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，通过雄心勃勃的国家增长和转型计划努力摆脱极端贫困，旨在到2025年实现中等收入地位。畜牧业占国民收入的很大比例，是经济发展的支柱。传统的粗放型耕作制度正在被集约型耕作制度所补充和取代，在奶制品生产方面，使用进口的荷斯坦-弗里斯兰杂交奶牛，以满足迅速增长的城市人口对奶制品的大量需求。牛结核病（bTB）是埃塞俄比亚的地方病，在新兴的密集型奶牛群体中流行率很高，但目前在当地的瘤牛中流行率很低。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的控制措施。因此，通过贸易传播bTB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）旨在为埃塞俄比亚制定可持续的bTB控制战略提供科学的理解，以降低bTB的高发病率及其在不断扩大的乳制品行业中的人畜共患病转移，特别是向更弱势的人群转移。本补充提案“ETHICOBOTS 2 - One Health with Impact”的重点是确保迄今为止开展的研究产生最大影响。它将改善ETHICOBOTS建立的科学基础，并将提供明确的循证工具，以解决乳制品行业不同部门的bTB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完成这项工作，解决关键的证据差距，以最大限度地发挥影响：-制定一条从国家牛群中消除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以疾病控制为基础的监测计划提供明确的本地范例。这将产生关于疾病控制的额外数据，并探索牛结核病感染牛中无反应性或试验不敏感性的流行情况。- 探索向农民宣传疾病控制的新工具。我们将与这一领域的创新者合作，他们已经建立了与非洲其他地区农民沟通的新方法，并与Farmerline合作，我们将在埃塞俄比亚奶牛场测试他们的方法。解决关于暴露于受感染牛的高风险人类结核病病因的主要证据缺口。通过与牛bTB感染高发地区的患者和卫生保健机构合作，我们将通过改进培养方法和使用现代分子检测来识别致病病原体（M.结核和M.牛）在一系列样品中，包括双重感染的测试结果将提供实用和有效的bTB控制策略，针对疾病及其人畜共患病传播给人类。通过与主要政府和行业利益相关者的密切合作，我们致力于防止疾病的进一步地理传播，并将进一步传播到国家瘤牛群的风险降至最低，以保护贫困农民的生计。该项目将在相关政府单位和当地社区的积极参与下实施，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.