Zoonoses in Livestock in Kenya (ZooLINK)

肯尼亚家畜人畜共患病项目（ZooLinK）的目标是使肯尼亚能够制定一个有效的国家人畜共患病（即通过接触动物或其产品获得的传染病）监测规划。为了实现这一目标，我们将与肯尼亚政府部门密切合作，在肯尼亚西部设立一个项目，作为国家方案的样板。建立ZooLinK的理由是，人畜共患疾病造成的疾病负担被大大低估了——正如我们从自己在研究地区的研究中所知道的那样。在最近的一项相对小规模的研究中，我们发现了14种不同的人畜共患病在人类和他们的牲畜中传播。此外，我们预计这一负担将在未来发生变化，因为肯尼亚和其他地方的畜牧生产系统将继续发生变化，以满足对畜产品日益增长的需求——我们有充分的证据表明这种情况正在发生。最重要的变化是以前自给农业的商业化和集约化，贸易模式的变化（例如牲畜及其产品运输的距离），以及受青睐品种的变化。所有这些都影响着人畜共患病和其他传染病的风险。例如，我们的工作表明，来自外来奶牛的基因正在“泄漏”到当地牛群中，并改变了对特定感染的易感性。因此，迫切需要对人畜共患病进行良好的监测，以便确定它们的真正负担以及这种情况如何变化。重要的是，这不需要从头开始设置。肯尼亚已经在牲畜市场、屠宰场和屠场以及更广泛的农业社区实施了传染病的兽医监测。它也有诊所和医院报告人们的传染病。所以这些系统是存在的，并且由训练有素的工作人员操作。需要的是，并且将由ZooLinK提供的是提高对人畜共患病的认识，更好的诊断支持，更好的记录、共享、分析和解释数据的方法，以及人类和动物卫生部门之间更紧密的整合。为了使潜在的资助者相信国家规划的价值，我们需要提供证据，证明加强监测系统能够以具有成本效益的方式促进改善公共卫生。出于这个原因，在我们的项目期间，我们将密切监视增强系统的性能，并将其与当前情况进行比较，确定哪些活动提供了（或不提供）物有所值的服务。ZooLinK还将为肯尼亚公共和动物卫生工作者提供一个平台，让他们获得实践培训（例如诊断方法或电子数据系统），并熟悉“一个健康”的监测方法。培训将由肯尼亚合作伙伴协调，并将培养一批对这种工作方式有第一手经验的骨干人员——这本身就应该留下一笔非常强大的遗产。除了解决这些实际问题外，ZooLinK还将提供一个独特的科学证据基础，帮助我们了解和预测人畜共患疾病负担的变化，并建议有效的干预措施。这将涉及对经济、社会、人口、遗传和流行病学驱动因素的详细研究，以及这些因素结合起来产生总体疾病负担和疾病暴发风险的方式。在这种情况下，ZooLinK不同寻常的综合性是一个主要优势：孤立地研究单一疾病或驱动因素存在明显的局限性（例如，有利于一种疾病的变化可能会降低另一种疾病的风险；或者一个驱动因素的变化可能会被另一个驱动因素的变化所抵消）。ZooLinK收集的高质量数据，加上最先进的诊断、遗传学、经济、统计和数学模型的支持，将使我们能够解决这些问题。

The goal the Zoonoses in Livestock in Kenya project (ZooLinK) is to enable Kenya to develop an effective national surveillance programme for zoonoses (meaning infectious diseases acquired through contact with animals or their products). To achieve this goal we will work in close collaboration with Kenyan government departments to set up a project in western Kenya as a model for a national programme.The rationale for ZooLinK is that the burden of disease caused by zoonoses is greatly underestimated - as we know from our own research in the study region. In one recent but relatively small-scale study, we found 14 different zoonoses circulating in humans and their livestock. In addition, we expect this burden to change in the future as a result of continuing changes to livestock production systems in Kenya and elsewhere in order to satisfy increased demand for livestock products - again, we have good evidence of this taking place. The most important changes are the commercialisation and intensification of what was previously subsistence farming, changes in trading patterns (e.g. the distances that livestock and their products are transported), and changes in favoured breeds. All of these affect the risk of zoonoses and other infectious diseases. For example, our work has indicated that genes from exotic dairy cattle are 'leaking' into local cattle populations and altering susceptibilities to specific infections.There is therefore a pressing need for good surveillance of zoonoses in order to establish their true burden and how that is changing. Importantly, this does not have to be set up from scratch. Kenya already has veterinary surveillance for infectious diseases in place at livestock markets, slaughterhouses and butcheries and in the wider farming community. It also has clinics and hospitals reporting infectious diseases in people. So the systems exist and are manned by trained staff. What is needed, and will be provided by ZooLinK, is increased awareness of zoonoses, better diagnostic support, better ways to record, share, analyse and interpret data, and closer integration between the human and animal health sectors. In order to convince potential funders of the value of a national programme, we need to provide evidence that an enhanced surveillance system can contribute to improving public health in a cost-effective manner. For this reason, during our project we will closely monitor our enhanced system's performance and compare it to the current situation, identifying which activities do (or do not) provide good value for money. ZooLinK will also provide a platform for Kenyan public and animal health workers to get hands-on training (e.g. in diagnostic methods or electronic data systems) and to become familiar with a 'One Health' approach to surveillance. Training will be coordinated by Kenyan partners and will generate a cadre of individuals with first-hand experience of this way of working - this should leave a very strong legacy in its own right.In addition to addressing these practical issues, ZooLinK will also provide a unique scientific evidence base which will help us to understand and anticipate changes in zoonotic disease burdens and to recommend effective interventions. This will involve detailed study of economic, social, demographic, genetic, and epidemiological drivers and the way that these combine to produce an overall burden of disease and risk of disease outbreaks. In this context the unusually comprehensive nature of ZooLinK is a major advantage: there are obvious limitations to studying single diseases or drivers in isolation (e.g. changes that favour one disease may reduce the risk of another; or effects due to changes in one driver may be outweighed by changes in another). The high quality data to be collected by ZooLinK, supported by state-of-the-art, diagnostics, genetics, and economic, statistical and mathematical modelling, will allow us to tackle such questions.