Integrated management-based approach for surveillance and control of zoonoses in emerging livestock systems: South East Asia Pig & Poultry Partnership

人类群体反复面临新的传染病挑战，其中许多是动物源性的（人畜共患病），然后成为动物和人类群体的地方病。这些人畜共患病的风险可能会因低收入和中等收入国家，特别是东南亚国家畜牧业生产系统的快速发展和多样化而恶化。这些新兴的畜牧业系统与人们不断变化的食物消费习惯、经济地位、愿望和人口变化以及政治背景有关。ELS的主要特点包括动物饲养的强化，抗生素的使用增加和供应链的延伸-所有这些都可能从食品安全的角度来看存在缺点。头条新闻合理地集中在新出现的人畜共患病上，例如高致病性流感（HPAI），但正是被遗忘的地方性人畜共患病，主要是胃肠道感染，给穷人的健康及其牲畜的生产力和盈利能力带来了最沉重的全球负担（ILRI向DfID提交的报告，2012年）。据估计，由沙门氏菌和弯曲杆菌等细菌引起的人畜共患胃肠道疾病以及相关的抗生素耐药性每年在全球造成约100万人死亡，约8亿人受到影响，其中大多数是5岁以下的儿童;这种情况也反映在我们的研究国家越南和缅甸，这两个国家因其ELS的快速性和多样性而排名前5位（国际劳工研究所向国际开发部报告）。我们的工作验证了这样一种观点，即这些人越来越依赖于食物的各种ELS，特别是猪和家禽生产，是这些感染的主要来源。我们还假设，这些人畜共患病的威胁的风险环境，病原体和宿主相关的因素，这些，反过来，将受到不同的ELS的规模和多样性的影响。越南和缅甸处于不同的快速发展阶段，但发展轨迹不同，我们将研究这些差异，以支持制定新的“一个健康”方法。我们的建议的目的是利用跨学科的专业知识，包括来自缅甸，越南和英国的社会，生物和政府参与者，利用知识驱动和文化相关的战略，同时改善动物健康和生产力，从而改善和保护人类健康，从而实现扶贫控制措施的逐步变化。为实现这一目标，需要在越南和缅甸同时开展以下工作：（1）改进猪和家禽生产系统和供应链。(2)了解主要利益攸关方对牲畜疾病、人畜共患病风险和基线预防机制的现有认识和做法。(3)确定不同畜牧系统对细菌性人畜共患感染的流行和多样性以及对抗菌素耐药性的影响。(4)（5）在越南和缅甸确定、试点和评估适当和有效的以知识为基础的ELS培训计划，并考虑如何将这些计划转化为其他环境。我们的研究将支持改善消费者的食品安全和福祉，改善食品链工作者的经济安全和健康，改善牲畜集约化管理带来的社区一级和环境效益，为细菌性人畜共患病控制制定有效和文化相关政策所依据的证据，微生物学试验室，基础设施，和培训，作为今后可持续监测细菌性地方性人畜共患病的基础（对新出现的人畜共患病的监测可与之结合），以及可适应其他国际环境的人畜共患病风险评估和控制方法。最后，该项目为跨学科团队在解决全球卫生问题中的作用提供了新颖的学术见解。

Human populations repeatedly face new infectious disease challenges, many of which are of animal origin (zoonotic) and then become endemic in animal and human populations. These zoonotic risks may be worsened by rapid development and diversification of livestock production systems now occurring in low- and middle-income countries, especially in South East Asia. These emerging livestock systems (ELS) are linked to peoples' changing food consumption habits, economic status, aspirations and population shifts, and to political contexts. Key features of ELS include intensification of animal keeping, increased use of antibiotics, and extended supply chains - all of which can have disadvantages from a food safety perspective. Headlines reasonably focus on the emerging zoonotic diseases, for example highly pathogenic influenza (HPAI), but it is the forgotten endemic zoonotic diseases, and primarily gastrointestinal (GI) infections that put the heaviest global burden on the health of poor people, and on productivity and profitability of their livestock (ILRI Report to DfID, 2012). It is estimated that zoonotic gastrointestinal disease, caused by bacteria such as Salmonella and Campylobacter and related antibiotic resistance, accounts for around 1 million human deaths per year globally with around 800 million people being affected, most of them children under five; a situation also reflected in our study countries Viet Nam and Myanmar which rank in the top 5 hotspots for rapidity and diversity of their ELS (ILRI report to DfID). Our work tests the idea that diverse ELS, specifically pig and poultry production, upon which these people increasingly depend for food, are major sources of these infections. We also hypothesise that these zoonotic threats are impacted by the risk environment, and pathogen- and host-related factors and that these, in turn, will be affected by the scale and diversity of different ELS. Viet Nam and Myanmar are at different stages of rapid but different development trajectories and we will study these differences to support development of new One Health approaches. Our proposal's aim is to exploit interdisciplinary expertise that includes social, biological, and governmental players from Myanmar, Viet Nam and UK to bring about step changes in pro-poor control measures using knowledge-driven and culturally relevant strategies that concomitantly improve animal health and productivity and thus improve and protect human health. The objectives to achieve this aim involve parallel work in Viet Nam and Myanmar:(1) To characterise pig and poultry production systems and supply chains.(2) To characterise key stakeholders' existing perceptions and practices related to livestock disease, zoonotic risk and baseline preventive mechanisms.(3) To identify the impact of different livestock systems on the prevalence and diversity of bacterial zoonotic infections and on antimicrobial resistance.(4) To up-scale regionally accessible diagnostic laboratories(5) To identify, pilot and evaluate appropriate and effective knowledge-based training programmes in ELS in Viet Nam and Myanmar, and consider how these might be translated to other contexts.Our research will underpin improved food safety and wellbeing for consumers, improved economic security and health for food chain workers, community-level and environmental benefits from improved management of livestock intensification, evidence on which to base effective and culturally relevant policy for bacterial zoonosis control, pilot microbiology laboratories, infrastructure, and training as the basis for sustainable future surveillance for bacterial endemic zoonoses (to which surveillance for emerging zoonoses could be bolted), and zoonotic risk evaluation and control methods that can be adapted to other international contexts. Finally, the project provides novel academic insights into the role of interdisciplinary teams in tackling global health issues.