Can improving animal health and biosecurity knowledge of para-veterinarians in Cambodia assist in addressing challenges in smallholder livestock farming?

Para-veterinarians are crucial in providing front-line veterinary care and advice to smallholder farmers in countries with under-resourced national veterinary services. Many of these individuals undergo basic training with minimal monitoring and evaluation of performance and knowledge levels. To identify the knowledge, attitudes and practices of Cambodian para-veterinarians a cross-sectional survey (n = 80) of Village Animal Health Workers (VAHWs) was conducted during August 2018 in the provinces of Tbong Khmum and Takeo in southern Cambodia. Descriptive statistics indicated that VAHWs had a high level (mean score 86%) of animal health and biosecurity knowledge. As the Royal Government of Cambodia continues to move towards commercial agricultural value chains, VAHWs are crucial to ensuring the safety and sustainability of these systems. Binomial logistic regression modelling found the length of employment (p = .003), reporting of pig diseases (p = .007), recommending the quarantine of newly purchased animals (p = .008), treatment of cases of haemorrhagic septicaemia with antibiotics (p = .032) and washing footwear with water when entering or leaving a farm (p = .008) were all positively associated with a higher (≥92%) animal health and biosecurity knowledge score. These results demonstrate the correlation of positive biosecurity and disease reporting behaviours with high levels of knowledge, providing evidence that improved training of VAHWs can ensure they remain important in supporting the under-resourced national veterinary services. Regular monitoring and evaluation of training programmes for VAHWs will likely further strengthen the livestock sector in Cambodia.

Foot-and-mouth disease seroprevalence and reporting behaviours in nine northern provinces in Lao PDR: The current situation and challenges for control.

Foot-and-mouth disease (FMD), caused by the FMD virus (FMDV), is one of the most important of global livestock diseases, impacting even-toed ungulates and distributed mostly in less developed countries that are home to 75% of the human population. A progressive control pathway for FMD (PCP-FMD) was developed to assist countries to better manage FMD risks and progress towards control and eradication. This requires evidence of current FMD seroprevalence to enable the informed risk assessment and the disease control planning required to progress along the initial stages of the PCP-FMD. Despite Laos being an active member of the South East Asia and China FMD campaign, these data have been challenging to obtain. To address this gap, a cross-sectional seroprevalence study in nine northern Lao provinces was conducted in early 2019. The study sampled 602 large ruminants and 19 goats from 30 villages. Overall, the large ruminant seroprevalence was 43.7% (95% CI 39.7-47.8), and 90% of sampled villages had at least one seropositive animal. Large ruminants suspected of having had clinical FMD in their lifetime were found to have an increased risk of being seropositive (odds ratio 1.96, 95% CI 1.06-3.65, p = .03). An examination of current reporting behaviours of farmers, village veterinary workers and district and provincial officials found that individuals were using their discretion as to whether disease events required reporting along the chain of command. This, plus the lack of a computerized reporting system, contributed to a loss of historical data, potentially compromising progression on the PCP-FMD. Laos requires ongoing support from donor agencies to improve the current animal disease surveillance system and implement effective FMD control strategies that can enable progress on the PCP-FMD.

Changes in farmer animal health and biosecurity knowledge, attitudes and practices: Insights from Cambodia and Laos.

Livestock agriculture in Cambodia and Laos is severely affected by endemic and exotic transboundary animal diseases, impacting household livelihoods and food and nutritional security. Collaborative animal health and biosecurity projects were conducted in each country between 2015 and 2019 aimed at increasing smallholder livestock production through mainly knowledge-based interventions in large ruminant disease prevention, nutrition, reproduction and marketing access. This study's objectives were to identify baseline animal health and biosecurity knowledge, attitudes and practices (KAP) of farmers, and temporal changes in key attitudes and practices associated with improved knowledge. Data for each country were analysed separately, and a formal between-country comparison was avoided due to major implementation and management differences. Binomial logistic regression without random terms compared the overall knowledge scores between 2015 and 2018 in each country, and binomial logistic regression with random terms was used to investigate possible associations between animal health and biosecurity knowledge scores and attitudes and practices. In Cambodia, the average animal health and biosecurity knowledge score increased from 4.8 (±2.2)/17 in 2015 to 13.0 (±2.8)/17 in 2018 (p < .0001). In Laos, the average scores improved from 7.2 (±2.5)/12 in 2015 to 7.9 (±2.9)/12 in 2018 (p = .0003). Clinical signs of foot-and-mouth disease were accurately reported by 100% of Cambodian and 88% of Lao project farmers, and overall, attitudes and practices improved in both countries over the study period. The belief that vaccination can improve livestock value was associated with increasing knowledge in both countries (Cambodia: OR 1.45, 95% CI 1.24-1.68, p < .0001; Laos: OR 1.43, 95% CI 1.16-1.75, p = .0006) as was the use of the services of village para-veterinarians if they had better training (Cambodia: OR 1.76, 95% CI 1.20-2.58, p = .004; Laos: OR 2.02, 95% CI 1.19-3.41, p = .009). However, the source of livestock information (District veterinary officials) was the only practice associated with knowledge in both Cambodia and Laos. The influence of resource scarcity on farmer decision making and knowledge measures was considered of particular relevance to the findings.

Managing Welfare and Antimicrobial-Resistance Issues in Treating Foot-and-Mouth Disease Lesions: A New Therapeutic Approach.

INTRODUCTION: Foot-and-mouth disease (FMD) causes negative impacts on global food security, the livestock trade, national economies, and farming-family livelihoods, particularly in resource-poor developing countries with inadequate biosecurity and low levels of vaccination from inadequate veterinary services. As smallholder farmers have limited understanding of disease-risk management, their focus in FMD outbreaks is on accessing clinically effective therapies. However, most are provided inappropriate traditional treatments and/or topical or parenteral antibiotics, often delivered by paraveterinarians inadequately trained in antimicrobial custodianship. This results in negative financial impacts on livelihoods plus risks of food safety and development of antimicrobial resistance. We report the use of a novel pain-relief therapy for FMD. METHODS: Clinical examinations in an outbreak of suspected FMD in April 2019 in Muang Khay village in Luang Prabang province, Laos confirmed signs and lesions of severe, subacute, ulcerative glossitis and interdigital dermatitis, typical of FMD. All affected buffalo (n=99) and cattle (n=37) presented for treatment in a population of 238 large ruminants, from 15 of 136 households, were administered a topical anesthetic pain-relief product (PRP) wound gel by spray-on (10-30 mL per animal) formulation developed for aversive husbandry procedures (Tri-Solfen, Animal Ethics, Australia). RESULTS: Treatment with PRP resulted in immediate improvement in demeanor and locomotion, and no adverse events were observed. On follow-up interview, all owners confirmed that their animals were eating within 2 days and lesions had healed within 5 days. Having experienced the positive clinical impacts of PRP on affected animals, these and surrounding farmers were keen to purchase the PRP for future use. The veterinary authorities rapidly registered the PRP for FMD therapy in Laos due to the observed efficacy. DISCUSSION: These findings suggest a potential paradigm shift from treating FMD with expensive antimicrobials, which risks antimicrobial resistance, to a new, less expensive therapeutic approach that reduces animal suffering and may motivate farmers to report disease to access treatment. Use of the PRP is suggested as an innovation that may improve future FMD management, particularly in developing countries.

Serological Evidence of Foot-and-Mouth Disease Infection in Goats in Lao PDR.

Foot and Mouth Disease (FMD) causes significant economic loss in Lao PDR (Laos) and perpetuates the cycle of smallholder poverty mainly through large ruminant productivity losses, increased costs of production and potential limitations to market access for trade in livestock and their products. Goats are emerging as an important livestock species in Laos, and there is an increasing trend in the number of households with goats, often farmed alongside cattle and buffalo. Although an FMD susceptible species, very little is known about the role of goats in the epidemiology of the disease in Laos. A cross-sectional seroprevalence study was conducted by detecting antibodies to the non-structural proteins (NSP), an indication of a previous infection, and serotype-specific structural proteins (SP) that could be due to vaccination or infection. The study commenced in late 2017 and sera were collected from 591 goats in 26 villages of northern, central and southern Laos. For a subset of sera samples, paired oral swab samples were also collected by a simple random sampling method to detect the prevalence of FMD virus infection at the time of collection. The NSP seroprevalence in the provinces of Borkeo and Xayabouli in the north was 42 and 8%, respectively and in Khammoune in the center, it was 20%. In the other five provinces, Luang Namtha and Luang Prabang (northern Laos), Xieng Khouang and Savannaket (central Laos), and Champasak (southern Laos), the seroprevalence was close to zero. The multivariable analysis indicated that age (p < 0.001) was positively associated with animal-level seropositivity and males were less likely to be seropositive than females (OR: 0.29; 95%CI: 0.10-0.83; p = 0.017). Continued sero-surveillance for FMD in goats is recommended to improve our understanding of their role in the epidemiology of FMD in the region and to extend support to FMD control decisions, particularly regarding vaccination.

Improving Village Animal Health Worker participation in national disease surveillance systems: A case study from Cambodia.

Para-veterinary systems have arisen in numerous developing countries to address the low capacity of national veterinary services in meeting livestock health demands of mainly smallholder farmers. In Cambodia, the village animal health worker (VAHW) system was established in the early 1990s, involving short training programmes to equip VAHWs to provide basic animal health services for smallholder farmers, particularly the vaccination of cattle for haemorrhagic septicaemia (HS). However, there are increasing expectations that VAHWs provide village level disease surveillance information to the national veterinary services, despite their low-level disease diagnostic skills. To identify opportunities to improve the disease reporting system in Cambodia, a closed-ended cross-sectional study of VAHWs (n = 80) from two provinces was conducted in 2015, examining their contact frequency with district and provincial animal health authorities. Ordinal logistic regression was used to determine factors associated with increased frequency of VAHW contact with the district animal health authorities responsible for national disease reporting. Positive associations between income generated from VAHW activities (p = .01) and the frequency of visiting farmers (p < .0001), with more frequent contacts with district animal health authorities, were identified. High levels of inappropriate use of antibiotics, with almost 90% of VAHW reporting they use antibiotics to treat FMD-affected animals, were reported. Although further research to increase the rates of reporting at the smallholder farmer and VAHW levels is required, increased emphasis on complying with the World Organisation for Animal Health's competency guidelines for veterinary paraprofessionals may be required if they are expected to contribute to national animal disease surveillance systems.