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Using participatory epidemiology tools to
investigate Contagious caprine
pleuropneumonia (CCPP) in Maasai flocks,
northern Tanzania
E. S.Swai & Neselle, M.O
Veterinary Investigation Centre, PO Box 1068, Arusha, Tanzania
Simanjiro Development Trust, Simanjro, Tanzania
Outline
• Introduction
• The disease
• Why the study
• Methodology
• Results
• Discussion
• Way forward
Introduction
• Goat production is widely
practised in Tanzania
• Play vital role but is poorly
recognized
• Majority 98% indigenous
stock and only 2% graded
• Current estimates: (2012)
- 1.75mil HH ;
- 15 mill goats;
- Average per HH: 9
The disease: ccpp
• Oie listed
• Endemic in West and East
Africa, Middle East, as
well as in Pakistan and
India
• Caused by Mycoplasma
capricolum subspecies
capripneumoniae (Mccp)
• Officially confirmed in
Tanzania in 1998
Why disease occurrence?
• Weak veterinary
services
• Inadequate logistical
support
• Uncontrolled animal
movements
• Poor diagnostic
services
• Poor reporting and
surveillance system
• Lack of effective
vaccination program
Outbreaks
are
reported
frequently
due to:
39
38
27
20
18 18
16
14
13
12
10
8
5
3
2 2 2 2 2 2 2 2
1 1 1 1 1 1
0
5
10
15
20
25
30
35
40
45
ANAP
ECF
TRYPS
BAB
FMD
ND
RABIES
BQ
HW
CCPP
LSD
CBPP
HELMIN
ASF
BRUC
TB
F/POX
F/TYPH…
HS
MASTITIS
M/FEVER
P/EYE
ANTH
FOOT…
MANGE
PPR
SCOURS
S/MAN…
D i s t r i b u t i o n o f D i s e a s e s a s
r e p o r t e d b y t h e L G A s i n 2 0 0 8
Why participatory surveillance?
• Maintaining nation
wide surveillance
system is a challenge
• Partly attributed by:
– Large area and
remoteness
– Poor infrastructure
– Poor communication
– Limited, yet
unmotivated personnel
and financial resources
Study area
Arusha region, Tanzania
3 districts
• Ngorongoro (14,036km2)
•Monduli (7,345km2)
•Longido (8,234km2)
Two rain season
• Long ( March – May)
•short ( October-Dec )
Livestock species
• cattle, sheep, goats,
donkey
Population
• ethnic : Maasai
Methodology 1
• Focus group discussion
18 villages
14 informants group
7- 14 people
Majority : men
Ethnic : Maasai
• Probing
• direct observation
flock
environment
Methodology 2
• Semi-structured interviews
– Information on owners
– Information on livestock types
– Use of livestock
– Disease encountered
• Proportional piling
– Rank livestock by numbers
– Relative contribution to livelihood
Methodology 3
• Matrix score
– Perceived association with clinical signs
– Perceived association with risk factors
– Perceived disease impact
• Relative annual incidence estimate
– Time frame July 2006- June 2007
– Focus on CCPP
Priority disease scoring
• Listed disease and their local name
– CCPP (orkipie)
– Mange (emukuji)
– Heart water (ormilo)
– anthrax (engeeya nairowa)
– Pox (elomoroj)
Methodology 4
• Key informants interview
– local government officials
– Non-Gvt developmental officials
– Community animal health workers
– Village leaders
Data mgt and analysis
• Data base constructed in M Excel
• agreement between informant groups was
determined using the Kendal coefficient of
concordance (W) in the SPSS
• agreement was termed weak, moderate and
good if :
– W-values were <0.26,
– between 0.26 and 0.38 (P < 0.05)
– >0.38 (P < 0.01 to 0.001)
Proportional piling: mean proportions (%) indicating the
relative populations of the livestock species
Livestock
species
Ngorongoro
( n=8)
Monduli
(n=5)
Longido
( n=5)
Overall
(=18)
Mean ± SD Mean ± SD Mean ± SD Mean ± SD
Cattle 29.1 ± 7.1 31.2± 4.1 35.5± 6.5 31.9± 11.2
Sheep 34.1 ± 9.2 35.5± 4.9 33.1± 8.7 34.3± 13.2
Goat 26.6 ± 9.3 20.8± 5.9 24.3± 6.9 23.9± 7.8
Othera 10.3± 7.5 11.3± 4.8 7.9± 6.7 9.9± 6.4
a Other livestock species mentioned by participant were chicken, ducks, dogs and donkeys
n – The number of villages involved in the proportional piling exercises
Proportion perceived to have acquired the disease July
2006-June 2007
Exchange
16%
Food
32%
Manure
6%
Cultural
14%
Hide/skin
9%
Income
23%
Benefit derived from goats
Cattle
32%
Goats
36%
Sheep
32%
The mean (%) relative importance of livestock species as scored by
Maasai pastoralist based on livelihood derived from each species
Livestock
species
Ngorongoro
(n=8)
Monduli
(n=4)
Longido
(n=4)
Overall
(n=16)
Mean ± SD Mean ± SD Mean ± SD Mean ± SD
Cattle 46.9 ± 4.3 47.8± 6.5 48.5± 7.3 47.7±12.1
Sheep 21.9 ± 7.6 20.8 ± 12.4 19.7 ± 5.9 20.8 ± 10.0
Goat 26.2 ± 5.1 14.6 ± 5.4 16.4 ± 8.2 19.06 ± 8.3
Othera 8.0 ± 6.7 15.7 ± 12.8 13.6 ± 9.8 12.4 ± 10.7
a Other livestock species mentioned by participant were chicken, ducks, dogs and
donkeys
n – The number of villages involved in the proportional piling exercises
Mean scores (out of a total of 25 per clinical sign) derived from simple
matrices for five diseases of goats according to the level to which they
manifest selected clinical signs
Assigned scorea, Mean ± SDev
Clinical sign (n) W Mange CCPP Pox Anthrax H/water
Salivation (11) W = 0.62* 1.3 ± 4.2 11.4 ± 7.4 5.4 ± 8.2 4.4 ± 5.4 2.5 ± 4.6
Kids death (14) W= 0.36* 2.0 ± 3.0 8.2 ± 4.4 5.8 ± 6.3 5.0 ± 3.6 4.0 ± 3.5
Adult sudden death (13) W =0.68* 0.3 ± 1.1 6.5 ± 4.2 1.5 ± 2.2 12.5 ± 6.3 4.2 ± 3.5
Diarrhea (14) W =0.72** 0.9 ± 3.2 17.7 ± 9.0 2.9 ± 6.6 3.5 ± 7.1 0
Abortions (14) W = 0.35* 5.8 ± 3.9 7.1 ± 3.3 6.7 ± 3.1 0 5.4 ± 2.6
Purulent nasal mucous (12) W =0.78** 1.1 ± 3.8 13.8 ± 9.6 4.8 ± 8.3 3.8 ± 6.8 1.5 ± 3.3
Circling (14) W =0.75*** 0 0 0 2.2 ± 4.3 22.8 ± 4.3
Labored breathing(13) W =0.65** 0 17.3 ± 7.3 5.3 ± 7.6 0 2.4 ± 4.3
Coughing (13) W =0.80*** 0.9 ± 3.3 23.8 ± 3.4 0 0.3 ± 1.1 0
Skin lesion (13) W =0.83*** 12.0± 2.4 0 13.0 ± 1.4 0 0
a -The higher the score, the more strongly pastoralists associated that clinical sign with the given disease
W – Kendal coefficient of concordance (*p<0.05; **p< 0.01; ***p<0.001);
Mean scores (out of a total of 25 per risk factor) derived from simple
matrices showing five goat diseases with respect to their perceived
strength of association with predetermined risk factors
Assigned scorea, Mean ± SDev
Risk factor (n) W Mange CCPP Pox Anthrax H/water
Sharing pasture (13) W = 0.54* 3.4 ± 4.6 11.1 ± 3.2 7.1 ± 4.8 2.9 ± 3.4 0.5 ± 1.9
Floods (6) W= 0.33* 0.8 ± 1.3 7.4 ± 6.0 7.7 ± 9.4 4.3 ± 6.2 4.8 ± 10.0
Tsetse (4) W =0.38* 4.8 ± 3.5 0 2.8 ± 3.5 2.5 ± 5.0 14.9 ± 7.5
Contact (4) W =0.62** 6.8 ± 4.6 8.1 ± 6.8 7.2 ± 6.7 0.5 ± 3.0 2.5 ± 3.5
Heavy rains (11) W = 0.58* 2.6 ± 2.8 4.3 ± 4.5 6.4 ± 8.7 5.5 ± 7.4 6.2 ± 5.8
Ticks (13) W =0.78*** 0 0.7 ± 2.4 0.9 ± 3.0 0.9 ± 3.0 22.5 ± 5.9
Sharing water point (13) W =0.68** 1.8 ± 3.7 11.2 ± 2.4 7.4 ± 5.0 3.7 ± 4.9 0.9 ± 1.8
a -The higher the score, the more strongly pastoralists associated that risk factor with the given disease
W – Kendal coefficient of concordance (*p<0.05; **p< 0.01; ***p<0.001);
The mean annual relative incidence and case mortality rates due to
CCPP in goats as scored by flock keepers involved in the study(n =13)
District Interviewed groups
Mean annual relative incidence,
( with 10th and 90th percentile range)
Morbidity (%) Case mortality (%)*
Ngorongoro Group 5(n = 72 ) 34 (27.1, 46.7) 62.2(52.3,78.5)
Monduli Group 4(n = 46 ) 32(25.4, 39.6) 66.3(54.1,76.3)
Longido Group 4(n = 34) 29(19.5, 38.8) 55.8(42.7, 68.3)
Overall 13(n =152 ) 31.6 (24.4,46.7) 61.4(48.1,82.3)
n – the number of participants involved in the proportional piling exercises
* - Case mortality represents the animals scored as having died from the pile of those that
got CCPP
Limitation
• Logistic, laboratory capacity and time
constraints preclude:
– Detailed clinical examination
– Sample collection
– Constructing timeline
– Participatory mapping
Way forward
• PE & Local knowledge – could generate
disease information with least cost
• Integrating/institutionalization PE in the
national surveillance system
– Engagement of decision-makers
– Training of trainers
– Private service providers
• Up-scaling PE in SADC region
– Concept note in progress
Acknowledgements
• MLFD & Vet Aid:
– for financial &logistic support
• ILRI/PENAPH :
– for invitation and
– support to participate in this workshop
• Participating district staff
• Pastoralists:
– For resilience and cooperation
Thanks
END

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Using Participatory Tools to Investigate Contagious Caprine Pleuropneumonia (CCPP) in Tanzania

  • 1. Using participatory epidemiology tools to investigate Contagious caprine pleuropneumonia (CCPP) in Maasai flocks, northern Tanzania E. S.Swai & Neselle, M.O Veterinary Investigation Centre, PO Box 1068, Arusha, Tanzania Simanjiro Development Trust, Simanjro, Tanzania
  • 2. Outline • Introduction • The disease • Why the study • Methodology • Results • Discussion • Way forward
  • 3. Introduction • Goat production is widely practised in Tanzania • Play vital role but is poorly recognized • Majority 98% indigenous stock and only 2% graded • Current estimates: (2012) - 1.75mil HH ; - 15 mill goats; - Average per HH: 9
  • 4. The disease: ccpp • Oie listed • Endemic in West and East Africa, Middle East, as well as in Pakistan and India • Caused by Mycoplasma capricolum subspecies capripneumoniae (Mccp) • Officially confirmed in Tanzania in 1998
  • 5. Why disease occurrence? • Weak veterinary services • Inadequate logistical support • Uncontrolled animal movements • Poor diagnostic services • Poor reporting and surveillance system • Lack of effective vaccination program Outbreaks are reported frequently due to: 39 38 27 20 18 18 16 14 13 12 10 8 5 3 2 2 2 2 2 2 2 2 1 1 1 1 1 1 0 5 10 15 20 25 30 35 40 45 ANAP ECF TRYPS BAB FMD ND RABIES BQ HW CCPP LSD CBPP HELMIN ASF BRUC TB F/POX F/TYPH… HS MASTITIS M/FEVER P/EYE ANTH FOOT… MANGE PPR SCOURS S/MAN… D i s t r i b u t i o n o f D i s e a s e s a s r e p o r t e d b y t h e L G A s i n 2 0 0 8
  • 6. Why participatory surveillance? • Maintaining nation wide surveillance system is a challenge • Partly attributed by: – Large area and remoteness – Poor infrastructure – Poor communication – Limited, yet unmotivated personnel and financial resources
  • 7. Study area Arusha region, Tanzania 3 districts • Ngorongoro (14,036km2) •Monduli (7,345km2) •Longido (8,234km2) Two rain season • Long ( March – May) •short ( October-Dec ) Livestock species • cattle, sheep, goats, donkey Population • ethnic : Maasai
  • 8. Methodology 1 • Focus group discussion 18 villages 14 informants group 7- 14 people Majority : men Ethnic : Maasai • Probing • direct observation flock environment
  • 9. Methodology 2 • Semi-structured interviews – Information on owners – Information on livestock types – Use of livestock – Disease encountered • Proportional piling – Rank livestock by numbers – Relative contribution to livelihood
  • 10. Methodology 3 • Matrix score – Perceived association with clinical signs – Perceived association with risk factors – Perceived disease impact • Relative annual incidence estimate – Time frame July 2006- June 2007 – Focus on CCPP
  • 11. Priority disease scoring • Listed disease and their local name – CCPP (orkipie) – Mange (emukuji) – Heart water (ormilo) – anthrax (engeeya nairowa) – Pox (elomoroj)
  • 12. Methodology 4 • Key informants interview – local government officials – Non-Gvt developmental officials – Community animal health workers – Village leaders
  • 13. Data mgt and analysis • Data base constructed in M Excel • agreement between informant groups was determined using the Kendal coefficient of concordance (W) in the SPSS • agreement was termed weak, moderate and good if : – W-values were <0.26, – between 0.26 and 0.38 (P < 0.05) – >0.38 (P < 0.01 to 0.001)
  • 14. Proportional piling: mean proportions (%) indicating the relative populations of the livestock species Livestock species Ngorongoro ( n=8) Monduli (n=5) Longido ( n=5) Overall (=18) Mean ± SD Mean ± SD Mean ± SD Mean ± SD Cattle 29.1 ± 7.1 31.2± 4.1 35.5± 6.5 31.9± 11.2 Sheep 34.1 ± 9.2 35.5± 4.9 33.1± 8.7 34.3± 13.2 Goat 26.6 ± 9.3 20.8± 5.9 24.3± 6.9 23.9± 7.8 Othera 10.3± 7.5 11.3± 4.8 7.9± 6.7 9.9± 6.4 a Other livestock species mentioned by participant were chicken, ducks, dogs and donkeys n – The number of villages involved in the proportional piling exercises
  • 15. Proportion perceived to have acquired the disease July 2006-June 2007 Exchange 16% Food 32% Manure 6% Cultural 14% Hide/skin 9% Income 23% Benefit derived from goats Cattle 32% Goats 36% Sheep 32%
  • 16. The mean (%) relative importance of livestock species as scored by Maasai pastoralist based on livelihood derived from each species Livestock species Ngorongoro (n=8) Monduli (n=4) Longido (n=4) Overall (n=16) Mean ± SD Mean ± SD Mean ± SD Mean ± SD Cattle 46.9 ± 4.3 47.8± 6.5 48.5± 7.3 47.7±12.1 Sheep 21.9 ± 7.6 20.8 ± 12.4 19.7 ± 5.9 20.8 ± 10.0 Goat 26.2 ± 5.1 14.6 ± 5.4 16.4 ± 8.2 19.06 ± 8.3 Othera 8.0 ± 6.7 15.7 ± 12.8 13.6 ± 9.8 12.4 ± 10.7 a Other livestock species mentioned by participant were chicken, ducks, dogs and donkeys n – The number of villages involved in the proportional piling exercises
  • 17. Mean scores (out of a total of 25 per clinical sign) derived from simple matrices for five diseases of goats according to the level to which they manifest selected clinical signs Assigned scorea, Mean ± SDev Clinical sign (n) W Mange CCPP Pox Anthrax H/water Salivation (11) W = 0.62* 1.3 ± 4.2 11.4 ± 7.4 5.4 ± 8.2 4.4 ± 5.4 2.5 ± 4.6 Kids death (14) W= 0.36* 2.0 ± 3.0 8.2 ± 4.4 5.8 ± 6.3 5.0 ± 3.6 4.0 ± 3.5 Adult sudden death (13) W =0.68* 0.3 ± 1.1 6.5 ± 4.2 1.5 ± 2.2 12.5 ± 6.3 4.2 ± 3.5 Diarrhea (14) W =0.72** 0.9 ± 3.2 17.7 ± 9.0 2.9 ± 6.6 3.5 ± 7.1 0 Abortions (14) W = 0.35* 5.8 ± 3.9 7.1 ± 3.3 6.7 ± 3.1 0 5.4 ± 2.6 Purulent nasal mucous (12) W =0.78** 1.1 ± 3.8 13.8 ± 9.6 4.8 ± 8.3 3.8 ± 6.8 1.5 ± 3.3 Circling (14) W =0.75*** 0 0 0 2.2 ± 4.3 22.8 ± 4.3 Labored breathing(13) W =0.65** 0 17.3 ± 7.3 5.3 ± 7.6 0 2.4 ± 4.3 Coughing (13) W =0.80*** 0.9 ± 3.3 23.8 ± 3.4 0 0.3 ± 1.1 0 Skin lesion (13) W =0.83*** 12.0± 2.4 0 13.0 ± 1.4 0 0 a -The higher the score, the more strongly pastoralists associated that clinical sign with the given disease W – Kendal coefficient of concordance (*p<0.05; **p< 0.01; ***p<0.001);
  • 18. Mean scores (out of a total of 25 per risk factor) derived from simple matrices showing five goat diseases with respect to their perceived strength of association with predetermined risk factors Assigned scorea, Mean ± SDev Risk factor (n) W Mange CCPP Pox Anthrax H/water Sharing pasture (13) W = 0.54* 3.4 ± 4.6 11.1 ± 3.2 7.1 ± 4.8 2.9 ± 3.4 0.5 ± 1.9 Floods (6) W= 0.33* 0.8 ± 1.3 7.4 ± 6.0 7.7 ± 9.4 4.3 ± 6.2 4.8 ± 10.0 Tsetse (4) W =0.38* 4.8 ± 3.5 0 2.8 ± 3.5 2.5 ± 5.0 14.9 ± 7.5 Contact (4) W =0.62** 6.8 ± 4.6 8.1 ± 6.8 7.2 ± 6.7 0.5 ± 3.0 2.5 ± 3.5 Heavy rains (11) W = 0.58* 2.6 ± 2.8 4.3 ± 4.5 6.4 ± 8.7 5.5 ± 7.4 6.2 ± 5.8 Ticks (13) W =0.78*** 0 0.7 ± 2.4 0.9 ± 3.0 0.9 ± 3.0 22.5 ± 5.9 Sharing water point (13) W =0.68** 1.8 ± 3.7 11.2 ± 2.4 7.4 ± 5.0 3.7 ± 4.9 0.9 ± 1.8 a -The higher the score, the more strongly pastoralists associated that risk factor with the given disease W – Kendal coefficient of concordance (*p<0.05; **p< 0.01; ***p<0.001);
  • 19. The mean annual relative incidence and case mortality rates due to CCPP in goats as scored by flock keepers involved in the study(n =13) District Interviewed groups Mean annual relative incidence, ( with 10th and 90th percentile range) Morbidity (%) Case mortality (%)* Ngorongoro Group 5(n = 72 ) 34 (27.1, 46.7) 62.2(52.3,78.5) Monduli Group 4(n = 46 ) 32(25.4, 39.6) 66.3(54.1,76.3) Longido Group 4(n = 34) 29(19.5, 38.8) 55.8(42.7, 68.3) Overall 13(n =152 ) 31.6 (24.4,46.7) 61.4(48.1,82.3) n – the number of participants involved in the proportional piling exercises * - Case mortality represents the animals scored as having died from the pile of those that got CCPP
  • 20. Limitation • Logistic, laboratory capacity and time constraints preclude: – Detailed clinical examination – Sample collection – Constructing timeline – Participatory mapping
  • 21. Way forward • PE & Local knowledge – could generate disease information with least cost • Integrating/institutionalization PE in the national surveillance system – Engagement of decision-makers – Training of trainers – Private service providers • Up-scaling PE in SADC region – Concept note in progress
  • 22. Acknowledgements • MLFD & Vet Aid: – for financial &logistic support • ILRI/PENAPH : – for invitation and – support to participate in this workshop • Participating district staff • Pastoralists: – For resilience and cooperation