ETHICOBOTS 2 - One Health Research for Impact

埃塞俄比亚是撒哈拉以南非洲人口第二多的国家。它也是一个以农业为主的国家，正在努力通过雄心勃勃的国家增长和转型计划摆脱极端贫困，目标是到2025年达到中等收入水平。畜牧业对国民收入的贡献很大，是经济发展的支柱。传统的粗放型农业系统正在被集约化农业所补充和取代，在乳制品生产方面，使用进口的荷尔斯坦-弗里西亚杂交品种，以满足快速增长的城市人口对乳制品的高需求。牛结核病（bTB）是埃塞俄比亚的地方病，在新兴的集约化奶牛种群中患病率很高，但目前在当地的Zebu牛中患病率较低。奶牛场在城市周边的扩张造成了结核病感染的热点，埃塞俄比亚没有法定控制措施。因此，结核杆菌通过贸易传播的可能性是一个新出现的风险。我们正在埃塞俄比亚进行的ZELS研究，埃塞俄比亚牛结核病控制战略（ETHICOBOTS）旨在为埃塞俄比亚bTB可持续控制战略的制定提供科学理解，以降低bTB的高发率及其在不断扩大的乳制品行业的人畜共患病转移，特别是向更弱势的人口部门转移。本补充提案“ETHICOBOTS 2 -一个有影响的健康”侧重于确保迄今开展的研究产生最大影响。它将改善在ETHICOBOTS中建立的科学基础，并将提供明确的、以证据为基础的工具，以解决乳制品行业不同部门中结核分枝杆菌的高负担和任何人畜共患病传播。我们将通过三个具体的工作包来开展这项工作，解决关键的证据差距，以最大限度地发挥影响：-制定消除国家牛群中一部分牛结核病感染的途径，与农业和畜牧业部密切合作，清除政府农场的bTB。这些农场将为如何成功实施基于疾病控制的监测规划提供一个明确的地方范例。这将产生关于疾病控制的额外数据，并探索感染结核病的牛的能量或测试不敏感的流行情况。-探索向农民宣传疾病控制的新工具。我们将与该领域的创新者合作，他们已经建立了与非洲其他地区农民沟通的新方式，我们将与farmline合作，在埃塞俄比亚的奶牛场测试他们的方法。-解决与受感染牛接触风险高的人的结核病病因方面的主要证据差距。我们将与牛中结核分枝杆菌感染高发地区的患者和卫生保健机构合作，通过改进培养方法和利用现代分子测试在一系列样本中确定病原体（结核分枝杆菌和牛分枝杆菌），包括双重感染测试，显著提高结核患者的诊决率。针对该疾病及其对人类的人畜共患传播。通过与主要政府和行业利益相关者的密切合作，我们的目标是防止该疾病在地理上进一步蔓延，并尽量减少进一步传播给全国zebu牛群的风险，以保护贫困农民的生计。该项目将在有关政府单位和当地社区在实地的积极参与下进行，以最大限度地将成果落实到政策和实践中。

Ethiopia is the second most populous sub Saharan African country. It is also a predominantly agrarian country struggling to emerge from extreme poverty through an ambitious national growth and transformation plan, aiming to achieve middle income status by 2025. Livestock contributes to a high proportion of national income and is a pillars of economic development. Traditional extensive farming systems are being supplemented and replaced with intensive farming, in the case of dairy production using imported Holstein-Friesian crosses to meet high demand for dairy products in the rapidly growing urban population. Bovine tuberculosis (bTB) is endemic in Ethiopia and the prevalence is high in the emerging intensive dairy population, but currently low in local Zebu cattle. Periurban expansion of dairy farms has created hotspots of TB infection and there are no statutory controls in Ethiopia. Consequently, the potential for spread of bTB through trade is an emerging risk.Our ongoing ZELS research in Ethiopia, Ethiopian Control of Bovine Tuberculosis Strategies (ETHICOBOTS) aims to provide a scientific understanding for the development of sustainable control strategies for bTB in Ethiopia, to reduce the high rate of bTB and its zoonotic transfer in the expanding dairy sector, especially to more disadvantaged population sectors. This Supplementary proposal 'ETHICOBOTS 2 - One Health with Impact' focusses on ensuring maximal impact of the research undertaken to date. It will improve the scientific base established in ETHICOBOTS and will provide clear, evidence-based tools to tackle the high burden of bTB in different sectors of the dairy industry and any zoonotic transmission. We will deliver this work through three specific work-packages, addressing critical evidence gaps to maximise impact: - Develop a pathway for the Elimination of bovine TB infection from a sub-set of national herds, working closely with the Ministry of Agriculture and Livestock to clear Government farms of bTB. These farms will provide a clear local exemplar of how disease control based surveillance programmes can be successfully implemented. This will generate additional data on disease control and explore the prevalence of anergy, or test-insensitivity, in bovine TB infected cattle. - Explore new tools to communicate disease control to farmers. We will work with innovators in this field who have established new ways to communicate with farmers in other parts of Africa and in a collaboration with Farmerline, we will test their methods in Ethiopian dairies.- Address the major evidence gap regarding the cause of tuberculous disease in humans at high risk of exposure to infected cattle. Working with patients and health care facilities in areas with a high prevalence of bTB infection in cattle, we will markedly improve the diagnostic rate in TB patients by improving culture methods and by using modern molecular test to identify the causative disease agent (M. tuberculosis and M. bovis) in a range of samples, including testing for dual infections The results will provide practical and effective bTB control strategies, targeted at the disease and its zoonotic transmission to humans. Delivering impact through close collaboration with key government and industry stakeholders, we aim to prevent further geographic spread of the disease and to minimise the risks of further transmission to national zebu herd, to protect the livelihood of poor farmers. The project will be carried out with the active participation of the relevant government units and local communities in the field to maximize the likelihood of implementation of results into policy and practice.