Rift Valley fever (RVF) is a viral, vector borne zoonosis that has significant threat to livestock health and production and public health in Africa. Recent outbreaks have led to high livestock mortalities and human morbidity and socio economic impacts in Garissa. To assess the level of knowledge of pastoralists to causation and transmission risk factors and describe their attitude and practices in response to RVF outbreaks and management in the context of climate change shocks. To estimate the livelihood losses and burden impacts in Garissa. A population based cross sectional household survey was conducted in March 2012 and March 2013 in four hotspots. A multistage purposive sampling was used to identify 250 participants who included pastoralists, veterinary and medical personnel and livestock traders. KAP evaluation was by questionnaires in depth key informant interviews and focus group discussions. Participatory rural appraisal tools were used to assess the economic significance of the RVF outbreaks, risk factors and management costs. 185 respondents (74%) had good knowledge of RVF (symptoms scored >50%) and risk factor analysis indicated > 150 (60%) understood the consumption of meat of dead or infected animal, milk, touching aborted foetuses caused disease. Estimated lost revenue due to closure of livestock markets and bans was over Ksh.3 billion. Intervention costs and burden of the outbreaks is discussed. There is good knowledge and attitude on RVF risk, transmission and control. It re-emergence is associated with negative impacts on livelihoods and economic endpoints in Garissa.

1. Rift Valley Fever : Socio-Economics and Burden
Impact using Knowledge Attitude and Practices in
Garissa, Kenya
Presented at KVA Scientific Conference at Boma Hotel, Eldoret 25th
April 2014
Nanyingi M O, Thumbi S M, Muchemi G M, Rashid I M, Bett B, Kiama S G and
Njenga K

2. History, Etiology and Epidemiology
Montgomery , 1912, Daubney 1931, Davies 1975, Jost et al., 2010
 RVF viral zoonosis of cyclic
occurrence(5-10yrs), described In
Kenya in 1912 isolated in 1931 in
sheep with hepatic necrosis and
fatal abortions.
 RVFV is an OIE transboundary
high impact pathogen and CDC
category A select agent.
Etiology: Phlebovirus in
Bunyaviridae (Family).
 Genome: tripartite RNA segments
designated large (L), medium (M),
and small (S) contained in a
spherical (80–120 nm in diameter)
lipid bilayer.
 Risk factors:
Precipitation: > 600mm, flooding
Altitude: <1100masl
Vector +: Aedes, culicines spp
NDVI: 0.1 units > 3 months
Soil : Solonetz, Solanchaks,
planosols
 Historical Outbreaks
 Epidemics in Africa and recently
Arabian Peninsula; in Egypt (1977),
Kenya (1997–1998, 2006-2007),
Saudi Arabia (2000–2001) and
Yemen (2000–2001), Sudan (2007)
and Mauritania (2010)

3. Research Objectives
 To assess the level of knowledge of pastoralists to
causation and transmission risk factors of RVF
occurrence in Garissa.
 To evaluate their attitude and practices in response
to RVF outbreaks and management in the context of
climate change shocks.
 To estimate the socioeconomic, livelihood losses
and burden impacts of Rift Valley Fever in Garissa
during the recent outbreak of 2006-2007.

4. Justification
 Economic and Public Health significance
There is significant impact on livestock and public health
leading due to morbidity, mortality with interventional costs
estimated at Ksh. 5 billion in Kenya.
Trade and Phytosanitary (SPS) barriers.
Recent RVF outbreaks in the Horn of Africa have led to decline
of 2.3% of potential marketed value of cattle and 1% decline in
the value of dairy and goat/sheep production and a 1% decline
in the overall value of meat. Consequent export market bans to
the EU and ME.

5. Kenya: RVF Geographical Distribution 2006 -2007
 Geographical coverage:
29 districts > 85% in
Garissa, Kilifi, Baringo, Ijara
 Livestock: Mortality of $10
Million
Human: 700 cases, 158
deaths.
3.4 DALYs per 1000 people
Household costs of $10 for
human cases
Munyua et al., 2010, Data source: DVS 2014

6. Research Methodology: Study Area and Design
 Garissa: 33,620km2
,
623,060 persons, 1,358,007
Livestock.
 Climate: Rainfall Bimodal
- MAM, OND annual av.
<300-600 mm, Diurnal T°
<20- 38°C Altitude 70- 400 m
asl
Historical OutbreakS:
Epidemics in 1997–1998,
2006-2007)
 Criteria: 2006-2007 village
hotspots, high pop. density,
urbanization, transhumance
corridors

7. Study Design and Approach
 Target population: Pastoralists within 2km radius of RVF “hotspot;
Kept livestock > 10yrs and present during the last outbreak.
 Community based cross-sectional household survey (March 2012 &
2013): Bulla unit of sampling(10-15 households) & clustering of
humans
Probability proportionate to size approach every tenth household in a
division
 Multistage sampling: consenting individuals aged ≥ 18 years living
in the study area for >1 year prior to study.
 Segregation according to occupation, age, gender level of education
and the duration of stay.
 Geomapping of 30 selected households households & recruitment
250 participants *(Pastoralists,Livestock traders/brokers,)
Dohoo et al., 2003).

8. Research tools and Participatory Rural Approaches
 Structured Questionnaires: 25 pretested for consistence and
validity in 20 households.
 Key Informant Interviews: in-depth face to face interviews to
selected participants for experience and expert opinion
(pastoralists, veterinary and health personnel).
 Focus Group Discussions: 30 participants (20 men/10
women), 5 participants per FGD for 30 mins
 Matrix and pair wise ranking and scoring: Listing of livestock
diseases.
 Transect walks and triangulation at livestock markets,
watering points

9. Economic model for Value chain Impacts
Adapted from Rich and Wanyoike 2010

10. Data Analysis
 Bivariate analysis was performed to explore associations
between overall knowledge and independent variables such as
age, sex, marital status, education and occupation.
 Associations were considered to be statistically significant if
they achieved a p < 0.05.
 Logistic regression models were fitted to estimate
independent associations between subscale knowledge and
predictor variables
 Livelihood analysis for value chain by disruption of livestock
markets and livelihood adaptation/diversification pathways.

11. Results : Disease Listing

12. Knowledge of clinical signs of RVF in Garissa livestock keepers
 There was a positive correlation between level of education, occupation
and knowledge of disease (Pearson’s correlation coefficient r2 = 0.6).
 185 respondents (74%) had good knowledge of RVF (symptoms scored
>50%).
 Risk factor analysis indicated > 150 (60%) understood the consumption
of meat of dead or infected animal, milk, touching aborted fetuses
caused disease.

13. Socio_economic impacts
 The minimum, average and maximum expenditure per
month of livestock households during outbreak period: Ksh
5000, 10,000 and 20,000 Ksh ) US$ 1 to Ksh 85.
 Mass vaccination and prophylaxis cost estimated to cost >
Ksh. 1 billion to confer (70% coverage for herd immunity),
RiftVax unit cost of Ksh.12per dose. (P = 0.414)
 Transhumance: School droput (50%), human displacement
and pastoral dropout was significant with projected
economic costs of Ksh. 500 Million .
 Foregone revenue due to disruption of livestock markets
during the outbreak period(3 months) estimated at Ksh. 3
Billion

14. Research Gaps
 Disease Burden Analysis for Zoonotic Diseases?
 Lack of denominator population data of livestock
causes underestimation of impact and Burden
 Lack of national level estimates of socioeconomics
of Zoonotic diseases.
 Collaborative linkages to be strengthened in
multidisciplinary groups = ZDU

15. ACKNOWLEDGEMENTS
Data and Financial Support
Field work facilitation
 Veterinary Staff
Kinyua J, Garissa
Asaava LL , Fafi
Obonyo M, Daadab
Study Participants and NGOs
 All community members in study sites
Local administrators
Department of Veterinary Services
Contact : mnanyingi@kemricdc.org, mnanyingi@gmail.com