Socio-Economic Determinants of Hepatitis B & C in Rural Poor of Pakistan
Organization for Social Development Initiative, Pakistan
Hepatitis B & C have been identified the most common diseases in Matyari, Khairpur and Shikarpur districts of Sind and Mardan KPK, Pakistan. Down the road more than 7000 individuals have been catered effectively in a number of screening and vaccination campaigns, supported by the disease specific awareness and periodic workshops by involving all stakeholders. Data collected over the period of last 4 years suggests moderate to high prevalence of hepatitis B & C in these districts that accounts for 4-6 % of all health complaints. Less income opportunities, out of pocket expenses (67% of total expenditure on health care) and illiteracy has dragged the importance of health care to the bottom line on their priority list. Unsafe blood transfusions soiled drinking water and poor sanitation has turned the situation worse. Social behaviors are complex in rural communities and being a male dominating society men are supposed to be the bread earner and almost all the decisions are made by them. Females are mostly involved in domestic works and not freely allowed to go out to the health facilities for their routine checkups and can’t take active participation in immunization campaigns. Mothers have less awareness regarding first line prevention of their children through common health and hygiene measures whereas general false believes and insecurities about the effects of different vaccines and medicines for secondary prevention made the situation vulnerable. Farming is the main source of livelihood in rural communities and demands more work. Due to old and traditional agricultural approaches farmers have to work from dawn to dusk to earn their livelihood that causes less interest of villagers in community development activities including health care prevention and practices and expose them to the vicious circle of health and poverty.
Use of Rapid Anthropology to Determine Taenia Solium Transmission Drivers and Control Options in a Remote Community in Northern Lao PDR
1School of Social and Political Science, The University of Edinburgh, 58 George Square, Edinburgh, United KingdomRepublic; 2National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang,Vientiane Capital, Lao Democratic People's Republic; 3CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
Taenia solium taeniasis-cysticercosis is a Neglected Tropical Disease of significant public health concerns. Humans are both the definitive and end host of the parasite, with consumption of undercooked pork, pour sanitation, and free ranging pig production are important risk factors for disease transmission. A recent parasitological study in northern Laos identified a hyperendemic Taenia solium tapeworm prevalence of 26% in a secluded minority community; the highest reported prevalence to date in south-east Asia. Interestingly, unlike the majority of communities examined in the project catchment area that did not exhibit T.solium hyperendemicity, this village was homogenous for a particular minority; it was therefore felt that a greater understanding of specific cultural practices could contribute valuable insights as to why the disease may exist at such elevated levels in this particular village. A rapid ethnographic approach consisting of a suite of social research methodologies was used to examine the community’s KAPs around various disease transmission dynamics, including sacrificial slaughter and consumption of pork, hygiene practices and pig production systems. Qualitative research around cultural practises revealed that although pork is normally consumed well cooked, in the event of sacrificial slaughter occurring around major animistic festivals and household events the pork was always consumed raw, and as such could explain the unusually high prevalence of T.solium in this homogenous community. This finding, coupled with important supporting information regarding cultural norms of food preparation, latrine use and disease knowledge, highlights the innate complexities of integrating disease control within certain cultural contexts, and the importance of understanding specific disease transmission dynamics for the development of longer term control recommendations. The use of rapid ethnography in this way showcases its relevance to NTD research as an important "first step" methodology for engaging and directing longer-term transdisciplinary approaches in an area traditionally dominated by the biomedical sciences.
“One Health Bangladesh” A Professional Initiative to Transform One Health Agenda to a One Health movement in Bangladesh
Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh, People's Republic of
The professional body ‘One Health Bangladesh’ is working to improve public health of the country.
Bangladesh the worst victim of climate change, having high population density, is struggling to combat emerging-reemerging infectious diseases, food safety and food security. The professionals in the field realized that country needs a multi-sectoral approach to address these diversified problems and formed ‘One Health Bangladesh’ in December 2007 involving wide range of professionals, researchers, academicians, young activists from different agencies, institutions, civil societies and networks. ‘One Health Bangladesh’ adopted multidisciplinary approach to combat disease at human animal interface, to ensuring food safety and food security.
The Institute of Epidemiology, Disease Control and Research (IEDCR) is working as secretariat of ‘One Health Bangladesh’, taking different initiatives like hosting regular meetings, creating awareness among professionals and stakeholders, arranging national conferences every year. These activities attracted development partners like FAO, WHO, UNICE and other stakeholders, who supported the initiatives so that a large group of people from different disciplines like public health specialists, veterinarians, wildlife specialists, environmentalists and social scientists are now working together under the umbrella of ‘One Health Bangladesh’.
The organization formulated ‘Strategic framework for One Health approach to infectious diseases in Bangladesh 2012’ endorsed by Ministry of Health & Family Welfare, Ministry of Fisheries & Livestock and Ministry of Environment & Forests. To develop One Health workforce, IEDCR introduced MPH (One Health and Biosecurity) in collaboration with Massey University New Zealand.
The 8th ‘One Health Bangladesh’ national conference in 2015, attracted huge participants, exceeding 400, life member 81, international expert in the field attended conference as paper presenter and panel discussants.
Full functional secretariat with designated staff and some budget to coordinate multi-sectoral approach of ‘One Health Bangladesh’ initiative is a crucial driving force to improve public health status of Bangladesh.
One Health Perspective and Assessment of Giardia and Cryptosporidium Infections Related to Wastewater and Excreta Use in Agriculture in Vietnam
1Hanoi School of Public Health, Vietnam; 2Swiss Tropical and Public Health Institute, Switzerland; 3University of Basel, Switzerland; 4International Livestock Research Institute
A quantitative microbial risk assessment of Giardia sp. and Cryptosporidium sp. infection was conducted using multi-trial Monte Carlo simulations to predict the risk of diarrhea related to the use of human and animal wastewater and excreta in an agricultural community in northern Vietnam. The Nhue River and irrigation systems received untreated wastewater from households and upstream urban settlements. A total of 173 wastewater and excreta samples were collected from 5 critical sampling points. The protozoan parasites Giardia and Cryptosporidium by immunofluorescent antibodies and microscopy. A survey with 235 households was conducted using a structured-questionnaire to assess people’s exposure to wastewater and excreta. The most hazardous exposures included direct contact with the Nhue River and pond water and composted excreta during field work. The highest arithmetic mean concentration of diarrhegenic Cryptosporidium (6 oocysts/100 ml) was in household sewage; whereas Giardia was highest in composted excreta (120 cysts/gram). Estimated annual infection risks in all the exposures were much higher than the commonly proposed thresholds of 10-4 (< 1 infection per 10,000 individuals); and the estimated annual diarrhea risks values were at least 10-fold greater than maximal risk of 10-3 set by the World Health Organization. The assessment indicated exceeded risks for Giardia and Cryptosporidium infections among people exposed to wastewater and excreta. Study results are useful in developing an integrated strategy for pathogen management and public health control in the agricultural settings where human and animal wastewater and excreta are intensively used as irrigation water sources and fertilizers.
Zoonotic Disease Unit of Kenya: Blueprint for National One Health Action
1Ministry of Health, Kenya; 2Zoonotic Disease Unit, Government of Kenya, Nairobi, Kenya; 3Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya; 4GIZ Health Programme, Nairobi, Kenya; 5Veterinaires Sans Frontieres-Germany
A One Health (OH) approach that integrates human, animal and environmental approaches to management of zoonotic diseases has gained momentum in the last decade as part of a strategy to prevent and control emerging infectious diseases. However, there are limited examples of institutionalized OH approaches. We describe Kenya’s roadmap towards establishment of a sustainable OH system at national and sub-national levels.
Since 2006, the Government of Kenya has worked to institutionalize OH approaches through creation of a multi-sectoral working group to manage zoonotic outbreaks and workshops to deliberate on mechanisms of maintaining OH practices. These efforts culminated in the establishment of an OH coordinating unit, referred to as the Zoonotic Disease Unit (ZDU) in 2011.
The ZDU bridges between the ministries of livestock and human health, with an epidemiologist deployed from each ministry aimed at establishing and maintaining collaboration at the animal and human health interface towards better prevention and control of zoonoses. As a guide for the ZDU, the country has a 5-year national strategic plan for the implementation of an OH approach. The benefits of this newly enhanced collaboration are already becoming apparent; recent outbreaks of zoonotic diseases, including Rift Valley fever (RVF) of 2006-07, rabies and anthrax were detected more rapidly, effectively responded to, better documented and the understanding of animal-human linkage of the diseases improved. This OH approach has enhanced compliance with the International Health Regulations (2005) on public health threats. The ZDU has also coordinated the development a national rabies elimination strategy that incorporates the OH approach and whose implementation is based on the Stepwise Approach to Rabies Elimination.
The ZDU is a successful model for coordination between human and animal health sectors that can be adopted in other settings.
Ambient Air Quality Surveillance: Environmental Impact of Brick Kiln Emission
Maharashtra Udayagiri Mahavidyalaya, India
Air Pollution due to small scale industries have been found to cause serious occupational health hazards and adverse effects on vegetation and potential impact on the environmental conditions. The study for air pollution impact assessment for brick kiln industries was undertaken. Although industrialization is very important for the development of a country, this is a bitter fact that it speeds up the process of environmental degradation as was observed at the Udgir of district Latur in Maharashtra State (India). The monitoring of brick kiln emissions was carried out on monthly basis to estimate the pollution level of gaseous pollutants like oxides of sulphur (SOX), Oxides of nitrogen (NOX) particulate pollutants (Respirable particulate matter –RSPM) and (Non respirable particulate matter –NRSPM) during the Non operational and Operational phases of brick kilns in the year 2012-2013. Survey of public health and brick kiln worker was carried out for the health disorders like bronchitis and skin related problems. The results revealed that all the pollutants (SOX), (NOX), RSPM and NRSPM were crossing the limits prescribed by National Ambient Air Quality Standards (NAAQS) during the operational phase of brick kilns. Further the Air quality index (AQI) were calculated and the study sites were categorized from severe to high pollution including residential areas which is of most concern in respect to health conditions of local people. To minimize the emission of level of air pollutants from brick kilns, possible air pollution mitigation measures are suggested.