The Role of Veterinary and
Medical Personnel in the Control
of Zoonoses in Urban Settlements
on the Shores of Lake Victoria,
Kenya.
Kanyari, PWN, Department of VPM&P,
Faculty of Veterinary Medicine, University of
Nairobi, Kenya
Kagira JM, IPR, Nairobi, Kenya.
Presented at the Association of Institutes of
Tropical Veteriary Medicine Conference,
Bangkok, Thailand in 23rd-26th August 2010.
Introduction
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Zoonoses are diseases transmitted
between man and animals directly or
indirectly as for rabies and cystercosis
respectively.
In developing countries, rapid urbanization
and the close interaction between man and
animals has been implicated in the
emergence and spread of zoonoses.
This is more so for populations living in the
slum areas with compromised sanitation.
Introduction-continued
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This is further complicated by the fact that,
such populations are usually high and lack
adequate medical facilities for disease
diagnosis and management
Additionally, there is little interaction
between medical and veterinary personnel
in knowledge sharing to control these
zoonoses.
This study was done to establish the roles
played by the two professionals in
zoonoses management.
Materials and Methods
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The study was conducted within Kisumu
municipality with a population of 500,000;
60% of these live in slums.
These areas have a low human
development index characterised by poor
sanitation, infrastructure and health facilties
and also a high level of poverty.
These communities keep and interact with
domestic ruminants, donkeys, pigs, poultry
and also dogs and cats.
KISUMU CITY
Materials and Methods-Continued
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Study Design:
A questionnaire designed in line with that by
Grant and Olsen(1999) was conducted
among the Medical and Veterinary
personnel involved in service provision in
Kisumu Municipality.
The questions required the frequency and
types of zoonoses encountered, animals
with the highest risks, advice offered to the
patients, role played by different disciplines
and communication between disciplines.
Data Analysis
◆ Data
was entered into Ms Excel data
sheets and then exported to Ms Statview®
for analysis.
◆ Frequency data were analyzed using likelihood ratio chi-square to compare
responses of the two types of personnel.
◆ A p-value of less than 0.05 was considered
to be significant
.
Results
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The veterinary personnel who participated were
15 and 9 for human physicians.
Zoonoses cases were observed by both the
veterinary and medical personnel
Veterinary personnel reported the following
zoonoses from cattle: Cysticercosis (10/15),
Hydatidosis (8/15), Rabies (10/15), Brucellosis
(6/15), Anthrax (2/15), Tetanus (1/15),
Dermatophytosis (1/15), Colibacillosis (1/15)
and Salmonellosis (1/15)
.
Results-Continued
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From small ruminants, Veterinarians reported:
Hydatidosis (3/15), Rabies (2/15), Tapeworms
(2/15), Mycobacteriosis (1/15), Tetanus (1/15),
and Colibacillosis (1/15).
From pigs, anthrax was the only zoonoses
recorded as having been observed by the
Veterinarians (3/15).
All the Veterinarians indicated that the most
common zoonosis in dogs was rabies.
.
Results-Continued
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Other zoonoses in dogs, were dermatophytosis,
tapeworms, hookworms, colibacillosis and
salmonellosis.
The Physicians observed among human
patients:Hydatidosis (2/9), Brucellosis (5/9),
Toxoplasmosis (3/9), Rabies (4/9), Anthrax
(1/9), Ticks (2/9), Hookworms (1/9),
Pneumocytis carinii pneumonia (1/9),
Bronchitis (1/9).
Overall, the veterinary personnel significantly
(p=0.04) encountered the more zoonoses cases
compared to the human physicians.
Results-Continued
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The animals with the highest risks according to
the veterinarians were dogs and for physicians it
was the cattle.
There was a significant difference (p<0.05) in
the proportion of veterinary and medical
personnel who considered cattle and chicken to
be of high risks.
Physicians highlighted the following as
important responsibilities for vets: general
maintenance of animal health, screening for
zoonoses in animals, zoonoses education for
patients and consulting physicians.
Results-Continued
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Veterinary personnel either sought or gave
advice to human physicians on rare occasions
(47%).
Human physicians had sought (11%) or rarely
give (22%) advice to veterinary personnel.
Only the veterinary personnel (47%) were
aware of existence of official communication
between veterinary and medical offices; and this
was only in cases of rabies control.
Discussion
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This study has for the first time documented the
veterinary and medical perceptions on the
occurrence and control of zoonoses in an urban
locality in Kenya. The findings here could be
quite representative of other urban dwellings in
the region.
Practicing graduate vets were fewer than
human physicians. Urban livestock keeping is
important in this town and considering the
critical role played by vets in animal and public
health, deployment of more vets is emperative
to impart effectively in the disease control.
Discussion-Continued
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The veterinarians were widely involved in meat
inspection hence were more familiar with
diseases such as bovine cysticercosis and
hydatidosis compared to the physicians.
Kenya reports high prevalences of cysticercosis
and hydatidosis in such rural areas as Narok
and Turkana (Onyango-Abuje 1996; Ndirangu
2001).
Epidemiological determination of these diseases
in Kisumu and other urban centres would help
in devising effective control strategies and
reduce human infections some of which can be
Discussion-Continued
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Physicians ranked cattle as the highest zoonoses
risks, possibly presumming them to be main
reservoirs of brucellosis.
Due to the high occurence of dog bites, and
possibly rabies in Kisumu, dogs were also
ranked high by both the veterinary and medical
personnel
In contrast to a significant proportion of
physicians who indicated that chicken could be
of high zoonoses risk, all the veterinarians
indicated that chicken were of low zoonosis
Discussion-Continued
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Chicken have been associated with zoonoses
such as toxoplasmosis, salmonellosis and
bronchitis pneumonia (Trevejo et al. 2005;
Dubey et al. 2005).
This study supports recent calls for interdisciplinary discussions and collaborative
ventures in control of zoonoses through the
“One health, One medicine” approach (Cripps
2000; WHO 2007).
This call which should be emphasized and upscaled for wider appreciation.
Acknowledgement
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The authors are very grateful to Lake Victoria
Research Initiative (VicRes) for providing
financial support to carry out the study.
We also highly appreciate the CTA Office for
International Cooperation[BIC], Utrecht for
covering the cost of Travel and
Accommodation.
◆ Thank
you for your attention