Operationalizing One Health Interventions in Tanzania

在坦桑尼亚实施“同一个健康”干预措施

• 批准号: BB/S013857/1
• 负责人: Sarah Cleaveland
• 金额: $ 74.14万
• 依托单位: University of Glasgow
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=BB%2FS013857%2F1
• 关键词: Operationalizing; Health; Interventions; Tanzania

Endemic livestock zoonoses are important causes of human febrile illness and livestock productivity losses. Despite having major societal impacts in low- and middle-income countries, this group of diseases remains widely neglected. Although many of these infections can be treated, a lack of access to robust diagnostic tests means that many cases remain undiagnosed, which also limits access to effective treatment. Furthermore, prevention and control measures are often challenging as these diseases span both human and animal populations. This proposal aims to address several existing barriers and constraints to the design and development of interventions to mitigate zoonotic disease impact, focussing on areas of interventions that have the potential for both immediate and longer-term impact. Our project will focus on key areas of One Health intervention research to prevent and control zoonotic diseases in poor livestock-keeping communities in Tanzania: (i) interventions delivered through the medical sector to improve clinical management of cases of human zoonotic diseases; (ii) community-led approaches to develop potential behavioural and livestock management interventions; and (iii) interventions to control infection in animal populations that could be implemented by veterinary service providers. The project builds directly from earlier ZELS research in Tanzania that have demonstrated clear potential for application and impact. Our research will focus in pastoral livestock-keeping communities, which have the greatest risk of zoonotic infections and where the greatest social and economic impact of zoonoses interventions is likely to be. Previous research has also demonstrated that rates of disease are higher for small ruminants (goats and sheep) than cattle. Therefore, for animal interventions, we will concentrate on establishing capacity for interventions targeted at small ruminants and associated transmission pathways.The work will involve linked research activities to develop disease-specific interventions against brucellosis and Q fever (caused by infection with Coxiella burnetii), alongside community-led strategies that have potential to reduce impacts across multiple pathogens. Medical-sector interventions will address the common problem of mis-diagnosis of zoonotic causes of febrile illness. Research will involve verification of existing human brucellosis diagnostic tests as a first step towards roll out across Tanzania and a healthcare utilisation survey to generate robust estimates of healthcare availability in pastoral areas. These research activities are explicitly designed to support the development of the National Strategy for Brucellosis Control in Tanzania. Community-based activities will involve novel participatory action research that engages community co-researchers alongside academic researchers to develop and implement behavioural interventions to reduce infectious disease risks. Animal interventions will focus on a C. burnetii vaccine trial to investigate safety and effectiveness at reducing shedding in local-breed goats in endemic settings. This study will generate baseline longitudinal on shedding and infection patterns that will inform development of transmission models and will be integrated with economic models to evaluate a range of potential intervention strategies. In addition to developing pathogen-specific interventions, our research activities will contribute to strengthening interdisciplinary capacity for One Health interventions that can be applied to a wider range of zoonoses. Our partnership with the Tanzanian One Health Coordination Desk (OHCD) in the Prime Minister's Office will ensure that the findings from this research will directly inform the Tanzanian One Health Strategic Plan through a series of stakeholder workshops to support knowledge exchange and effective communication with policymakers.

地方性家畜人兽共患病是造成人类发热性疾病和家畜生产力损失的重要原因。尽管这类疾病在低收入和中等收入国家产生重大社会影响，但仍被广泛忽视。虽然这些感染中有许多是可以治疗的，但缺乏可靠的诊断检测手段意味着许多病例仍未得到诊断，这也限制了获得有效治疗的机会。此外，预防和控制措施往往具有挑战性，因为这些疾病跨越人类和动物群体。该提案旨在解决设计和制定干预措施以减轻人畜共患病影响的几个现有障碍和限制，重点关注有可能产生直接和长期影响的干预领域。我们的项目将侧重于“一个健康”干预研究的关键领域，以预防和控制坦桑尼亚贫穷畜牧社区的人畜共患病：（i）通过医疗部门提供干预措施，以改善对人类人畜共患病病例的临床管理;（ii）社区主导的方法，以制定潜在的行为和牲畜管理干预措施;（iii）通过卫生部门提供干预措施，以改善对人类人畜共患病病例的临床管理。以及（iii）可由兽医服务提供者实施的控制动物群体感染的干预措施。该项目直接建立在ZELS早期在坦桑尼亚的研究基础上，这些研究已经显示出明显的应用潜力和影响力。我们的研究将集中在畜牧业社区，那里的人畜共患病感染的风险最大，人畜共患病干预措施的社会和经济影响可能最大。以前的研究也表明，小型反刍动物（山羊和绵羊）的发病率高于牛。因此，在动物干预方面，我们将集中精力建立针对小型反刍动物和相关传播途径的干预能力，这项工作将涉及相关的研究活动，以制定针对布鲁氏菌病和Q热（由贝氏柯克斯体感染引起）的疾病特异性干预措施，以及社区主导的有可能减少多种病原体影响的战略。医疗部门的干预措施将解决误诊人畜共患发热性疾病的常见问题。研究将涉及验证现有的人类布鲁氏菌病诊断测试，作为在坦桑尼亚推广的第一步，以及医疗保健利用调查，以生成对牧区医疗保健可用性的可靠估计。这些研究活动明确旨在支持坦桑尼亚布鲁氏菌病控制国家战略的制定。以社区为基础的活动将涉及新的参与性行动研究，使社区共同研究人员与学术研究人员一起制定和实施行为干预措施，以减少传染病风险。动物干预将集中在C。贝氏疫苗试验，以调查在地方性环境中减少当地品种山羊散毒的安全性和有效性。这项研究将产生关于排毒和感染模式的基线纵向数据，为传播模型的开发提供信息，并将与经济模型相结合，以评估一系列潜在的干预策略。除了开发病原体特异性干预措施外，我们的研究活动还将有助于加强“一个健康”干预措施的跨学科能力，这些干预措施可应用于更广泛的人畜共患病。我们与总理办公室坦桑尼亚一个健康协调办公室（OHCD）的伙伴关系将确保这项研究的结果将通过一系列利益攸关方研讨会直接为坦桑尼亚一个健康战略计划提供信息，以支持知识交流和与政策制定者的有效沟通。

项目成果

Taenia multiceps in Northern Tanzania: An Important but Preventable Disease Problem in Pastoral and Agropastoral Farming Systems

坦桑尼亚北部的多头带绦虫：牧区和农牧业系统中一个重要但可预防的疾病问题

• DOI: 10.3390/parasitologia2030020
• 发表时间: 2022
• 期刊: Parasitologia
• 作者: Kibona T

Latent class evaluation of the performance of serological tests for exposure to Brucella spp. in cattle, sheep, and goats in Tanzania.

• DOI: 10.1371/journal.pntd.0009630
• 发表时间: 2021-08
• 期刊: PLoS neglected tropical diseases
• 影响因子: 3.8
• 作者: Bodenham RF;Mazeri S;Cleaveland S;Crump JA;Fasina FO;de Glanville WA;Haydon DT;Kazwala RR;Kibona TJ;Maro VP;Maze MJ;Mmbaga BT;Mtui-Malamsha NJ;Shirima GM;Swai ES;Thomas KM;Bronsvoort BMD;Halliday JEB
• 通讯作者: Halliday JEB

Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014.

• DOI: 10.4269/ajtmh.20-1036
• 发表时间: 2021-12-20
• 期刊: The American journal of tropical medicine and hygiene
• 作者: Pisharody S;Rubach MP;Carugati M;Nicholson WL;Perniciaro JL;Biggs HM;Maze MJ;Hertz JT;Halliday JEB;Allan KJ;Mmbaga BT;Saganda W;Lwezaula BF;Kazwala RR;Cleaveland S;Maro VP;Crump JA
• 通讯作者: Crump JA

Cystic echinococcosis in northern Tanzania: a pilot study in Maasai livestock-keeping communities.

• DOI: 10.1186/s13071-022-05518-x
• 发表时间: 2022-10-28
• 期刊: Parasites & vectors
• 影响因子: 3.2