Zoonoses Control in Africa: Measures to Enhance Involvement through Application of Community-Based Intelligence Gathering

Abstract

Many of the zoonosis control measures adopted in Africa over the years have not been entirely successful because of neglect of some socioecological factors which are crucial and peculiar to Africa. This study seeks ways to enhance control of zoonosis by adopting a pattern of research and implementation that incorporates socioecological factors and community-based intelligence gathering of data in Africa. A literature search using established data sources: PubMed and Scopus, scooping review to get information on the previous measures used for zoonosis control. It was seen that previous research was inclined more to problem identification than to an evidence-based problem-solving approach. It was also observed that East and Southern Africa are at the forefront of zoonoses and One Health research in Africa, while West Africa is leading in studies related to heavy metals contamination. The results showed that emphasis should be shifted to newer approaches that embrace socioecological factors; hence, community-based intelligence plays a major role in gathering information in Africa for proper implementation of zoonoses control. To ensure this, a holistic means of acquiring information and applying the One Health approach, which takes cognizance of the interaction of humans, animals, and the environment is essential.

1. Introduction

The livestock population in Africa is placed at 3.2 billion with 68% in the rural setting. Fifty-two percent (52%) of the human population in Africa are engaged in agriculture with 39% of farm labor being women. Hence, sustainability of livestock in Africa will no doubt protect the livelihood of the rural poor, especially women and youth in the rural setting.

Livestock population comprises of cattle 356 million (M), sheep 384 M, goats 438 M, pigs 40.5 M, and poultry 2 billion with Ethiopia and Tanzania leading. Therefore, the thriving of sustainable intervention programs sponsored by various funding agencies in the south and eastern parts of Africa is substantial than in other parts of Africa [1]. The poultry population which predominates followed by cattle, goats, and sheep are widespread. Over 60% of the livestock mass in the arid zones is concentrated in East Africa, especially Somalia and Sudan [2].

These livestock are often bedeviled with diseases that not only have marked economic effects but some can crossover to humans. Some of the diseases that have been identified as limiting factors, are zoonotic meaning, can be transmitted from animals to humans and vice versa [3]. These zoonotic diseases are on the rise recently with some having attending threat to global health security. It has been reported that two-thirds of emerging infectious diseases [3, 4, 5] are zoonotic, which include Ebola, pandemic H1N1 influenza and highly pathogenic H5N1 avian influenza, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS), however, the status of COVID-19 as zoonotic disease is still being investigated. The reasons stated above clearly showed the need for research, outbreak investigations, and prompt diagnosis, which are quite expedient for rapid response and containment.

1.1 Research efforts in zoonoses in Africa

Various research efforts are done in Africa but as reported above, the level of research on viral zoonoses is more and the studies include those on endemic zoonoses which are avian influenza, rabies, and human influenza in pigs. The emerging ones include that of brucellosis in goats, tuberculosis in food animals while emerging ones include studies on Arcobacter and Helicobacter spp. and current trends of trypanosomiasis in food animals. The less focused ones are that of heavy metal pollution in selected organs of animals, especially burrowing animals such as African giant rats, which can be useful as environmental monitoring animals. This was well described by Usende et al. Other areas include zoonoses associated with fish in coastal areas, antibiotics residues and resistance in fish and studies on pneumonia-inducing zoonoses, especially deep mycoses in immunosuppressed animals.

In Ghana, research efforts are mostly on the six priority zoonotic diseases: viral, parasitic, pig, bat, or primates-related zoonoses [6] where the preponderance of rabies had been associated with dog consumption in some parts of Northern Ghana. Some efforts have been on swine flu, rift valley fever, and avian influenza, which is still ravaging many regions in Ghana. Ghana had also had a share of emerging viral zoonoses, which include Marburg and Monkeypox. The spread and the nature are still being investigated; however, a lot was related to the incursion of wild animals.

Some parasitic zoonoses which had been reported include toxoplasmosis, trypanosomiasis in food animals, and cysticercosis, while less focused areas are that of Arcobacter and Helicobacter spp. and the cross-species transmission of avian influenza into pigs. Other non-infectious aspects that will benefit from the One Health approach include antibiotics residues and resistance, climate change, and heavy metal pollution that is termed “Chemical zoonoses” based on the level of artisanal mining, hunting practices, and some cultural practices that promote bioaccumulation of heavy metals in human, especially pregnant women [7].

It will be great to examine the trends of research and training on zoonoses and One Health in Africa to evaluate the volume and the parts of Africa that benefit more. This evaluation will help in the call for more emphasis on the training and research to aid capacity development for the containment of pandemics in Africa.

1.2 Trends of training and research in zoonoses and one health in Africa

1.2.1 Methodology employed

To understand the trends of training and research in zoonoses and One Health in Africa, information was sourced by online search using PubMed, Scopus, and Google Scholar to evaluate the volume of journal papers on training and research in zoonoses and One Health in Africa. Information was also obtained from various stakeholders in One Health through collaboration and organized workshops by international agencies.

1.3 Results

The results obtained were expressed in bar charts in terms of the volume of journal articles in the following thematic areas:

Distribution of publications (output per region) in terms of One Health research, zoonoses research, training in zoonoses, and training in One Health.

Prose on the graphs below:

From Figures 1 and 2, there are indications of the level of research and training in One Health showed South and East Africa leading, which reflects the nature of work done in the area of One Health and the level of capacity building in this area. This clearly showed the need to focus on other parts of Africa, especially West Africa, which had been devastated by Ebola and recently threatened by Monkeypox.

Figure 1.

Level of research done using the One Health approach.

Figure 2.

Level of training received on one health.

Figures 3 and 4 show the level of training and research done on zoonosis. This showed a similar pattern with East Africa and West Africa leading, supporting the need to embrace One Health more in West Africa which in no doubt would help the inter-sectorial collaboration and prudent use of scarce resources should pandemic and other forms of zoonoses control be taken seriously. No doubt, this obvious gap calls for deliberate efforts to develop various One Health training programs involving the various sectors, namely human, animal, and environment.

Figure 3.

Level of training using the one health approach.

Figure 4.

Level of research done using the one health approach of training received in zoonosis.

Figure 4 shows that viral zoonoses are the most researched followed by bacterial and ectoparasitic diseases. This may be associated with the fatality rate of most viral zoonoses as compared with parasitic or bacterial zoonoses. Figure 5, clearly shows that most zoonotic disease publications in Africa are from bovines, which are quite numerous and more abundant, closely followed by wildlife and canine. This trend is interesting and clearly shows that wildlife is becoming a serious hub of zoonotic infection possibly because of the spill-over tendencies of disease. This underscores the fact that many ecological threats could precipitate or enhance the human-wildlife interface.

Figure 5.

Level of research done on heavy metal accumulation in Africa.

Often, the involvement of environmental issues that precipitate zoonoses is neglected or not given the required attention. This is why it is expedient to examine the trend of research on heavy metal contamination or accumulation in Africa. This clearly shows that research in this area needs urgent attention because the volume of research is grossly inadequate and is not a true reflection of the volume of illegal mining that ravages most parts of Africa. The distribution of research on heavy metal contamination in Africa clearly showed West Africa leading with very scanty information from East and North Africa. This calls for deliberate actions to reduce the untold destruction of the ecosystem that could have subsequent effects on disease patterns in future.

Trends in Africa

The mining activities in Africa had led to land encroachment, land disputes, destruction of farms, and farmer-pastoralist clashes. This is because mining activities make the land inadequate for animal grazing and crop farming. This in turn will lead to migration from the north toward the south in search of pastures. The land being used for farming, mining and grazing exposes these animals to heavy metal accumulation. This clearly shows that emphasis should be more on environmental toxicity, heavy metal accumulation, and the possible effect of this trend on zoonoses and disease outbreaks. This is an aspect that needs further elucidation to ensure effective control of zoonoses or pandemics in Africa.

From Figure 5 above, indicates that the level of research on heavy metal accumulation in Africa does not match the enormity of the problem. These and others call for an integrated approach to control, taking cognizance of the interaction of humans, animals, and the environment, hence the need for a “One Health Concept” approach.

1.4 One health approach

One Health recognizes that the health of people is connected to the health of animals and the environment. One Health is defined as a collaborative, multisectoral, and trans-disciplinary approach to achieving optimal health outcomes by recognizing the interconnection between people, animals, plants, and their shared environment CDC [8]. The goal of One Health is to encourage the collaborative efforts of multiple disciplines-working locally, nationally, and globally to achieve the best health for people, animals, and our environment. Though it is not a new concept, this is because there are frequent changes in the environment, animal diversity and human-animal interactions have often led to the emergence and reemergence of many diseases, including zoonotic diseases. This reoccurrence necessitates proactive measures which should include public health interventions that require the cooperation of human, animal, and environmental health communities through collaborations to succeed [9]. It should be noted however that those collaborations and interventions will need to incorporate these ecological and cultural peculiarities of Africa into the outbreak investigations in One Health (Figure 6).

Figure 6.

An image of a Ghanaian family living near their domestic animals. (Source: Picture was taken by courtesy of Tasiame William in the Northern Region of Ghana).

1.4.1 Ecological peculiarities of Africa

The cultural practices and the family ties that exist in Africa are unique with very close interaction between domestic animals and human, which is seen in the figure above. This proximity allows for the interaction of various species and animals within the same environment. This proximity allows for the easy spread of diseases between animals and humans within the same ecosystem. This eco peculiarity allows for the use of One Health and that allows for the possible introduction of One Health hospital to take care of animals and humans using shared facilities that include laboratory and diagnostic imaging. This will no doubt cut costs and allow for judicious use of resources.

1.4.2 The use of indigenous knowledge and development in zoonoses control

Indigenous knowledge is a systematic body of knowledge acquired by local people through the accumulation of experiences, informal experiments, and an intimate understanding of the environment in a given culture. Indigenous knowledge is unique to a given culture or society. It is the formation base for a society that facilitates communication and decision-making. It forms the basis for decision-making, which is operationalized through indigenous organizations, and they provide the foundation for local innovations and experimentation.

A study was conducted in the Kumasi Metropolis, Ghana to know the consumer preference and possible health implications of cattle and goat offal [10]. The objectives of this study were to provide sufficient information on consumer preference for offal and related public health zoonotic implications in the offal supply chain and also to provide a basis for the development of consumer safety and welfare policies in Ghana, in respect of offal-borne zoonotic infections. This study indicated that 1.1% of the populace preferred the lungs of the animals, 38.7% preferred the liver, 7.5% the intestines, and 52.7% the stomach contents. Some factors which influence consumer preference are availability, affordability, nutritional value, taste, customs, and individuals’ level of education.

Research was equally done on the offal of the cattle and goat and significant histopathological changes were observed in both cattle and goat liver. Well-formed hepatic granuloma of different sizes scattered within the interstitium with eggs and segments of parasites. Multiple focal abscesses and hepatic necrosis were observed as well. In such an instance, a clear relationship was established between preference for offal and the spread of zoonoses. This showed that the application of a native intelligence approach to disease information can be more effective.

1.4.3 Native intelligence in zoonoses control

Native intelligence is a community approach to intelligence gathering of information. It is also a nonconventional or traditional method of sourcing information at the community level using the participatory epizootiology approach. This will include the use of community leaders, opinion leaders, and the involvement of women, men, district heads, chiefs, market women, hunters, trade groups, associations, established health institutions, churches, mosques, and food vendors in the control of zoonoses. These groups are often neglected but often useful as a tool to obtain information at the community level. This group should be well-trained and deployed to obtain the necessary information on zoonoses at the community level.

1.4.4 Cultural practices promoting zoonoses

Some cultural practices have been identified as promoters of zoonoses in Africa, such methods include the killing and eating of bush rats and grasscutters using cutlass, which is mostly laden with crocodile bile.

Some tribes use the stomach content of killed grasscutter for soup, while some local butchers and meat sellers did not see tubercles in the lungs of livers as a threat, some take a bit during slaughtering and claim they have taken such for years with no dire consequence.

These observations clearly show the need for research into the sociocultural factors in Africa. Some of these include the experience and interactions of hunters and hunting dogs in terms of rabies transmission at the community level, there is also a need to evaluate the indiscriminate slaughtering of certain domestic animals such as donkeys and dogs, and the evidence of rabies transmission as suggested by some researchers [11].

1.4.5 Paradigm shift

There is therefore the need for research to be more inclined to an evidence-based problem-solving approach. This informs the need to have centers of excellence that focus on pandemics or zoonosis control in West Africa and others located more in East and Southern Africa. Such centers in West Africa include the Center for Control and Prevention of Zoonoses in West Africa (CCPZ) https://www.ui.edu.ng/content/centre-control-and-prevention-zoonoses-West-Africa. The main partners were Faculty of Veterinary Medicine, University of Ibadan, Department of Animal Science, Njala University Sierra leone, and Cuttington University in Liberia while the German-West African Center for Pandemic Control (G-WAC) https://g-wac.org/ had main partners, which include Medical Faculty and University Hospital Bonn UKB, Berlin School of Public Health, Technische Universitat Berlin (TUB) and Charite Universititatsmedizin- Berlin, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), and Kumasi Ghana. G-WAC is a center of excellence with expertise in health systems/health economics, virology/diagnostics, bacteriology/parasitology, epidemiology and surveillance, community engagements/social sciences, digital health, and zoonoses.

Noting that there is more work desired in West Africa, the center that will be driven by the effect of environmental degradation on human and animal health will be strongly recommended judging from the enormous environmental degradation caused by illegal mining often reported in Ghana, Nigeria, and Sierra Leone.

1.5 Conclusions

This chapter reiterates the fact that community-based intelligence plays a major role in gathering information in Africa for proper implementation of zoonoses control. Hence, there is a need for a wholistic means of acquiring information and application of One health approach taking cognizance of the interaction of humans, animals, and the environment.

Acknowledgments

We appreciate the efforts of the research team, which comprises biologists, veterinarians, and nurses, who actively aid in the thinking process. They include Ruth Fiadjoe, Belinda Dogbe, Derrick Adu Asare, Abigael Emikpe, and Obadiah Opoku-Bamfoh who typed and edited the chapter.