Implementation of the One Health approach to fight arbovirus infections in the Mediterranean and Black Sea Region: Assessing integrated surveillance in Serbia, Tunisia and Georgia

Abstract

BackgroundIn the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter‐sectoral collaboration; however, no standardized methodology exists to study One Health surveillance.MethodsWe designed a situation analysis study to document how integration of laboratory/clinical human, animal and entomological surveillance of arboviruses was being implemented in the Region. We applied a framework designed to assess three levels of integration: policy/institutional, data collection/data analysis and dissemination. We tested the use of Business Process Modelling Notation (BPMN) to graphically present evidence of inter‐sectoral integration.ResultsSerbia, Tunisia and Georgia participated in the study. West Nile Virus surveillance was analysed in Serbia and Tunisia, Crimea‐Congo Haemorrhagic Fever surveillance in Georgia. Our framework enabled a standardized analysis of One Health surveillance integration, and BPMN was easily understandable and conducive to detailed discussions among different actors/institutions. In all countries, we observed integration across sectors and levels except in data collection and data analysis. Data collection was interoperable only in Georgia without integrated analysis. In all countries, surveillance was mainly oriented towards outbreak response, triggered by an index human case.DiscussionThe three surveillance systems we observed prove that integrated surveillance can be operationalized with a diverse spectrum of options. However, in all countries, the integrated use of data for early warning and inter‐sectoral priority setting is pioneeristic. We also noted that early warning before human case occurrence is recurrently not operationally prioritized.

Türkiye’de Kırım Kongo Kanamalı Ateşi Hastalığının Güncel ve Gelecekteki Etkileri

“…Since CCHFV possesses a zoonotic behaviour, it is an excellent subject to establish a one health initiative-based campaign, which requires multidisciplinary collaborative studies including human and veterinary medicine and other related disciplines. Because of the lack of the effective prophylactic vaccine and limited treatment facilities, it is essential to implement all possible protective measures to prevent and control future outbreaks [21] . Implementation of one health disease surveillance and interdisciplinary actions investigating circulation of CCHFVs in ticks, wild animals and livestock by well-designed molecular epidemiologic studies in both disease endemic and potentially endemic areas in Turkey will lead to quicker disease recognition, efficient outbreak response and disease control.…”

“…Since CCHFV infection is presented by a complex cycle that includes both human and several vertebrate host and tick vector, a collaborative action involving multiple disciplines, particularly human and veterinary medicine, based on the one health initiative is extremely important to combat the disease [21] . One health initiative to deal with this pathogen is extremely important, not only in Turkey, but also for all disease endemic and potentially endemic regions in the world.…”

Integrated Early Warning Surveillance: Achilles′ Heel of One Health?

“…The OH approach is promising in terms of surveillance and control of vector-borne diseases (VBDs) because it makes use of trans-disciplinary cooperation at the human-animal-ecosystem interfaces [8,9]. Among VBDs, arboviruses have complex life cycles involving both human and animal hosts and, being transmitted by arthropod vectors, are closely linked to environmental and climatic conditions [10].…”

“…With limitations, integrated surveillance ("One Health surveillance describes the systematic collection, validation, analysis, interpretation of data and dissemination of information collected on humans, animals and the environment to inform decisions for more effective, evidence-and system-based health interventions" [9]) systems for arbovirus infections have been implemented in a number of countries [8,15,16]. It appears, however, that in the majority of the countries, even when the different sectors involved (i.e., human, animal, entomological, and environmental) collect surveillance data, rarely is this information shared in a timely manner between sectors to prevent outbreaks.…”

“…This subject is crucial in the networking project named MediLabSecure (MLS), which involves 22 non-EU countries of the Mediterranean, Black Sea, and Sahel regions [34]. The network is focused on strengthening integrated surveillance of arbovirus infections, given that the use of early warning data is still considered "pioneeristic" in the MLS region [8].…”