Diagnosing the causative agent of febrile illness in resource-limited countries is a challenge in part due to lack of adequate diagnostic infrastructure to confirm cause of infection. Most febrile illnesses (>60%) are non-malarial, with a significant proportion being zoonotic and likely from animal origins. To better characterize the pathways for zoonotic disease transmission and control in vulnerable communities, adequate information on the communities’ experiences and lexicon describing fever, and their understanding and perceptions of risk pathways is required. We undertook an ethnographic study to understand behaviors, exposures, and attitudes toward fever at the community level. Our hope is to better elucidate areas of priority surveillance and diagnostic investment. A focused ethnography consisting of participant observation, informal conversations, 4 barazas (community meetings), and formal ethnographic interviews (13 Focus group discussions and 17 Key informant interviews) was conducted between April and November 2015 in Kasese and Hoima Districts in Uganda. Perception of illness and associated risk factors was heavily influenced by the predominant livelihood activity of the community. The term “fever” referred to multiple temperature elevating disease processes, recognized as distinct pathological occurrences. However, malaria was the illness often cited, treated, or diagnosed both at the health facilities and through self-diagnosis and treatment. As expected, fever is as an important health challenge affecting all ages. Recognition of malarial fever was consistent with a biomedical model of disease while non-malarial fevers were interpreted mainly through ethno etiological models of explanation. These models are currently being used to inform education and prevention strategies and treatment regimens toward the goal of improving patients’ outcomes and confidence in the health system. Development of treatment algorithms that consider social, cultural, and economic contexts, especially where human-animal interaction is prevalent, should factor animal exposure and zoonotic illnesses as important differentials.

American Journal of Public Health (AJPH) from the American Public Health Association (APHA) Outcomes of Climate Change in a Marginalized Population: An Ethnography on the Turkana Pastoralists in Kenya, an article from American Journal of Public Health, Vol 108 Issue S2

Pork is one of the most popular consumer meat choices globally, second to poultry. In the past two decades, the rising demand in pork, has seen pig farming move toward intensive farming methods, characterized by high pig densities which is a risk for swift spread of disease necessitating proper and strict biosecurity adherence to facilitate disease-free conditions and business continuity. North America is the second largest pig producer globally. We conducted a review of available peer-reviewed original publications to scope for available data on the knowledge, attitudes, perceptions, and practices concerning biosecurity among swine producers in North America from the year 2011 to 2022 using the PRISMA-SCr guidelines. Out of the 323 papers that fit our search criteria, we present insights from the 18 papers that were relevant to our study. We summarize key findings on biosecurity practices and propose critical practices for biosecurity adherence. We also present our findings on the complexities that influence producers’ adoption of biosecurity plans and note variations in biosecurity strictness between states and how these are influenced by farm size and perceived disease risk. In conclusion, this review highlights the need for updated assessments of biosecurity practices, leveraging technology particularly machine learning, for risk assessment, and acknowledges the role that demographics and risk perception play in biosecurity adoption. Ultimately, effective biosecurity measures are imperative for safeguarding North American swine production systems against disease threats especially foreign animal diseases like the African swine fever (ASF), foot and mouth disease (FMD) and classical swine fever.

Background: African trypanocide resistance is an emerging public health emergency whose control requires a revisit on farmer’s knowledge, attitudes, and practices in developing countries. African animal trypanocide resistance (AATr) is rife in an environment where drug use and policy decisions are disjointed. The objective of the study was to identify community factors responsible for the development of AATr. This was important since diminazene aceturate (DA), isometamidium chloride (ISM), and homidium bromide (HB) have existed for over 30 years and no new drugs have been provided to farmers. Methods: An electronic keyword search across 12 databases was conducted using a search criterion from 1806 to June 2022. This generated a total of 24 publications, but after removing duplicates, review articles, and nonrelated articles, a total of eight papers were included in the analysis by following the PRISMA checklist. A meta-analysis was conducted on the data extracted and the risk ratio and inverse variance at 95% confidence interval were calculated using RevMan^®. Results: All the eight articles in the study showed that DA was the most preferred trypanocide in both West and Eastern Africa. Poor farmer knowledge of AATr and limited drug options were major drivers for trypanocide resistance. In addition, farmer treatments, use of untrained personnel, poor administration, poor dosing, and preparation of trypanocides were major drivers for the development of AATr and similarities were identified in DA and ISM practices (P = 0.13). Conclusions: AATr is spread in developing countries due to a lack of community knowledge, attitudes, and drug-use practices. This situation could be reversed through interdisciplinary collaborations in endemic communities by promoting effective treatments and responsible drug handling.

Animal health and veterinary medicine are integral to One Health, contributing important perspectives on complex challenges arising at the human–animal–environment interface. The published Competency-Based Veterinary Education (CBVE) framework dedicates a domain of competence and three associated sub-competencies to public health (Domain 4). However, a panel of One Health scientists sought to establish additional outcomes believed necessary to support core veterinary curricula related to veterinary public health (VPH)/One Health. We hypothesized that early career veterinarians use knowledge, skills, and abilities consistent with VPH/One Health and that the existing CBVE could incorporate these concepts. We conducted key informant and exploratory interviews with veterinarians across 12 sectors of veterinary medicine and used inductive coding to identify VPH/One Health codes. We then cross-analyzed these codes with the existing CBVE framework to incorporate field-validated VPH/One Health codes into the published framework. Thirty codes emerged which were designated as either adequately represented (5), not represented (6), or represented with sub-competency creation or augmentation recommended (19) in the existing framework. This information was used to cross-map, validate, and update the CBVE sub-competencies so that they accurately reflect the breadth and depth of One Health engagement required for competent veterinarians. This iterative, evidence-based revision process is a model for integrating One Health into medical professional curricula.

In 2014, Uganda was identified as a high-risk country for Ebola Virus Disease (EVD), with a series of outbreaks recorded since 2000. In 2007, the second outbreak in Bundibugyo district resulted in 149 reported cases and 37 confirmed Ebola deaths. Through the outbreak response, a new strain of the Ebola virus ( Bundibugyo ebolavirus) was discovered. Although much is known about the nature of Ebola, including disease signs and symptoms, transmission and management, there is limited understanding of the short and long-term sociocultural impacts of the disease in communities. The study team conducted a focused ethnography in Bundibugyo District 10 years after the 2007 outbreak. Data collection included a review of archival data, participant observation, field notes and 19 in-depth interviews with survivors and affected families. Results underscored time-limited social, cultural and economic disruptions caused by the outbreak. We interpreted findings through an Eco-health framework with an emphasis on ways that underlying stigma accentuated detrimental long-term effects of the outbreak. Affected women, particularly widows, experienced social exclusion, and economic strain, and acknowledged loss of opportunity for a better life for their orphaned children. Deepening fear of the possible recurrence of Ebola resulted in ethnic tension driven by speculations on the 2007 outbreak source. Survivors reported varying persistent health effects including impaired vision and general body weakness. Community members reported positive changes in health seeking behaviors. Health care workers described high levels of alert for early clinical signs of Ebola, a critical factor for early outbreak detection at the community level. Our findings can inform future Ebola response and recovery interventions, particularly those targeting community re-integration and a mitigation of the fear and stigma associated with survivorship.