RESUMO
BACKGROUND: Politzer's tuning fork test is a little-known special examination with a chequered history. OBJECTIVE: This paper gives Politzer's original description, and explains how he intended it to be used. METHODS: The historiographical research in this study is based on primary references. Secondary documentation is only cited when it is necessary to substantiate any historical argument. RESULTS AND CONCLUSION: After the apparent disappearance of Politzer's tuning fork test from the otological scene in the 1950s, its consequent resurrection was not what it seemed. This story underlines the need for a standardisation of otological nomenclature, particularly when eponyms are used.
Assuntos
Otolaringologia , Masculino , Humanos , História do Século XX , História do Século XIXRESUMO
BACKGROUND AND PURPOSE: Our aim was to evaluate whether serial administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children is associated with T1-weighted hyperintensity within the dentate nucleus, an imaging surrogate for gadolinium deposition. MATERIALS AND METHODS: We identified a retrospective cohort of 10 patients younger than 18 years of age who underwent between 4 and 8 gadoteridol-enhanced MR imaging examinations of the brain from 2016 to 2017. For comparison, we identified a retrospective cohort of 9 pediatric patients who each underwent 6 gadodiamide-enhanced MR imaging examinations. For each examination, both dentate nuclei were contoured on unenhanced images and the mean dentate-to-pons signal intensity ratio was calculated. Dentate-to-pons signal intensity ratios from the first and last scans were compared using paired t tests. RESULTS: In the gadoteridol group, there was no significant change in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 0.99, P = .59). In the gadodiamide group, there was a significant increase in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 1.10, P = .001). CONCLUSIONS: Repeat administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children was not associated with T1-weighted dentate hyperintensity, while the repeat administration of the linear gadolinium-based contrast agent gadodiamide was associated with T1-weighted dentate hyperintensity, presumably due to gadolinium deposition.
Assuntos
Núcleos Cerebelares/diagnóstico por imagem , Meios de Contraste/farmacocinética , Compostos Heterocíclicos/farmacocinética , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Compostos Organometálicos/farmacocinética , Adolescente , Criança , Meios de Contraste/efeitos adversos , Feminino , Gadolínio/efeitos adversos , Gadolínio/farmacocinética , Compostos Heterocíclicos/efeitos adversos , Humanos , Imageamento por Ressonância Magnética/efeitos adversos , Masculino , Neuroimagem/efeitos adversos , Compostos Organometálicos/efeitos adversos , Estudos RetrospectivosRESUMO
N. caninum, bovine viral diarrhoea virus, Brucella abortus and Leptospira interrogans serovar Hardjo are globally significant reproductive pathogens that cause abortion and reproductive loss in large ruminants. Prevalence information is lacking in Lao People's Democratic Republic (Laos) despite the poor reproductive performance of cattle and buffalo. Serological examination of frozen cattle (n=90) and buffalo (n=61) sera by commercially available enzyme-linked immunosorbent assays provided the first reported screening of some of these pathogens in Laos. Seroprevalence differed amongst these large ruminant species, with N. caninum, BVDV and L. interrogans serovar Hardjo antibodies found in 68.9% (95% CI±11.6), 4.9% (95% CI±5.4) and 3.3% (95% CI±4.5) of buffalo sera, respectively, and in 7.8% (95% CI±5.5), 10.0% (95% CI±6.2) and 22.2% (95% CI±8.6) of cattle sera, respectively. Buffalo sera had a significantly higher seroprevalence of N. caninum compared to cattle (p<0.001) and cattle sera had a significantly higher seroprevalence of L. interrogans serovar Hardjo compared to buffalo (p=0.003). Variability was also observed across provinces for N. caninum in buffalo (p=0.007) and for L. interrogans serovar Hardjo in cattle (p=0.071), suggesting provincial risk factors conducive to pathogen transmission. BVDV and N. caninum seropositivity were negatively associated in buffalo (p=0.018) and cattle (p=0.003). In buffalo, L. interrogans serovar Hardjo and BVDV seropositivity were associated (p=0.035, p=0.039). The identification of antibodies against three major abortifacient pathogens in Laos prompts further research to determine if infection is associated with low reproductive efficiency and the risk factors for infection. This is needed for the development of evidence based prevention strategies for improved large ruminant reproductive management among smallholders in Laos.
Assuntos
Anticorpos/sangue , Brucelose/microbiologia , Brucelose/parasitologia , Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/parasitologia , Leptospirose/microbiologia , Leptospirose/parasitologia , Animais , Brucelose/epidemiologia , Bovinos/microbiologia , Doenças dos Bovinos/epidemiologia , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Laos/epidemiologia , Leptospira interrogans/isolamento & purificação , Leptospirose/epidemiologia , Gravidez , Prevalência , Ruminantes/microbiologia , Estudos SoroepidemiológicosRESUMO
Forage technology has been successfully introduced into smallholder cattle systems in Cambodia as an alternative feed source to the traditional rice straw and native pastures, improving animal nutrition and reducing labour requirements of feeding cattle. Previous research has highlighted the positive impacts of forage technology including improved growth rates of cattle and household time savings. However, further research is required to understand the drivers, challenges and opportunities of forage technology for smallholder cattle households in Cambodia to facilitate widespread adoption and identify areas for further improvement. A survey of forage-growing households (n = 40) in July-September 2016 examined forage technology adoption experiences, including reasons for forage establishment, use of inputs and labour requirements of forage plot maintenance and use of forages (feeding, fattening, sale of grass or seedlings and silage). Time savings was reported as the main driver of forage adoption with household members spending approximately 1 h per day maintaining forages and feeding it to cattle. Water availability was reported as the main challenge to this activity. A small number of households also reported lack of labour, lack of fencing, competition from natural grasses, cost of irrigation and lack of experience as challenges to forage growing. Cattle fattening and sale of cut forage grass and seedlings was not found to be a widespread activity by interviewed households, with 25 and 10% of households reporting use of forages for these activities, respectively. Currently, opportunities exist for these households to better utilise forages through expansion of forage plots and cattle activities, although assistance is required to support these households in addressing current constraints, particularly availability of water, if the sustainability of this feed technology for smallholder cattle household is to be established in Cambodia.
Assuntos
Criação de Animais Domésticos/instrumentação , Criação de Animais Domésticos/métodos , Criação de Animais Domésticos/economia , Animais , Camboja , Bovinos , Características da FamíliaRESUMO
AIM: To determine whether repeated gadolinium-based contrast agent administration (GBCA) in children is associated with the development of increased T1-weighted signal intensity within the cerebellar dentate nucleus. MATERIALS AND METHODS: With institutional review board approval for this The Health Insurance Portability and Accountability Act-compliant retrospective study, a cohort of 41 patients under the age of 18 years who underwent at least four contrast-enhanced magnetic resonance imaging (MR) examinations of the brain from 2005 to 2015 were identified. For each examination, both dentate nuclei were manually contoured, and the mean dentate nucleus-to-pons signal intensity (DN-P SI) ratio was calculated. The DN-P SI ratios from the last to first MRI examination were compared, and the correlation between DN-P SI ratio and cumulative gadolinium dose was calculated using a linear mixed effect model to control for potentially confounding variables. RESULTS: For the 41 patients in the cohort, there was a significant increase in the mean DN-P SI ratio from the first MRI to the last MRI examination (1.05 versus 1.11, p=0.004). After controlling for patient diagnosis, history of chemotherapy or radiation, sex, and age, there was a significant positive association between DN-P SI ratio and cumulative gadolinium dose (coefficient=0.401, p=0.032). CONCLUSION: Repeated GBCA administration in children is associated with increased T1-weighted signal intensity within the dentate nucleus.
Assuntos
Encefalopatias/diagnóstico por imagem , Encefalopatias/metabolismo , Núcleos Cerebelares/diagnóstico por imagem , Núcleos Cerebelares/metabolismo , Meios de Contraste/administração & dosagem , Meios de Contraste/farmacocinética , Gadolínio/administração & dosagem , Gadolínio/farmacocinética , Adolescente , Criança , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Masculino , Estudos RetrospectivosRESUMO
Porcine reproductive and respiratory syndrome (PRRS) was first identified in Cambodia in 2010, causing serious problems on affected farms, although the costs of the disease have not been well defined. The household financial impact of a PRRS outbreak in Cambodia was investigated using partial budget analysis, examining the economic benefit of three proposed interventions: (i) quarterly PRRS vaccine use, (ii) biosecurity implementation, and (iii) implementation of vaccination and biosecurity. The analyses were applied to three farm models: (i) a two-sow breeder; (ii) a five-pig fattener; and (iii) a single-sow, three-pig farrow-to-finish/breeder. Data was derived from a knowledge, attitude, and practice survey of 240 smallholder farmers (61 with pigs) from 16 villages across 5 provinces, plus case studies of 12 farmers selected for more detailed financial analysis. The study indicated that financial losses associated with PRRS were severe, with a 25% mean loss to the annual household income of 61 interviewed farmers. Partial budget analysis identified a strongly positive incentive for vaccination and biosecurity to be implemented in combination, with the highest annual net benefit of USD 357.10 realised by the breeder system. However, due to current scarcity of the PRRS vaccine and its high cost to smallholders, biosecurity interventions may be more cost-effective, especially for low PRRS incidence regions. It was concluded that PRRS critically constrains the profitability of smallholder pig farms and that these findings will assist development of village-level livestock disease risk management programmes that encourage adoption of vaccination and biosecurity practices to enhance farmer livelihoods in Cambodia.
Assuntos
Criação de Animais Domésticos/economia , Surtos de Doenças/veterinária , Síndrome Respiratória e Reprodutiva Suína/economia , Vacinação/veterinária , Animais , Camboja , Surtos de Doenças/economia , Surtos de Doenças/prevenção & controle , Fazendeiros , Feminino , Gado , Síndrome Respiratória e Reprodutiva Suína/prevenção & controle , Inquéritos e Questionários , Sus scrofa , Suínos , Vacinação/economiaRESUMO
In Cambodia, the majority of the population is rural and reliant on subsistence agriculture, with cattle raised by smallholder farmers using traditional practices, resulting in low productivity and vulnerability to foot-and-mouth disease (FMD). As FMD causes deleterious impacts on rural livelihoods, known FMD risk factors were reviewed, using knowledge, attitudes and practice (KAP) surveys of smallholders (n = 240) from four regions. The study aimed to understand current biosecurity threats to smallholder livelihoods and investigate the hypothesis that smallholder farmers practising FMD risk management should be associated with higher incomes from cattle. Descriptive data were examined to demonstrate trends in KAP and a multivariable linear regression model developed to identify cattle income predictors. Results showed that baseline mean knowledge scores were low at 28.4% across all regions and basic biosecurity practices, including quarantine of new cattle, isolation of sick cattle and FMD vaccination, were lacking. As farmers purchase and sell cattle from and to various administration levels (including export), there is high risk of FMD transmission into and from smallholder communities. The final multivariable linear regression model identified significant explanatory parameters for annual cattle income, including region, number of calves born, forage plot size (ha), vaccination of cattle and the number of cattle purchased (F pr. < 0.001, R2 = 29.9). Individual biosecurity practices including FMD vaccination were not significant predictors of income. With the current focus of farmers on treatment of FMD with inappropriate antibiotics leading to potential anti-microbial residue issues, yet receptivity to payment for vaccine in most regions, there is an urgent need for a coordinated national biosecurity and FMD management public awareness campaign. Further, to enhance the association between improved cattle health and rural livelihoods, it is recommended that livestock development programmes implement a systems approach to enhance farmer KAP in biosecurity, nutrition, reproduction and marketing of cattle.
Assuntos
Doenças dos Bovinos/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Fazendeiros/psicologia , Febre Aftosa/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/métodos , Animais , Camboja , Bovinos , Doenças dos Bovinos/virologia , Febre Aftosa/virologiaRESUMO
A cross-sectional survey of 445 Village Animal Health Workers (VAHWs) from 19 provinces in Cambodia was undertaken. The aim was to establish their levels of training, farm visit frequency, reasons for visits and disease reporting practices, enabling the strengths and weaknesses of the VAHW system in Cambodia to be determined, in providing both a fee-based smallholder livestock clinical service and a government partnership in transboundary animal disease (TAD) surveillance and control. The study used 'guided group interviews' and identified that VAHWs had good contact with farmers with 61.5% making more than one farm visit daily. However, incomes from services remained low, with 45% VAHWs obtaining between 20 and 40% of their household income from VAHW activities. VAHWs recorded relatively high rates of disease reporting, with 72% claiming they report diseases immediately and 74% undertaking monthly reporting to veterinary authorities. Logistic regression analysis revealed VAHW contact frequency with district and/or provincial officers was associated with more VAHW farm visits, and frequency of VAHW visits to smallholder farms was positively associated with average monthly expenditure on animal medication and equipment. This suggests that increased veterinary extension to VAHWs and access to veterinary equipment, vaccines and drugs may further increase VAHW-farmer engagement. VAHWs provide an accessible, market-based, animal health 'treatment and reporting' service linked to livestock smallholders across Cambodia. However, for improved TAD prevention and more efficient control of outbreaks, research that assesses provision of an animal health 'preventive-based' business model is urgently needed to reduce both the costs to farmers and the risks to the economy due to foot-and-mouth disease and other TADs in Cambodia.
Assuntos
Doenças dos Bovinos/prevenção & controle , Surtos de Doenças/prevenção & controle , Fazendeiros , Pessoal de Saúde , Criação de Animais Domésticos , Animais , Camboja , Bovinos , Doenças dos Bovinos/transmissão , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
Improved large ruminant productivity is increasingly acknowledged as a pathway for the alleviation of rural poverty and food insecurity in smallholder communities in Southeast Asia; yet, in much of Laos, bovine reproductive management is practically absent. Large ruminant reproduction skills were studied, using face-to-face surveys (n=60) of the knowledge, attitudes, and practices (KAP) of farmers, plus an extension of an examination of parameters of reproductive efficiency (n = 1786 cattle and 434 buffalo) in the northern provinces of Luang Prabang and Xieng Khouang. The surveys particularly involved female farmers to provide gender-disaggregated data, with females making up 38.3 % of participants. Results confirmed that KAPs of smallholder farmers on bovine reproductive management were low (34-46 %) with trends toward higher KAP scores in male survey respondents. Poor reproductive parameters were identified in both provinces, with low calving percentages of 54-75 and 45-54 % in cattle and buffalo groups, respectively, and prolonged inter-calving intervals of 14.1-19.8 and 26.0 months for the cattle and buffalo groups, respectively. Improving the reproductive efficiency of large ruminants in the northern upland regions would enable smallholder farmers to be more effectively engaged in the dramatic economic growth of the Southeast Asia region, although these findings indicate that intensive training and supportive interventions are required to improve large ruminant reproductive outcomes in communities that have low-level large ruminant husbandry skills.
Assuntos
Criação de Animais Domésticos/métodos , Doenças dos Bovinos/prevenção & controle , Carne Vermelha/provisão & distribuição , Agricultura , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Búfalos , Bovinos , Clima , Fazendeiros , Feminino , Abastecimento de Alimentos , Humanos , Laos , Masculino , Carne , Reprodução , População Rural , Estações do Ano , Inquéritos e Questionários , Fatores de TempoRESUMO
This study aimed to identify factors associated with cattle reproductive output in rural smallholder farms in Cambodia in order to determine the main causes of reproductive failure and design efficient interventions for improvement. The majority of the nation's beef is produced on smallholder farms where productivity is constrained by poor animal reproductivity reflected in the recent livestock population decline of approximately 13 % from 2009 to 2013. Farmers (n = 240) from 16 villages from five provinces were surveyed in mid-2015 to determine their baseline knowledge, attitude and practices (KAP) associated with cattle reproduction. In addition, 16 case studies from three of these provinces were conducted to provide a more detailed assessment of current cattle reproductive husbandry practices. In order to assess the reproductive impact of previously implemented interventions, an endpoint KAP survey and longitudinal health and husbandry study from three Cambodian provinces conducted between 2008 and 2013 were also analysed. Three multivariable prediction models (two KAP and one longitudinal) identified the following significant factors associated with the reproductive outcomes 'number of calves born' or probability that cows 'gave birth': target feeding (P = 0.074), growing vegetables (P = 0.005), attitudes towards cattle vaccination (P = 0.010), improving bull selection (P = 0.032), local breed use (P = 0.005), number of joining attempts (P < 0.001), discontinuation of animal draught practices (P = 0.003) and retention of breeding animals (P < 0.001). The identification of significant factors and interventions in this study has led to intervention recommendations that can potentially improve reproductive efficiency, combat the declining cattle population and improve smallholder capacity to supply to expanding regional meat demand in South-East Asia and China.
Assuntos
Criação de Animais Domésticos/métodos , Doenças dos Bovinos/epidemiologia , Indústria Alimentícia/métodos , Carne Vermelha , Reprodução , Animais , Cruzamento , Camboja/epidemiologia , Bovinos , Fazendeiros , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Análise Multivariada , População Rural , Inquéritos e Questionários , Vacinação/veterináriaRESUMO
To assist policies on Foot-and-Mouth Disease (FMD) control in Laos and the Mekong region, the financial impact of recent outbreaks at village and national levels was examined. Village-level impacts were derived from recent research on financial losses due to FMD per smallholder household and number of households with FMD-affected livestock in the village. National-level impacts of FMD were determined from examination of 2011-2013 FMD reported to the Lao Department of Livestock and Fisheries (DLF), with the 2011 epidemic reported separately due to the large number and size of outbreaks of FMD in that year. Estimates of the national financial impact of FMD were based on (i) total FMD financial losses at the village level and (ii) the costs of FMD responses and other related costs at the DLF, provincial and district levels where FMD was reported, but excluding the costs of revenue forgone. A Monte Carlo simulation was utilized to account for likelihood of FMD over- and under-reporting. Foot-and-mouth disease was recorded in four provinces of Phonsaly, Bokeo, Xayyabouli and Champasak in three consecutive years from 2011 to 2013. However, the FMD epidemic in 2011 was more widely distributed and involved 414 villages in 14 provinces, with thousands of cases of morbidity in cattle and buffalo and some mortalities. The estimated financial losses due to FMD in 2011 were USD 30 881(±23 176) at the village level and USD 13 512 291 at the national level based on the number of villages with FMD outbreaks reported. However, when the likelihood of FMD under-reporting was accounted for, the estimated financial losses at the national level could potentially increase to USD 102 094 464 (±52 147 261), being almost 12% of the estimated farm gate value of the national large ruminant herd. These findings confirm that FMD causes substantial financial impacts in villages and to the national economy of Laos, providing justification for sustained investments in FMD control programmes.
Assuntos
Febre Aftosa/economia , Animais , Búfalos , Bovinos , Países em Desenvolvimento , Surtos de Doenças/economia , Fazendas , Laos , Método de Monte CarloRESUMO
Foot and mouth disease (FMD) is endemic in Cambodia and throughout the Greater Mekong Subregion and causes significant losses to rural smallholders owning the majority of the national large ruminant population. However, due to underreporting, paucity of knowledge of FMD impacts, limited veterinary capacity and deficits of data available for analysis, the quantifiable benefits of a national FMD control programme are unknown. To address this deficit, existing literature and research data from the 'Best practice health and husbandry of cattle, Cambodia' project conducted between 2007 and 2012, were used to develop a three-phase analysis framework to: assess the impacts of the recent widespread FMD epizootic in Cambodia in 2010, conduct a value chain analysis of the large ruminant market and estimate the costs and benefits for a national large ruminant biannual FMD vaccination programme. A trader survey conducted in 2010-2011 provided cattle and buffalo value chain information and was matched to village herd structure data to calculate a total large ruminant farm-gate value of USD 1.271 billion in 2010. Monte Carlo simulation modelling that implemented a 5-year biannual vaccination programme at a cost of USD 6.3 an animal per year identified a benefit-cost ratio of 1.40 (95% CI 0.96-2.20) when accounting for recent prices of cattle and buffalo in Cambodia and based on an expected annual incidence of 0.2 (assuming one major epizootic in the 5-year vaccination programme). Given that the majority of the large ruminants are owned by rural smallholders, and mostly the poor are involved in agricultural employment, the successful implementation of an FMD control programme in Cambodia would be expected to avoid estimated losses of USD 135 million; equivalent to 10.6% of the 2010 farm-gate value and contributing to important reductions in rural poverty and food insecurity.
Assuntos
Febre Aftosa/prevenção & controle , Vacinação/economia , Vacinas Virais , Animais , Búfalos , Camboja , Bovinos , Doenças dos Bovinos/economia , Doenças dos Bovinos/prevenção & controle , Análise Custo-Benefício , Febre Aftosa/economia , Método de Monte CarloRESUMO
Transboundary animal diseases including foot-and-mouth disease and haemorrhagic septicaemia remain a major constraint for improving smallholder large ruminant productivity in the Mekong region, producing negative impacts on rural livelihoods and compromising efforts to reduce poverty and food insecurity. The traditional husbandry practices of smallholders largely exclude preventive health measures, increasing risks of disease transmission. Although significant efforts have been made to understand the social aspects of change development in agricultural production, attention to improving the adoption of biosecurity has been limited. This study reviews smallholder biosecurity risk factors identified in the peer-reviewed literature and from field research observations conducted in Cambodia and Laos during 2006-2013, considering these in the context of a change management perspective aimed at improving adoption of biosecurity measures. Motivation for change, resistance to change, knowledge management, cultural dimensions, systems theory and leadership are discussed. Due to geographical, physical and resource variability, the implementation of biosecurity interventions suitable for smallholders is not a 'one size fits all'. Smallholders should be educated in biosecurity principles and empowered to make personal decisions rather than adopt prescribed pre-defined interventions. Biosecurity interventions should be aligned with smallholder farmer motivations, preferably offering clear short-term risk management benefits that elicit interest from smallholders. Linking biosecurity and disease control with improved livestock productivity provides opportunities for sustainable improvements in livelihoods. Participatory research and extension that improves farmer knowledge and practices offers a pathway to elicit sustainable broad-scale social change. However, examples of successes need to be communicated both at the 'evidence-based level' to influence regional policy development and at the village or commune level, with 'champion farmers' and 'cross-visits' used to lead local change. The adoption of applied change management principles to improving regional biosecurity may assist current efforts to control and eradicate transboundary diseases in the Mekong region.
Assuntos
Criação de Animais Domésticos , Doenças dos Bovinos/prevenção & controle , Fazendeiros , Abastecimento de Alimentos , Animais , Camboja/epidemiologia , Bovinos , Febre Aftosa/prevenção & controle , Septicemia Hemorrágica/prevenção & controle , Septicemia Hemorrágica/veterinária , Laos/epidemiologia , Inquéritos e QuestionáriosRESUMO
Haemorrhagic septicaemia (HS) is an acute fatal infectious disease of mainly cattle and buffalo and outbreaks occur commonly in Cambodia. Disease outbreak reports were examined to select five villages from three provinces for a retrospective investigation of HS epidemiology and socioeconomic impact on smallholders, with an aim of identifying potential benefits from improving disease prevention through biosecurity and vaccination. The Village Animal Health Worker (VAHW) or Chief in each village and 66 affected smallholders were surveyed. At the village level, 24% of all households were affected with an estimated mean village herd morbidity of 10.1% and mortality of 28.8%. Affected farmers reported HS disease morbidity and mortality at 42.7% and 63.6% respectively. Buffalo had a higher morbidity (OR = 2.3; P = 0.003) and mortality (OR = 6.9; P < 0.001) compared with cattle, and unvaccinated large ruminants a higher morbidity (OR = 2.9; P = 0.001). The financial impact varied depending on whether the animal survived, provision of treatment, draught replacement and lost secondary income. The mean cost per affected household was USD 952.50 based on ownership of five large ruminants. The impact per affected animal was USD 375.00, reducing the pre-disease value by 66.1%. A partial budget revealed an overwhelming incentive for farmers to practice biannual vaccination, with a net benefit of USD 951.58 per household based on an annual disease incidence rate of 1. Sensitivity analysis showed that a net benefit of USD 32.42 remained based on an outbreak every 20 years. This study indicates HS can cause a catastrophic financial shock to smallholders and remains a critical constraint to improving large ruminant productivity and profitability. Addressing HS disease control requires a focus on improving smallholder farmer knowledge of biosecurity and vaccination and should be priority to stakeholders interested in addressing regional food insecurity and poverty reduction.
Assuntos
Criação de Animais Domésticos , Doenças dos Bovinos/epidemiologia , Surtos de Doenças/veterinária , Fazendeiros , Septicemia Hemorrágica/veterinária , Animais , Búfalos , Camboja/epidemiologia , Bovinos , Doenças dos Bovinos/economia , Doenças dos Bovinos/prevenção & controle , Demografia , Surtos de Doenças/economia , Feminino , Septicemia Hemorrágica/economia , Septicemia Hemorrágica/epidemiologia , Septicemia Hemorrágica/prevenção & controle , Humanos , Masculino , Estudos Retrospectivos , Ruminantes , Inquéritos e Questionários , Vacinação/veterináriaRESUMO
A retrospective investigation of financial losses incurred by large ruminant smallholder farmers due to outbreaks of foot and mouth disease (FMD) in 2010-12 in northern Laos was conducted in 2012. The aim was to support recommendations on sustainable transboundary animal disease control strategies in the Greater Mekong Subregion (GMS). Large ruminant smallholders in the three northern provinces of Luang Prabang (LPB), Xiengkhoung (XK) and Xayyabouli (XYL) were interviewed (n = 310). Financial losses were determined, including direct losses due to mortality (100% of pre-FMD sale value) and morbidity (difference between the expected sale price pre-FMD and 1 month following onset of FMD), and indirect losses due to costs of treatments. The losses due to FMD per household varied between provinces (P < 0.001) and were USD 1124, USD 862 and USD 381 in LPB, XK and XYL, respectively, being 60, 40 and 16% of annual household income. Comparison of the costs of FMD with annual household income from sales of large ruminants indicated losses of 213, 181 and 60% of the income in LPB, XK and XYL, respectively. The variation in losses between provinces was due to differences in levels of morbidity with highest in LPB, treatment methods with antibiotic use common in LPB, age of animals sold and sale prices with higher prices in XK. Partial budget analysis of biannual FMD vaccination indicated an average net benefit of USD 22 and USD 33 for cattle and buffalo, respectively. However, vaccination alone is unlikely to control FMD in the region. Promotion of multiple large ruminant health and production intervention programmes to stimulate interest in biosecurity in addition to vaccination is recommended, providing a more sustainable pathway for poverty reduction through the current expansion of livestock investments in the GMS.
Assuntos
Criação de Animais Domésticos/economia , Surtos de Doenças/veterinária , Fazendeiros , Febre Aftosa/epidemiologia , Animais , Búfalos , Bovinos , Surtos de Doenças/prevenção & controle , Febre Aftosa/economia , Febre Aftosa/prevenção & controle , Humanos , Laos/epidemiologia , Estudos Retrospectivos , Inquéritos e Questionários , Vacinação/veterináriaRESUMO
To better understand how smallholder farmers whom own the majority of Cambodian cattle can contribute to efforts to address food security needs in the Mekong region, a five-year research project investigating methods to improve cattle health and husbandry practices was conducted. Cattle production in Cambodia is constrained by transboundary animal diseases (TADs) including foot-and-mouth disease (FMD) and haemorrhagic septicaemia (HS) plus poor nutrition, reproduction and marketing knowledge. The project worked in six villages in Kandal, Takeo and Kampong Cham province during 2007-12. Farmers from three 'high intervention' (HI) villages incrementally received a participatory extension programme that included FMD and HS vaccination, forage development and husbandry training. Evaluation of project impacts on livelihoods was facilitated by comparison with three 'low intervention' (LI) villages where farmers received vaccinations only. Results of knowledge, attitude and practice (KAP) and socio-economic surveys conducted in 2012 of 120 participating farmers identified that farmer knowledge in the HI project sites exceeded LI sites on the topics of biosecurity, internal parasites, nutrition and reproduction. HI farmers adopted biosecurity practices including a willingness to vaccinate for FMD and HS at their own cost, separate sick from healthy cattle, grow and feed forages and displayed awareness of the benefits of building fattening pens. HI farmers that grew forages observed time savings exceeding two hours per day each for men, women and children, enabling expansion of farm enterprises, secondary employment and children's schooling. Logistic regression analysis revealed that farmers in the HI group significantly increased annual household income (P < 0.001), with 53% reporting an increase of 100% or more. We conclude that improving smallholder KAP of cattle health and production can lead to improved livelihoods. This strategy should be of interest to policymakers, donors, researchers and extension workers interested in addressing TAD control, food insecurity and rural poverty in Southeast Asia.
Assuntos
Criação de Animais Domésticos/economia , Criação de Animais Domésticos/métodos , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Doenças dos Bovinos/prevenção & controle , Febre Aftosa/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Septicemia Hemorrágica/veterinária , Agricultura , Criação de Animais Domésticos/educação , Animais , Camboja , Bovinos , Feminino , Septicemia Hemorrágica/prevenção & controle , Modelos Logísticos , Masculino , Inquéritos e Questionários , Vacinação/veterináriaRESUMO
The financial impact of an outbreak of FMD in 2010 on 62 smallholder cattle farmers in four villages in southern Cambodia was investigated by a financial impact survey questionnaire. Financial losses associated with FMD infection were severe with variation depending on whether the animal survived or died or was used for draft. The average post-FMD loss varied from USD 216.32, a 54% reduction from the pre-FMD value because of weight loss and treatment costs, to USD 370.54, a 92% reduction from pre-FMD values if the animal was treated, died and a rental draft replacement was required. Partial budget analysis identified a strongly positive incentive for cattle to be vaccinated biannually for FMD, providing USD 31.48 per animal for each animal owned. However low vaccination rates suggest that farmers are mostly unaware of the need or averse to the practice of vaccinating their cattle for FMD. This may be due to poor understanding of preventative disease strategies such as vaccination, unavailable disposable income for purchase of vaccines, and failure to recognize the full costs that are incurred when the disease occurs. Enhancing smallholder cattle productivity through the introduction of forage growing systems has been suggested as a pathway for alleviating rural poverty in the Mekong region. As our financial analysis identified a net benefit of vaccination for smallholder farmer enterprises in an endemic FMD area in Cambodia, it is considered important that farmer education strategies aimed at improving cattle productivity, also include both access to vaccine and training in preventative disease risk management and biosecurity practices in Cambodia.
Assuntos
Criação de Animais Domésticos/economia , Doenças dos Bovinos/economia , Surtos de Doenças/veterinária , Febre Aftosa/economia , Vacinação/veterinária , Vacinas Virais/economia , Adulto , Agricultura , Animais , Camboja/epidemiologia , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/prevenção & controle , Surtos de Doenças/economia , Surtos de Doenças/prevenção & controle , Feminino , Febre Aftosa/epidemiologia , Febre Aftosa/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Vacinas Virais/uso terapêuticoRESUMO
BACKGROUND AND PURPOSE: Currently it is difficult to predict tumor response to anti-angiogenic therapy in individual patients. Our aim was to determine if ADC histogram analysis can stratify progression-free and overall survival in patients with newly diagnosed GBM treated "up-front" (ie, before tumor recurrence) with bevacizumab. MATERIALS AND METHODS: Up-front bevacizumab-treated and control patients (n = 59 and 62, respectively) with newly diagnosed GBM were analyzed by using an ADC histogram approach based on enhancing tumor. Progression-free and overall survival was determined by using Cox proportional HRs and the Kaplan-Meier method with logrank and Wilcoxon tests. RESULTS: For up-front bevacizumab-treated patients, lower ADC(L) was associated with significantly longer progression-free survival (median, 459 days for ADC(L) < 1200 versus 315 days for ADC(L) ≥ 1200 10(-6)mm(2)/s; P = .008, logrank test) and trended with longer overall survival (581 versus 429 days, P = .055). ADC values did not stratify progression-free or overall survival for patients in the control group (P = .92 and P = .22, respectively). Tumors with MGMT promoter methylation had lower ADC(L) values than unmethylated tumors (mean, 1071 versus 1183 10(-6)mm(2)/s; P = .01, 2-group t test). CONCLUSIONS: Pretreatment ADC histogram analysis can stratify progression-free survival in bevacizumab-treated patients with newly diagnosed GBM. Lower ADC is associated with tumor MGMT promoter methylation, which may, in part, account for the favorable outcome associated with low ADC(L) tumors.