Users' perception of the OH-EpiCap evaluation tool based on its application to nine national antimicrobial resistance surveillance systems.

Introduction: Antimicrobial resistance (AMR) is a One Health (OH) challenge. To achieve or maintain an effective and efficient AMR surveillance system, it is crucial to evaluate its performance in meeting the proposed objectives, while complying with resource restrictions. The OH-EpiCap tool was created to evaluate the degree of compliance of hazard surveillance activities with essential OH concepts across the following dimensions: organization, operational activities, and impact of the surveillance system. We present feedback on the application of the OH-EpiCap tool from a user's perspective, based on the use of the tool to evaluate nine national AMR surveillance systems, each with different contexts and objectives. Methods: The OH-EpiCap was assessed using the updated CoEvalAMR methodology. This methodology allows the evaluation of the content themes and functional aspects of the tool and captures the user's subjective experiences via a strengths, weaknesses, opportunities, and threats (SWOT) approach. Results and Discussion: The results of the evaluation of the OH-EpiCap are presented and discussed. The OH-EpiCap is an easy-to-use tool, which can facilitate a fast macro-overview of the application of the OH concept to AMR surveillance. When used by specialists in the matter, an evaluation using OH-EpiCap can serve as a basis for the discussion of possible adaptations of AMR surveillance activities or targeting areas that may be further investigated using other evaluation tools.

A One Health Evaluation of the Surveillance Systems on Tick-Borne Diseases in the Netherlands, Spain and Italy.

To identify ideal elements for the monitoring and prevention of tick-borne diseases (TBD), we analysed the surveillance systems in place in the Netherlands, Spain and Italy. We applied a semi-quantitative evaluation to identify outcomes and assess the degree of One Health implementation. Differences emerged in the surveillance initiatives, as well as the One Health scores. The Dutch surveillance is dominated by a high level of transdisciplinary and trans-sectoral collaboration, enabling communication and data sharing among actors. Different project-based monitoring, research and educational activities are centrally coordinated and the non-scientific community is actively involved. All this yielded measurable health outcomes. In Italy and Spain, TBD surveillance and reporting systems are based on compulsory notification. Law enforcement, alongside dedicated time and availability of economic resources, is fragmented and limited to the most severe health issues. Veterinary and human medicine are the most involved disciplines, with the first prevailing in some contexts. Stakeholders are marginally considered and collaborations limited to local initiatives. Research activities have mostly contributed to gaining knowledge on the distribution of tick vectors and discovery of new pathogens. Although all TBD surveillance plans comply with EU regulations, initiatives characterised by transdisciplinary collaboration may be more effective for the surveillance and prevention of TBD.

A Survey on One Health Approach in Colombia and Some Latin American Countries: From a Fragmented Health Organization to an Integrated Health Response to Global Challenges.

The "One Health" (OH) approach has been recognized by world health authorities such as FAO/OIE/WHO, advocating for effective, multi-sectoral, and transdisciplinary collaboration. However, there is a lack of published evidence of the awareness of the OH concept in Colombia and other countries in the Latin American Region. In order to explore existing collaboration amongst the animal health, human-public health, environmental health sectors, and to describe the perception, knowledge, and barriers on OH in Colombia and other countries of Latin America, an online questionnaire-based survey was distributed among key professionals representing the three OH pillars (August 2018-August 2020). Overall, 76 key respondents from 13 countries (Colombia, México, Chile, Brazil, Argentina, Bolivia, Costa Rica, Ecuador, Perú, Guatemala, Nicaragua Uruguay, and Venezuela) completed the questionnaire. Respondents worked in institutions of animal (59%), public (20%), human (7%), and environmental health (7%); they mainly belonged to higher academic institutions (59%), followed by ministries (11%), and research organizations (9%). Most participants (92%) were familiar with the OH term and 68% were aware of the formal cooperation among sectors in their countries, mostly on zoonoses; in 46% of the cases, such connections were established in the last 5 years. The main reported limiting factors to intersectorality were the lack of commitment of policy-makers, resources, and budget for OH (38%) and the "siloed approach" of sectors and disciplines (34%). Respondents ranked a median score of 3.0 (1-5 scoring) in how good OH activities are implemented in their countries, and a median score of 2.0 in the citizen awareness on OH as regards their countries. The most important OH issues were identified in vector-borne diseases, rabies, wrong and/or improper use of antimicrobials, emerging viral diseases, food-borne diseases, neglected parasitic diseases, deforestation, and ecosystem fragmentation. Although there is a high-perceived importance on conjoint cooperation, OH implementation, and operationalization remain weak, and the environmental component is not well-integrated. We consider that integration and implementation of the OH Approach can support countries to improve their health policies and health governance as well as to advocate the social, economic, and environmental sustainability of the Region.

Assessment of Evaluation Tools for Integrated Surveillance of Antimicrobial Use and Resistance Based on Selected Case Studies.

Regular evaluation of integrated surveillance for antimicrobial use (AMU) and resistance (AMR) in animals, humans, and the environment is needed to ensure system effectiveness, but the question is how. In this study, six different evaluation tools were assessed after being applied to AMU and AMR surveillance in eight countries: (1) ATLASS: the Assessment Tool for Laboratories and AMR Surveillance Systems developed by the Food and Agriculture Organization (FAO) of the United Nations, (2) ECoSur: Evaluation of Collaboration for Surveillance tool, (3) ISSEP: Integrated Surveillance System Evaluation Project, (4) NEOH: developed by the EU COST Action "Network for Evaluation of One Health," (5) PMP-AMR: The Progressive Management Pathway tool on AMR developed by the FAO, and (6) SURVTOOLS: developed in the FP7-EU project "RISKSUR." Each tool was scored using (i) 11 pre-defined functional aspects (e.g., workability concerning the need for data, time, and people); (ii) a strengths, weaknesses, opportunities, and threats (SWOT)-like approach of user experiences (e.g., things that I liked or that the tool covered well); and (iii) eight predefined content themes related to scope (e.g., development purpose and collaboration). PMP-AMR, ATLASS, ECoSur, and NEOH are evaluation tools that provide a scoring system to obtain semi-quantitative results, whereas ISSEP and SURVTOOLS will result in a plan for how to conduct evaluation(s). ISSEP, ECoSur, NEOH, and SURVTOOLS allow for in-depth analyses and therefore require more complex data, information, and specific training of evaluator(s). PMP-AMR, ATLASS, and ISSEP were developed specifically for AMR-related activities-only ISSEP included production of a direct measure for "integration" and "impact on decision making." NEOH and ISSEP were perceived as the best tools for evaluation of One Health (OH) aspects, and ECoSur as best for evaluation of the quality of collaboration. PMP-AMR and ATLASS seemed to be the most user-friendly tools, particularly designed for risk managers. ATLASS was the only tool focusing specifically on laboratory activities. Our experience is that adequate resources are needed to perform evaluation(s). In most cases, evaluation would require involvement of several assessors and/or stakeholders, taking from weeks to months to complete. This study can help direct future evaluators of integrated AMU and AMR surveillance toward the most adequate tool for their specific evaluation purpose.

A Survey on One Health Perception and Experiences in Europe and Neighboring Areas.

A questionnaire survey was promoted under the COST Actions "Network for Evaluation of One Health-NEOH" and "European Network for Neglected Vectors and Vector-Borne Infections-EURNEGVEC", from June 2016 to April 2017, to collect information on the existence of One Health (OH) collaboration and implementation of OH initiatives in 37 EU COST Countries. The questionnaire was to be answered by key respondents representing the three major OH components: (i). Animal Health; (ii). Human Health/Public Health; (iii). Environmental Health. A target respondent rate of nine respondents/country was aimed for, representing the following categories: (i). ministries; (ii). academia-research; (iii). private sector and NGOs, associations and scientific societies. The questionnaire, composed of 27 questions organized in six sections, was circulated to target respondents by Committee Members of the two COST actions. A total of 171 respondents from 34 countries completed the questionnaire, mainly belonging to academic and research institutions (55.5%), and to Animal Health/Animal Science fields (53.8%). Although the majority (57.9%) declared they had heard about OH, few respondents (10.7%) provided a complete definition. The "human" and "animal" elements prevailed over other key elements of OH definition (ecosystem, intersectoral, transdisciplinary, holistic, collaboration). Overall, 62.6% respondents declared to take part in OH initiatives. Antimicrobial resistance, avian influenza and environmental pollution were cited as the top three OH issues over the past 5 years. Limitations and gaps in intersectoral collaboration included communication and organizational problems resulting in poor networking, differing priorities and a lack of understanding between sectors. Regarding control and monitoring of zoonotic diseases, respondents from different sectors preferentially selected their own directorates/ministries while actually in most countries both Ministry of Health and Ministry of Agriculture are engaged. According to respondents, the level of awareness of OH amongst the general public is limited. Similarly, a dearth of opportunities of collaborations at different institutional and/or professional levels was described. Our survey provided an overview of how respondents in COST countries perceived and experienced OH and current limits to OH implementation. Identifying how initiatives are currently working and knowing the promoting and hindering factors allowed suggesting strategies to promote efficiency and effectiveness of OH implementation in the future.

Control of Cattle Ticks and Tick-Borne Diseases by Acaricide in Southern Province of Zambia: A Retrospective Evaluation of Animal Health Measures According to Current One Health Concepts.

One health thinking for health interventions is increasingly being used to capture previously unseen stakeholders and impacts across people, animals, and the environment. The Network for One Health Evaluation (NEOH) proposes a systems-based framework to quantitatively assess integration and highlight the added value (theory of change) that this approach will bring to a project. This case study will retrospectively evaluate the pioneering use of a One Health (OH) approach during an international collaboration (satellite project to tackle production losses due to tick-borne disease in cattle in Southern Zambia in late 1980s). The objective of the evaluation is twofold: retrospective evaluation the OH-ness of the satellite project and identification of costs and benefits. Data for evaluation was recovered from publications, project documents, and witness interviews. A mixed qualitative and quantitative evaluation was undertaken. In this case study, a transdisciplinary approach allowed for the identification of a serious public health risk arising from the unexpected reuse of chemical containers by the local public against advice. Should this pioneering project not have been completed then it is assumed this behavior could have had a large impact on public wellbeing and ultimately reduced regional productivity and compromised welfare. From the economic evaluation, the costs of implementing this OH approach, helping to avoid harm, were small in comparison to overall project costs. The overall OH Index was 0.34. The satellite project demonstrated good OH operations by managing to incorporate the input across multiple dimensions but was slightly weaker on OH infrastructures (OH Ratio = 1.20). These quantitative results can be used in the initial validation and benchmarking of this novel framework. Limitations of the evaluation were mainly a lack of data due to the length of time since project completion and a lack of formal monitoring of program impact. In future health strategy development and execution, routine monitoring and evaluation from an OH perspective (by utilizing the framework proposed by NEOH), could prove valuable or used as a tool for retrospective evaluation of existing policies.

One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal.

The increasing occurrence of human cysticercosis, a zoonotic neglected disease, is challenging the traditional prevention and control paradigm and calling for One Health (OH) solutions in industrialized countries. OH solutions for health interventions are increasingly being used to capture expected and unexpected outcomes across people, animals, and the environment. The Network for Evaluation of One Health (NEOH) proposes an evidence-based framework, relying on systems and mixed methods approaches to evaluate the One Health-ness. In this case study, this tool is used to evaluate the design of the Observatory of Taeniasis and Cysticercosis, as an example of intersectorial collaboration for surveillance in Portugal. The OH Initiative (drivers and expected outcomes) and its system (boundaries, aim, dimensions, actors, and stakeholders) were described. The different aspects of this Initiative were scored with values from 0 (=no OH approach) to 1 (=perfect OH approach). The OH index was 0.31. Its OH ratio is 1.98. Overall scores were as follows: OH thinking 0.75; OH planning 0.60; OH working 0.60; OH sharing 0.35; OH learning 0.50; and systemic organization 0.50. Operational levels of the Initiative are the main strengths, indicating a comprehensive multidimensional innovative approach and transdisciplinarity. Critical issues in the supporting infrastructure were observed, related to communication, learning and organizational gaps in the project, with the evaluation being conducted as the project is being designed and implemented. The strengths and weaknesses detected may be used to refine the Initiative. This case study therefore exemplifies and supports OH assessment also for ongoing projects, at design and early implementation stages for guiding and guaranteeing an OH-oriented perspective.

Microbial agents in macroscopically healthy mammary gland tissues of small ruminants.

BACKGROUND: Health of mammary glands is fundamental for milk and dairy products hygiene and quality, with huge impacts on consumers welfare. METHODS: This study aims to investigate the microbial agents (bacteria, fungi and lentiviruses) isolated from 89 macroscopically healthy udders of regularly slaughtered small ruminants (41 sheep, 48 goats), also correlating their presence with the histological findings. Multinomial logistic regression was applied to evaluate the association between lesions and positivity for different microbial isolates, animal age and bacteria. RESULTS: Twenty-five samples were microbiologically negative; 138 different bacteria were isolated in 64 positive udders. Coagulase-negative staphylococci were the most prevalent bacteria isolated (46.42%), followed by environmental opportunists (34.76%), others (10.14%) and pathogens (8.68%). Most mammary glands showed coinfections (75%). Lentiviruses were detected in 39.3% of samples. Histologically, chronic non-suppurative mastitis was observed in 45/89 glands, followed by chronic mixed mastitis (12/89) and acute suppurative mastitis (4/89). Only 28 udders were normal. Histological lesions were significantly associated with the animal species and lentiviruses and coagulase-negative staphylococci infections. Goats had significantly higher risk to show chronic mixed mastitis compared to sheep. Goats showed a significantly lower risk (OR = 0.26; 95% CI [0.06-0.71]) of being infected by environmental opportunists compared to sheep, but higher risk (OR = 10.87; 95% CI [3.69-37.77]) of being infected with lentiviruses. DISCUSSION: The results of the present study suggest that macroscopically healthy glands of small ruminants could act as a reservoir of microbial agents for susceptible animals, representing a potential risk factor for the widespread of acute or chronic infection in the flock.

A Blueprint to Evaluate One Health.

One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy.

Positioning Animal Welfare in the One Health Concept through Evaluation of an Animal Welfare Center in Skopje, Macedonia.

The Animal Welfare Center (AWC) in Macedonia was established in 2009. The objectives of the center are animal welfare (AW) education, research, raising public awareness of AW, and increasing cooperation between the stakeholders. One Health (OH) was not the major focus of the AWC work initially, but, rather, a focus that evolved recently. The objective of this study was to evaluate the AWC from the OH perspective as an example case for positioning the AW within the overall OH concept. Three types of evaluation were performed: (1) assessment of OH-ness, by quantitative measurement of the operational and infrastructural aspects of the AWC; (2) impact evaluation, by conducting quantitative surveys on stakeholders and students; and (3) transdisciplinary evaluation, using semi-quantitative evaluation of the links of cooperation between the AWC and the stakeholders in society by the custom designed CACA (Cooperation, Activities, Communication, and Agreement) scoring system. Results for the OH-ness of the AWC showed relatively high scores for OH thinking, planning and working and middle scores for OH learning and sharing dimensions, i.e., dominance of the operational over infrastructural aspects of the AWC. The impact evaluation of the AWC shows that familiarity with the OH concept among stakeholders was low (44% of the respondents). However, there was a commonality among stakeholder's interest about AW and OH. According to the stakeholders' and students' opinions, the influence of AW on Animal, Environmental, and Human Health is relatively high (in the upper third of the 1-10 scale). The transdisciplinary evaluation of the AWC indicated the presence of transdisciplinarity work by the AWC, with a higher focus on the Universities and Research Institutions and some governmental institutions, and less linked with the Non-Governmental Organizations and Professional Associations (Chambers), e.g., the Veterinary Chamber in Macedonia. The evaluations conducted indicated that the AWC's work is closely dedicated to improving animal, environmental, and human health and has a considerable OH role among the stakeholders in the society. This study describes the significant role and importance that AW has in OH.

Experiences in Tick Control by Acaricide in the Traditional Cattle Sector in Zambia and Burkina Faso: Possible Environmental and Public Health Implications.

Livestock, especially cattle, play a paramount role in agriculture production systems, particularly in poor countries throughout the world. Ticks and tick-borne diseases (TBDs) have an important impact on livestock and agriculture production in sub-Saharan Africa. The authors review the most common methods used for the control of ticks and TBDs. Special emphasis is given to the direct application of acaricides to the host animals. The possible environmental and public health adverse effects (i.e., risks for the workers, residues in the environment and in food products of animal origin) are mentioned. The authors present two case studies, describing different field experiences in controlling ticks in two African countries. In Zambia (Southern Africa), a strategic dipping regime was used to control Rhipicephalus appendiculatus ticks, vectors of theileriosis, a deadly disease affecting cattle in the traditional livestock sector in Southern Province. The dipping regime adopted allowed to reduce the tick challenge and cattle mortally rate and, at the same time, to employ less acaricide as compared to the intensive dipping used so far, without disrupting the building-up of enzootic stability. In Burkina Faso (West Africa), where dipping was never used for tick control, an acaricide footbath was employed as an alternative method to the traditional technique used locally (portable manual sprayers). This was developed from field observations on the invasion/attachment process of the Amblyomma variegatum ticks - vector of cowdriosis - on the animal hosts, leading to a control method aimed to kill ticks temporarily attached to the interdigital areas before their permanent attachment to the predilection sites. This innovative method has been overall accepted by the local farmers. It has the advantage of greatly reducing costs of treatments and has a minimal environmental impact, making footbath a sustainable and replicable method, adoptable also in other West African countries. Although the two methods described, developed in very different contexts, are not comparable - if public health and environmental implications are taken into account, if a balance among efficacy of the control method(s), cost-effectiveness and sustainability is reached - a way forward for the implementation of a One Health strategy can be set.

Severe meningeal fibrinoid vasculitis associated with Theileria taurotragi infection in two short-horned Zebu cattle.

The Authors describe a severe vasculitis with fibrinoid necrosis of the meningeal arteries observed in two brains of indigenous short-horn zebu (Bos indicus) cattle, with bovine cerebral theileriosis (BCT) caused by a tick-transmitted hemoprotozoan, Theileria taurotragi, from Northern Tanzania. In the Author's opinion, the role of T. taurotragi infection in the angiocentric and angiodestructive detected features remains to be evaluated. A possible immunopathologic cancerous mechanism, secondary to the lymphoid deregulation, could be involved. This report suggests further studies to better characterize the lymphoid cell involvement in the pathogenesis of the meningeal vascular lesions by T. taurotragi.

"Ormilo disease" a disorder of zebu cattle in Tanzania: bovine cerebral theileriosis or new protozoan disease?

"Ormilo" disease is a neurological disorder of cattle described by Maasai herders in Tanzania. It is attributed to infection by Theileria species, although no detailed data are available in the literature. The authors describe the macroscopical and histological changes observed in 30 brains of indigenous short-horn zebu cattle from Northern Tanzania, aged 2-9 years, with the characteristic neurological signs of "Ormilo". Moreover, the ultrastructural details observed in 14 selected brain samples were reported. Areas of congestion and hemorrhages, associated with the obstruction of the cerebral vessels with large numbers of parasitized lymphoid cells, were observed. Electron microscopy showed the presence of intralymphocytic parasites morphologically comparable to flagellated protozoa, not previously described in the lymphoid cells of cattle, but only reported during the sexual stages within the vector. Theileria taurotragi was detected by polymerase chain reaction (PCR) and reverse line blot (RLB) in nine samples. The authors hypothesize that the parasite detected by electron microscopy could be a strain of a Theileria endemic to this region till now not investigated, having an intralymphocytic phase and being associated with other Theileria spp. infestation. Further studies are needed to better understand the etiology of "Ormilo" disease and to characterize the morphology of the observed parasite, clarifying its role in the disease in Tanzania.

Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia.

OBJECTIVE: To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. METHODS: A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. RESULTS: Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. CONCLUSIONS: According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia / Establecimiento de prioridades en la vigilancia, la prevención y el control de las zoonosis en Bogotá, Colombia

OBJECTIVE: To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. METHODS: A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. RESULTS: Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. CONCLUSIONS: According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

OBJETIVO: Establecer prioridades en la vigilancia, la prevención y el control de las zoonosis en Bogotá, Colombia. MÉTODOS: Se constituyó un grupo Delfos de expertos en veterinaria y medicina que utilizó un método validado de asignación de prioridades con objeto de evaluar la importancia de 32 zoonosis seleccionadas. Esta actividad se complementó con una encuesta de cuestionario que utilizó el método de conocimientos, actitudes y prácticas (CAP) y que se administró en 19 distritos de Bogotá, de septiembre del 2009 a abril del 2010, a una población en situación de riesgo (empleados de consultorios veterinarios, tiendas de mascotas, carnicerías y mercados de alimentos tradicionales que venden aves de corral, carne, queso y huevos). Se creó un indicador de riesgo basado en el nivel de conocimiento acerca de las zoonosis mediante análisis de componentes principales para datos categóricos y análisis de regresión logística. RESULTADOS: En el grupo Delfos participaron doce expertos. Las enfermedades calificadas como de mayor prioridad fueron la gripe A(H1N1), la salmonelosis, la infección por Escherichia coli, la leptospirosis y la rabia. Las enfermedades calificadas como de menor prioridad fueron la anquilostomiasis, la escabiosis, la tiña y la triquinosis. Se recopilaron y se analizaron un total de 535 cuestionarios. Los encuestados informaron de que habían padecido escabiosis (21%), infecciones por hongos (8%), brucelosis (8%) y pulicosis (8%). Los trabajadores cuyos conocimientos sobre zoonosis eran más limitados y por consiguiente estaban sometidos a un mayor riesgo para su salud fueron los que 1) no tenían una formación profesional, 2) contaban con poca o nula capacitación en materia de prevención de zoonosis, y 3) trabajaban en las localidades de Usme, Bosa o Ciudad Bolívar. CONCLUSIONS: Según los expertos, la gripe A(H1N1) fue la zoonosis más importante. La rabia, la leptospirosis, la brucelosis y la toxoplasmosis fueron consideradas como enfermedades prioritarias tanto por los expertos como por los trabajadores expuestos. Esta es la primera actividad de asignación de prioridades centrada en la vigilancia, la prevención y el control de las zoonosis en Colombia. Estos resultados podrían servir de guía en la toma de decisiones para la asignación de recursos en salud pública.

Small ruminant lentivirus genotype B and E interaction: evidences on the role of Roccaverano strain on reducing proviral load of the challenging CAEV strain.

Live attenuated vaccines provide the most consistent protective immunity in experimental models of lentivirus infections. In this study we tested the hypothesis that animals infected with a naturally attenuated small ruminant lentivirus field strain of genotype E may control a challenge infection with a virulent strain of the caprine arthritis encephalitis virus (CAEV-CO). Within genotype E, Roccaverano strain has been described as attenuated since decreased arthritic pathological indexes were recorded in Roccaverano-infected animals compared to animals of the same breed infected with genotype B strains. Moreover, under natural conditions, animals double-infected with genotypes B and E appear less prone to develop SRLV-related disease, leading to a putative protective role of Roccaverano strain. Here we present evidence that goats experimentally infected with the avirulent genotype E SRLV-Roccaverano strain control the proviral load of a pathogenic challenge virus (CAEV-CO strain) more efficiently than naïve animals and appear to limit the spread of histological lesions to the contralateral joints.

Risk perception about zoonoses in immigrants and Italian workers in Northwestern Italy.

OBJECTIVE: To assess factors associated with a low risk perception of zoonoses and to identify the gaps in knowledge about transmission and prevention of zoonoses in immigrant and Italian workers. METHODS: A cross-sectional study with 175 workers in the agro-livestock and agro-food industry in Piemonte, Italy, was carried out. Data were collected with a semi-structured questionnaire based on knowledge, attitudes and practices (KAP) survey. We calculated proportions and used chi-square tests and odds ratios to assess associations. Eight individual interviews with key informants on immigration and public health in Piemonte were carried out. RESULTS: Participants were 82 (47%) Italians and 93 (53%) immigrants. Immigrants were from Romania, Morocco, Albania, India, China, Argentina, Peru, Macedonia, Ivory Coast, Ukraine and Colombia. The study revealed significant differences in risk perception at work (p = 0.001). We found associations between "not having correct knowledge about zoonoses" and the following variables: i. "being immigrant" OR = 4.1 (95%CI 1.7;9.8 p ≤ 0.01); ii. "working in the livestock industry" OR = 2.9 (95%CI 1.2;15.4 p = 0.01); and iii. "being an unqualified worker" OR = 4.4 (95%CI 2.9;15.4 p ≤ 0.01). Another strong association was found between being immigrant and having a low job qualification OR = 6.7 (IC95% 2.9 - 15.4 p ≤ 0.01). Asian immigrants were the group with the highest frequency of risky behaviours and the lowest level of knowledge about zoonoses. CONCLUSIONS: Our results indicate that there were differences in risk perception of zoonoses between the groups participating in our study. These results suggest that immigrant status can be considered a risk factor for having lower risk perception and lower level of knowledge of zoonoses at work. There is a relationship between this specific knowledge of zoonoses and lack of training and instruction among migrant populations. Our results stress the need for developing education programs on zoonoses prevention among the immigrant population in Piemonte, Italy.

Risk perception about zoonoses in immigrants and Italian workers in Northwestern Italy / Percepção de risco sobre zoonoses em trabalhadores imigrantes e italianos no Noroeste da Itália / Percepción de riesgo de zoonosis en trabajadores inmigrantes e italianos en el noroeste de Italia

OBJETIVO: To assess factors associated with a low risk perception of zoonoses and to identify the gaps in knowledge about transmission and prevention of zoonoses in immigrant and Italian workers. MÉTODOS: A cross-sectional study with 175 workers in the agro-livestock and agro-food industry in Piemonte, Italy, was carried out. Data were collected with a semi-structured questionnaire based on knowledge, attitudes and practices (KAP) survey. We calculated proportions and used chi-square tests and odds ratios to assess associations. Eight individual interviews with key informants on immigration and public health in Piemonte were carried out. RESULTADOS: Participants were 82 (47%) Italians and 93 (53%) immigrants. Immigrants were from Romania, Morocco, Albania, India, China, Argentina, Peru, Macedonia, Ivory Coast, Ukraine and Colombia. The study revealed significant differences in risk perception at work (p = 0.001). We found associations between "not having correct knowledge about zoonoses" and the following variables: i. "being immigrant" OR = 4.1 (95%CI 1.7;9.8 p ≤ 0.01); ii. "working in the livestock industry" OR = 2.9 (95%CI 1.2;15.4 p = 0.01); and iii. "being an unqualified worker" OR = 4.4 (95%CI 2.9;15.4 p ≤ 0.01). Another strong association was found between being immigrant and having a low job qualification OR = 6.7 (IC95% 2.9 - 15.4 p ≤ 0.01). Asian immigrants were the group with the highest frequency of risky behaviours and the lowest level of knowledge about zoonoses. CONCLUSÕES: Our results indicate that there were differences in risk perception of zoonoses between the groups participating in our study. These results suggest that immigrant status can be considered a risk factor for having lower risk perception and lower level of knowledge of zoonoses at work. There is a relationship between this specific knowledge of zoonoses and lack of training and instruction among migrant populations. Our results stress the need for developing education programs on zoonoses prevention among the immigrant population in Piemonte, Italy.

OBJECTIVE: Analisar fatores associados à baixa percepção de risco de zoonoses e identificar as lacunas no conhecimento sobre a transmissão e prevenção de zoonoses em trabalhadores imigrantes e italianos. METHODS: Estudo transversal com 175 trabalhadores da indústria agropecuária e agroalimentar em Piemonte, Itália. Os dados foram obtidos por meio de questionário semiestruturado baseado em estudo sobre conhecimentos, atitudes e práticas. Foram calculadas proporções, com uso de teste qui-quadrado e odds ratio para estimar associações. Oito entrevistas individuais com informantes-chave em matéria de imigração e saúde pública foram realizadas. RESULTS: Cerca de 47% dos trabalhadores eram italianos e 53%, imigrantes, provenientes da Romênia, Marrocos, Albânia, Índia, China, Argentina, Peru, Macedônia, Costa do Marfim, Ucrânia e Colômbia. Houve diferenças significativas na menor percepção do risco no trabalho (p = 0,001). Observou-se associação entre falta de conhecimentos corretos sobre zoonoses e ser imigrante (OR = 4,1; IC95% 1,7;9,8; p ≤ 0,01), trabalhar na indústria pecuária (OR = 2,9; IC95% 1,2;6,8; p = 0,01) e ser um trabalhador não qualificado (OR = 4,4; IC95% 1,2;15,4; p = 0,01). Outra forte associação ocorreu entre ser imigrante e ter emprego de baixa qualificação (OR = 6,7; IC95% 2,9;15,4; p ≤ 0,01). Maior frequência de comportamentos de risco e menor nível de conhecimento sobre zoonoses foram encontrados no grupo dos imigrantes asiáticos. CONCLUSIONS: Foram observadas diferenças na percepção de risco de zoonoses entre os grupos participantes. O status de imigrante pode ser considerado fator de risco para ter baixa percepção de risco e menor nível de conhecimento das zoonoses no trabalho. Existe relação entre esse conhecimento específico de zoonoses e falta de formação e instrução entre as populações migrantes. É necessário desenvolver programas de educação sobre a prevenção de zoonoses entre a população imigrante.

OBJETIVO: Analizar factores asociados a la baja percepción de riesgo de zoonosis e identificar los vacíos de conocimiento sobre la transmisión y prevención de zoonosis en trabajadores inmigrantes e italianos. MÉTODOS: Estudio transversal con 175 trabajadores de la industria agropecuaria y agroalimentaria en Piemonte, Italia. Los datos fueron obtenidos por medio de cuestionario semi-estructurado basado en estudio sobre conocimientos, actitudes y prácticas. Se calcularon proporciones y usó la prueba de Chi-cuadrado y odds ratio para estimar asociaciones. Se realizaron ocho entrevistas individuales con informantes clave en materia de inmigración y salud pública. RESULTADOS: Cerca de 47% de los trabajadores eran italianos y 53%, inmigrantes provenientes de Rumania, Marruecos, Albania, India, China, Argentina, Perú, Macedonia, Costa de Marfil, Ucrania y Colombia. Hubo diferencias significativas en la menor percepción del riesgo en el trabajo (p = 0,001). Se observó asociación entre falta de conocimientos correctos sobre zoonosis y ser inmigrante (OR=4,1; IC95% 1,7;9,8;p ≤ 0,01), trabajar en la industria pecuaria (OR = 2,9; IC95% 1,2;6,8;p = 0,01) y ser un trabajador no calificado (OR = 4,4; IC95% 1,2;15,4;p = 0,01). Otra fuerte asociación ocurrió entre ser inmigrante y tener empleo de baja calificación (OR = 6,7; IC95% 2,9;15,4;p ≤ 0,01). Se encontró mayor frecuencia de conductas de riesgo y menor nivel de conocimiento sobre zoonosis en el grupo de los inmigrantes asiáticos.

An integrated database on ticks and tick-borne zoonoses in the tropics and subtropics with special reference to developing and emerging countries.

Tick-borne zoonoses (TBZ) are emerging diseases worldwide. A large amount of information (e.g. case reports, results of epidemiological surveillance, etc.) is dispersed through various reference sources (ISI and non-ISI journals, conference proceedings, technical reports, etc.). An integrated database-derived from the ICTTD-3 project ( http://www.icttd.nl )-was developed in order to gather TBZ records in the (sub-)tropics, collected both by the authors and collaborators worldwide. A dedicated website ( http://www.tickbornezoonoses.org ) was created to promote collaboration and circulate information. Data collected are made freely available to researchers for analysis by spatial methods, integrating mapped ecological factors for predicting TBZ risk. The authors present the assembly process of the TBZ database: the compilation of an updated list of TBZ relevant for (sub-)tropics, the database design and its structure, the method of bibliographic search, the assessment of spatial precision of geo-referenced records. At the time of writing, 725 records extracted from 337 publications related to 59 countries in the (sub-)tropics, have been entered in the database. TBZ distribution maps were also produced. Imported cases have been also accounted for. The most important datasets with geo-referenced records were those on Spotted Fever Group rickettsiosis in Latin-America and Crimean-Congo Haemorrhagic Fever in Africa. The authors stress the need for international collaboration in data collection to update and improve the database. Supervision of data entered remains always necessary. Means to foster collaboration are discussed. The paper is also intended to describe the challenges encountered to assemble spatial data from various sources and to help develop similar data collections.