Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach

Abstract

To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.

Research priorities for control of zoonoses in South Africa

“…The Guinea study found that coordination, training, infrastructure, public awareness and research were the main gaps and challenges. 44 Although the methodology is similar that study was more systems focused; broadly speaking it shows an overlap with our research themes.…”

“… 43 Meanwhile, a health systems study for prevention and control of zoonoses in Guinea found rabies, anthrax, brucellosis, viral haemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza as the country's top priority zoonoses and used these zoonoses as case studies to evaluate existing processes for prevention and control. 44 In Ethiopia, rabies, anthrax, brucellosis, leptospirosis and echinococcosis were considered the top priorities, and that additional public health and veterinary laboratory enhancement, along with intersectoral (human and animal health) linkages, were needed. 38 A network mapping study in Jordan found that while there is informal communication and effective coordination across the Ministry of Health and Ministry of Agriculture in the event of the emergence of one of the priority zoonoses studied, routine formal coordination is lacking.…”

One Health, “Disease X” & the challenge of “Unknown” Unknowns

“…It is important to institutionalize these One Health linkages to ensure continuity and enable initiation of preparedness and response activities in a timely fashion when the next disease threat inevitably emerges. This need for improved communications across the multiple sectors of human, animal, environmental and economic well-being, has been highlighted as a major lacuna by multiple priority-setting exercises undertaken globally 44 45 .…”

Trypanosomiasis: Recent advances in strategies for control

“…Serological diagnosis indicative of schistosomiasis is connected to hypereosinophilia, approximately three weeks past the onset of the symptomatology [15]. Hypereosinophilia is characteristic of infection; however, there is a belated onset of eosinophilia in comparison to the outward show of symptoms [14].…”

“…Identification of the meiotic life cycle stage of Trypanosoma in the blood and lymphatic frameworks reveals side effects including irregular fever, lymphadenopathy, pruritus and specifi c profound agony vibrations. There is also an expression of slight neurological and hormone-related unsettling infl uences which are further indications of sensory system inclusion and, together with an extreme cerebral pain, this is a sign of transition to the second stage of the ailment [6,15]. Subsequently, sleep disorderliness affect circadian rhythms.…”