Detection of Highly Pathogenic Avian Influenza outbreak using participatory epidemiology techniques...

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Presented by Tinuke Ahamed at the PENAPH First Technical Workshop, Chiangmai, Thailand, 11 – 13 December 2012.

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Dr Tinuke Ahamed

(Resident) Nigeria Field Epidemiology and Laboratory Training Program

Paper presented at PENAPH first international workshop,

Chiang Mai ,Thailand

11-13 Dec.2012

Outline � Introduction

� Methodology

� Study area

� Sampling and sampling technique

� Data collection and management

� Results

� Conclusion/Discussion

2

Introduction � outbreak of highly pathogenic Avian Influenza (HPAI)

first reported in Nigeria’s Kaduna state in February 2006.

� Nigeria is the most populous country in Africa and is home to about 175 million domestic poultry.

� Poultry production system in Nigeria is both extensive and intensive.

3

Introduction � The extensive system consists of the vast majority of

poultry (>143 million) are free ranging birds in rural area

� Reported outbreaks in Nigeria occurred

� in the semi-commercial/ commercial operations.

� backyard poultry production units in urban and peri-urban areas

� no reported spread into the surrounding rural areas

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Introduction � Risk of transmission is very high

� Few large commercial farms have adequate bio-security measures.

� Nigerian Government formed a national steering committee to implement strategies to control the spread of the disease

� Despite the control strategies at national and state levels, the disease continued to spread

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Introduction � Attributed to weaknesses in existing disease

surveillance system for early detection of the disease and poor reporting from rural areas.

� Participatory Epidemiology

� approach to disease investigation in rural areas

� uses community participation

� gives stakeholders a role in disease identification and shaping control programs.

6

Introduction � Study was conducted to identify possible undetected

HPAI outbreaks using participatory epidemiology (PE) techniques in villages in Niger state.

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Methodology � Study area: Niger state

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Methodology � North West zone of Nigeria

� 25 Local Government Areas.

� human population of approximately 3,954,772

� area of 73,363 Km2.

� Livestock population

� Cattle -2 million

� Sheep -2.1million

� Goat -2.6million

� Poultry - 6million

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Methodology � Sampling and sampling technique

� A village represents a sampling unit.

� multi-stage sampling was used

� 4 LGA were selected from the 25 LGAs

� 30 villages were selected randomly

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Methodology � Data collection

� Focus group discussions (FGD) involving at least 8 people were conducted using the local language

� guided by a check list of open ended questions

� Information was collected on perceived importance and prevalence of Livestock and livestock diseases

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Methodology � The primary focus was on poultry diseases that

occurred in the village over the past one year.

� The prevalence of villages with suspected HPAI outbreaks was determined using matrix scoring techniques

� The scoring exercises utilized 100 and 30 beans.

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Methodology � livestock species kept in the village were scored based on

number and importance to family income

� List of signs of disease were given instead of diseases hence matrix scoring for diseases was difficult.

� With probing, 2 types of mortalities were established

� matrix scoring was carried out for the 2 types of mortality against a standardized case definition for HPAI

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Methodology � HPAI case definition

� sudden death (1-12hrs);

� rapidly increasing mortality

� observation of other clinical signs

� swollen head,

� difficulty in breathing,

� diarrhea,

� hemorrhagic shanks

� absence before 2006

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RESULTS � livestock species kept

� Cattle,

� sheep

� goats

� chickens

� Duck

� guinea fowl

� turkey

� pigeons

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Livestock

species

Number

Median

Percentiles

10th

90th

Cattle

Sheep

Goats

Chicken

Duck &others

10

12

15.5

47

13

7

10

11.9

36.7

4

16

20.1

23.1

54.4

19

Table 1 Median scores and their respective percentiles as a result of ranking livestock species kept in

villages in Niger state by number (n =30)

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Table 2: Contribution of Animals kept to Family Income- Simple Ranking. Note: 1 is

most important, 8 is the least important.

Livestock species kept Average scores

Cattle

Sheep

Goats

Chickens

Ducks

Guinea fowl

Turkey

pigeon

1.5

2.8

3.6

2.1

5.5

6.5

6.1

7.9

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RESULTS � No active outbreaks of HPAI were identified during

the fieldwork.

� Some past probable outbreaks that fit the case definition for HPAI were recorded in 16 of the 30 (53%) villages visited.

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RESULTS

Table 3: Matrix scoring - association of clinical signs with mortality(Probable positive for HPAI)

Death in 1-12 hrs 3 27 0

Did not occur before 2006 0 30 0

Blue/black head

0 30 0

Popoi Swollen head 7 15 8

Difficulty in breathing 12 18 0

Diarrhea 22 8 0

Twisting of head 30 0 0

Pox 0 0 30

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RESULTS Table 4: Matrix scoring - association of clinical signs with mortality(HPAI negative)

Sudden death (without symptoms) 30 0 0

Death in 1-12 hrs 30 0 0

Did not occur before 2006 0 0 0

Blue/black head 24 0 6

Gusasai Swollen head 21 0 9

Difficulty in breathing 23 0 7

Diarrhea 24 0 6

Twisting of head 30 0 0

Pox 0 0 30

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Conclusion/Discussion � Probable outbreaks of HPAI were detected in selected

villages in Niger state using PE techniques.

� PE techniques modified for surveillance purposes is an effective means to detect animal diseases in rural areas where conventional surveillance methods are limited.

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� Early identification of zoonotic diseases in animals, such as HPAI, would provide information for early prevention of human disease.

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Acknowledgement � Dr Enoch Edoh – Ministry of Agriculture, Minna,

Niger state

� International Livestock Research Institute, Ibadan

� Federal Ministry of Agriculture, Abuja

� Nigeria Field Epidemiology and Laboratory Training Program, Abuja

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THANK YOU FOR

LISTENING

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