neglected disease that requires further investigation in order to develop practical and sustainable disease control strategies within endemic regions.

A community-based participatory study investigating the epidemiology and effects of rabies to livestock owners in rural Ethiopia.

A participatory study was carried out in the Oromia region of Ethiopia to ascertain the principal epidemiological features of rabies and its impact on livestock owners. Due to the variation in topography (and therefore livestock and human populations within the study area) villages from both high (>1500 m) and lowland areas were included. Local development agents who had no knowledge of the study's purpose recruited a total of one hundred and ninety six participants from eleven lowland and ten highland villages. A facilitator trained in animal health and participatory techniques conducted the interviews with groups of up to eleven participants. Methods used included ranking, scoring, proportion piling, seasonality calendars and open discussions to investigate a set of questions pre determined from a pilot study. The relative importance of rabies to other zoonoses, temporal distributions of the disease, the species affected, current methods of control within affected species and consequences of their loss were all explored. Data was compared between high and lowland areas and previously published studies. The study found that rabies was considered the zoonosis of greatest risk to public health in both areas. It reportedly occurred with higher frequency in highland areas and subsequently affected more livestock in these parts. Two distinct temporal patterns within the areas were described and participants provided reasons of biological plausibility for the occurrence. Livestock were found to contribute as a higher proportion of all species affected than previously shown in published material. This is likely to be due to the low level of reporting of affected animals to the available veterinary services, from where comparative data originated. The death of infected livestock species was found to have numerous social and economic implications and the ramifications of this are made greater by the perception that the highest incidence of clinical disease being in areas of greatest livestock density. The underestimation of the burden of disease by central bodies is likely to influence the economic rationale behind effective rabies control in the future.

Evaluation of basal plasma α-melanocyte-stimulating hormone and adrenocorticotrophic hormone concentrations for the diagnosis of pituitary pars intermedia dysfunction from a population of aged horses.

REASONS FOR PERFORMING STUDY: The sensitivity and specificity of basal plasma α-melanocyte-stimulating hormone (α-MSH) and adrenocorticotrophic hormone (ACTH) for the diagnosis of pituitary pars intermedia dysfunction (PPID) has not been evaluated in a population-based study. OBJECTIVES: To evaluate basal plasma α-MSH and ACTH concentrations for the diagnosis of PPID in a population of horses aged ≥ 15 years. METHODS: Owner-reported data were obtained using a postal questionnaire distributed to an equestrian group. A subgroup of surveyed owners was visited and veterinary examination performed on horses aged ≥ 15 years. Blood samples were analysed for plasma α-MSH and ACTH concentrations. Seasonally adjusted cut-off values for α-MSH and ACTH concentrations for the diagnosis of PPID were obtained using Youden index values against a clinical gold standard diagnosis (hirsutism plus 3 or more clinical signs of PPID). RESULTS: α-melanocyte-stimulating hormone and ACTH were highly correlated with each other and with clinical and historical indicators of PPID. The increase in both α-MSH and ACTH with increasing numbers of clinical signs in affected horses supports a spectrum of disease. Both variables were affected by season, with derived cut-off values being higher in autumn compared with other seasons. Sensitivity and specificity were moderate and good in nonautumn seasons (59 and 93%, respectively) for α-MSH using a cut-off of 52.0 pmol/l. Sensitivity and specificity were good in nonautumn seasons (80 and 83%, respectively) for ACTH using a cut-off of 29.7 pg/ml. For both α-MSH and ACTH, sensitivity and specificity were close to 100% for samples obtained during the autumn period. CONCLUSIONS AND POTENTIAL RELEVANCE: Basal plasma α-MSH and ACTH had moderate-to-good sensitivity and specificity for the diagnosis of PPID, which improved substantially during the autumn period, suggesting this may be the ideal time to test. Further studies to develop seasonally adjusted reference intervals for different geographical locations are warranted.

Prevalence, risk factors and clinical signs predictive for equine pituitary pars intermedia dysfunction in aged horses.

REASONS FOR PERFORMING STUDY: Equine pituitary pars intermedia dysfunction (PPID) is an ageing-related neurodegenerative disorder. The prevalence and risk factors for PPID using seasonally adjusted basal adrenocorticotropic hormone (ACTH) concentrations in aged horses have not been previously reported. OBJECTIVES: To determine the prevalence, risk factors and clinical signs predictive for PPID in a population of horses aged ≥ 15 years in Queensland, Australia. METHODS: Owner-reported data was obtained using a postal questionnaire distributed to an equestrian group. A subgroup of surveyed owners were visited and a veterinary physical examination performed on all horses aged ≥ 15 years. Blood samples were analysed for basal plasma alpha melanocyte-stimulating hormone (α-MSH) and ACTH concentrations, routine haematology and selected biochemistry. Aged horses with elevations above seasonally adjusted cut-off values for basal plasma ACTH were considered positive for PPID. Positive horses were compared with their aged counterparts to determine risk factors and clinical signs associated with PPID. RESULTS: Pituitary pars intermedia dysfunction was prevalent in aged horses (21.2%) despite owners infrequently reporting it as a known or diagnosed disease or disorder. Numerous clinical or historical signs were associated with an increased risk of PPID in the univariable model, but only age (odds ratio (OR) 1.18; 95% confidence interval (CI) 1.11-1.25, P<0.001) and owner-reported history of hirsutism (OR 7.80; 95% CI 3.67-16.57, P<0.001) remained in the final multivariable model. There were no routine haematological or biochemical variables supportive of a diagnosis of PPID. CONCLUSIONS AND POTENTIAL RELEVANCE: Pituitary pars intermedia dysfunction occurs commonly in aged horses despite under-recognition by owners. The increased risk of PPID with age supports that this is an ageing associated condition. Aged horses with clinical or historical signs consistent with PPID, especially owner-reported hirsutism (delayed shedding and/or long hair coat), should be tested and appropriate treatment instituted.