Correction: Wet market biosecurity reform: Three social narratives influence stakeholder responses in Vietnam, Kenya, and the Philippines.

[This corrects the article DOI: 10.1371/journal.pgph.0001704.].

Wet market biosecurity reform: Three social narratives influence stakeholder responses in Vietnam, Kenya, and the Philippines.

In 2020, Covid-19 led to global policy statements promoting bans and reforms to wet markets in Asia and Africa to prevent future pandemics. We conducted a comparative, exploratory qualitative study in 2021 in three countries (Kenya, Vietnam and the Philippines) to understand the social and political dimensions to biosecurity reform at wet markets. This included 60 key informant interviews and rapid ethnographic research in 15 markets, as well as a review of policy documents and online media articles. We found no evidence that the rhetoric of pandemic spillover that emerged in 2020 had any influence on policy or reform efforts apart from those related to Covid-19 infection control. Rather, we identified three main narratives that frame the problem of biosecurity and preferences for reform. The first, a human health narrative, questioned global framings about pandemic risk, viewed markets as sources for food security rather than disease, emphasized the need to strengthen the control of endemic diseases, and conceptualized health through the lens of 'freshness' rather than biomedical categories. A second modernization narrative approached biosecurity as part of a broader process of socio-economic development that emphasized infrastructural gaps, spatial arrangements, cleanliness and a conflict between reform and economic interests. A third narrative centered on local livelihoods and the tension between local market stakeholders and biosecurity and modernization efforts. This final narrative called into question the appropriateness of certain regulations and policies, including bans and closures, emphasized the importance of preserving cultural heritage and highlighted the need for collective political action to resist certain veterinary policies. In conclusion, wet market biosecurity strategies occur in the context of three contrasting narratives that emphasize different aspects of health and risk, and reflect different worldviews and interests. Within this context, there is a need for local government to strengthen market management and biosecurity in ways that enhance the agency of market stakeholders and strengthen local livelihoods and food security as part of a pluralistic and democratic politics.

Prioritization of livestock diseases by pastoralists in Oloitoktok Sub County, Kajiado County, Kenya.

INTRODUCTION: Livestock diseases are a big challenge for the livelihood of pastoralists in sub-Saharan Africa because they reduce livestock productivity and increase mortality. Based on the literature available there is limited understanding on how pastoralists prioritize these diseases in the context of their culture, ecosystems and livelihoods. A study was conducted to provide insights on lay prioritization of animal diseases by pastoralists in Kenya. METHODOLOGY: A qualitative study was undertaken between March and July 2021. Thirty in-depth interviews and six focus group discussions (FGDs) were conducted with community members to explore community attitudes on livestock diseases prioritization. Male and female livestock keepers were purposively selected and interviewed and they were all long-term residents of the area. Fourteen key informant interviews (KIIs) were conducted with professionals from different key sectors to provide detailed stakeholder perspectives on livestock diseases. The interviews were analyzed thematically using the QSR Nvivo software to identify the emerging themes related to the study objectives. RESULTS: The pastoralists prioritized livestock diseases based on effect on their economic wellbeing, cultural values and utilization of ecosystem services. There were gender variabilities in how diseases were prioritized among the pastoralists. Men cited high priority diseases as foot and mouth disease and contagious bovine pleuropneumonia due to their regular occurrence and effect on livelihood. Notably, women regarded coenuruses as very important because it affected sheep and goats with a high mortality rate and lumpy skin disease because it rendered the meat from the carcasses inedible. Malignant catarrhal fever and trypanosomiasis were noted as some of the common diseases in the livestock-wildlife interface but not cited as priority diseases. Challenges related to disease control in pastoralist contexts exist including limited access to livestock treatment services, inadequate information on disease impact and complex environmental factors. CONCLUSION: This study sheds light on the body of knowledge in Kenya regarding livestock diseases and their prioritization by livestock keepers. This could aid in the development of a common disease control framework and prioritization at the local level which would take into consideration the dynamic socio-cultural, ecological, livelihood and economic contexts of the communities.

Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania.

BACKGROUND: Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. METHODS: Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. RESULTS: Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. CONCLUSION: The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons.

Lay attitudes and misconceptions and their implications for the control of brucellosis in an agro-pastoral community in Kilombero district, Tanzania.

Brucellosis is a priority zoonotic disease in Tanzania that causes ill-health in people and affects livestock productivity. Inadequate awareness and behavior risking transmission can impede control efforts. We conducted a cross-sectional survey of 333 livestock owners in three villages in the Kilombero district, Tanzania, to understand their awareness, knowledge and behavior associated with brucellosis. Six Focus Group Discussions (FGDs), two in each village, were conducted, as well as an additional FGD with male herders from one of the villages. Factors associated with knowledge on brucellosis, food consumption and animal husbandry behavior risking transmission of this disease, were identified using generalized linear models. Predictors for knowledge of brucellosis were being male and having a higher educational level, while age was positively associated with a higher level of knowledge. Faith and ethnicity were associated with the performance of practices risking transmission. Following traditional religion and belonging to the Wamaasai ethnicity significantly increased the odds of carrying out these practices. Qualitative analysis gave insight into risk practices and reasoning. Of the 333 respondents, 29% reported that they had experienced abortions in their herds, 14% witnessed retained placentas, and 8% had seen still-births in their cattle within the previous year. However, survey results also showed that only 7.2% of participants had heard about brucellosis as a disease in livestock. Of those who had heard about brucellosis in livestock, 91% associated abortions with it and 71% knew that humans can get infected through raw milk consumption. People overwhelmingly attributed symptoms and transmission of brucellosis in livestock to infection with trypanosomiasis and to supernatural reasons instead. In the community, consumption of raw milk was valued and handling of aborted material was not considered a risk for infection. This agro-pastoralist community holds on to long-held beliefs and practices and lacks understanding of the biomedical concept of brucellosis. Transmission routes and symptoms of brucellosis in humans and livestock are completely unknown. The disparity between risk perception and actual transmission risk related to animal handling and consumption of animal products presents a challenge for disease awareness communication. This study recommends focused community engagement and sensitization to address the limited awareness and misconceptions among agro-pastoralists.