Understanding the epidemiology of Brucella infection in urban and peri-urban populations of Lomé, Togo and a One Health approach to the control of
Lead Research Organisation:
London School of Hygiene & Tropical Medicine
Department Name: Epidemiology and Population Health
Abstract
...Brucellosis in this setting
West Africa has seen increasing migration from rural areas to urban settlements, which has resulted in changing dietary patterns and subsequent increases in dairy production in peri-urban areas. These small local dairy farms are poorly regulated resulting in potentially sub-optimal food safety standards.
Brucellosis is a bacterial disease transmitted to people through consumption of dairy products. Endemic zoonoses such as Brucellosis act as poverty promoters in poor agricultural settings globally. They do this through two modes of action: disease of livestock keepers in contact with animals and those in the community exposed to contaminated animal products (including milk and dairy products), and through decreased productivity of affected animals. Brucellosis presents as a febrile disease in humans with non-specific signs. As such it is likely to go underdiagnosed, as well as being frequently misdiagnosed as malaria or typhoid fever. This is partly due to similarity in generic symptoms and signs, and partly due to limited diagnostic capabilities locally. Brucellosis can go on to produce debilitating chronic disease and sometimes severe complications. Surveillance and reporting for Brucellosis in Sub-Saharan Africa is very limited and as such there is currently little knowledge of its prevalence and risk factors in these communities. A study testing peri-urban dairy herds for Brucellosis around Lomé in Togo has shown a high herd prevalence of Brucellosis. It is hypothesised that there is a consequent burden of the disease in the local human population. Surveillance, livestock movement control, local elimination campaigns and vaccination are the main means of Brucellosis control in sub-Saharan Africa. Outside southern Africa there has been little implementation of these control measures. Modelling studies of mass livestock vaccination programmes in other regions have found vaccination of cattle, sheep and goats to have positive economic and health benefits.
The aim of the project is to use a 'One Health' approach to further elucidate the epidemiology of Brucellosis in urban and peri-urban human populations in Lomé, Togo in order to identify risk factors for transmission from animals to humans, and to investigate the impact of disease control measures applied to the livestock population through the use of mathematical models. The project will be embedded in a larger multi-disciplinary programme of work to "establish multisectoral Brucellosis control in West and Central Africa" funded through the Zoonoses and Emerging Livestock Systems (ZELS) consortium.
The project will comprise of four studies, the first of which is a large serosurvey in the urban and peri-urban population to establish seroprevalence and risk factors for disease. Age-specific prevalences will be used to develop a mathematical model of disease transmission and estimate the incidence of infection. A further serosurvey will be conducted in those occupationally exposed through contact with livestock in the Lomé area, to investigate risk factors associated with disease in a high-risk population. In parallel to these studies, I will examine the dairy supply chain to outline the flow of products and activities along each pathway in the dairy system, with particular focus on practices associated with increased disease transmission to assess foodborne risk. Finally, I will produce a mathematical model, which will utilise data obtained from the earlier studies and from a larger livestock study in the region. This will examine the impacts on human disease of different livestock-based vaccination schemes.
This project will generate knowledge about the epidemiology of Brucellosis in an urban low-income setting where data is sparse and resources scarce, to support policymakers in making informed decisions on control, and inform healthcare workers on its diagnosis and treatment, to improve the livelihoods and food security of people i
West Africa has seen increasing migration from rural areas to urban settlements, which has resulted in changing dietary patterns and subsequent increases in dairy production in peri-urban areas. These small local dairy farms are poorly regulated resulting in potentially sub-optimal food safety standards.
Brucellosis is a bacterial disease transmitted to people through consumption of dairy products. Endemic zoonoses such as Brucellosis act as poverty promoters in poor agricultural settings globally. They do this through two modes of action: disease of livestock keepers in contact with animals and those in the community exposed to contaminated animal products (including milk and dairy products), and through decreased productivity of affected animals. Brucellosis presents as a febrile disease in humans with non-specific signs. As such it is likely to go underdiagnosed, as well as being frequently misdiagnosed as malaria or typhoid fever. This is partly due to similarity in generic symptoms and signs, and partly due to limited diagnostic capabilities locally. Brucellosis can go on to produce debilitating chronic disease and sometimes severe complications. Surveillance and reporting for Brucellosis in Sub-Saharan Africa is very limited and as such there is currently little knowledge of its prevalence and risk factors in these communities. A study testing peri-urban dairy herds for Brucellosis around Lomé in Togo has shown a high herd prevalence of Brucellosis. It is hypothesised that there is a consequent burden of the disease in the local human population. Surveillance, livestock movement control, local elimination campaigns and vaccination are the main means of Brucellosis control in sub-Saharan Africa. Outside southern Africa there has been little implementation of these control measures. Modelling studies of mass livestock vaccination programmes in other regions have found vaccination of cattle, sheep and goats to have positive economic and health benefits.
The aim of the project is to use a 'One Health' approach to further elucidate the epidemiology of Brucellosis in urban and peri-urban human populations in Lomé, Togo in order to identify risk factors for transmission from animals to humans, and to investigate the impact of disease control measures applied to the livestock population through the use of mathematical models. The project will be embedded in a larger multi-disciplinary programme of work to "establish multisectoral Brucellosis control in West and Central Africa" funded through the Zoonoses and Emerging Livestock Systems (ZELS) consortium.
The project will comprise of four studies, the first of which is a large serosurvey in the urban and peri-urban population to establish seroprevalence and risk factors for disease. Age-specific prevalences will be used to develop a mathematical model of disease transmission and estimate the incidence of infection. A further serosurvey will be conducted in those occupationally exposed through contact with livestock in the Lomé area, to investigate risk factors associated with disease in a high-risk population. In parallel to these studies, I will examine the dairy supply chain to outline the flow of products and activities along each pathway in the dairy system, with particular focus on practices associated with increased disease transmission to assess foodborne risk. Finally, I will produce a mathematical model, which will utilise data obtained from the earlier studies and from a larger livestock study in the region. This will examine the impacts on human disease of different livestock-based vaccination schemes.
This project will generate knowledge about the epidemiology of Brucellosis in an urban low-income setting where data is sparse and resources scarce, to support policymakers in making informed decisions on control, and inform healthcare workers on its diagnosis and treatment, to improve the livelihoods and food security of people i