By Ngumbo Njoroge
Adoption of One Health (OH) approach to integrate human, animal and environmental health has enhanced Kenya’s preparedness for emerging infectious diseases.
Researchers revealed that OH, through ensuring early detection and response to public health emergencies is vital in achieving Universal Health Coverage.
Washington State University’s Country Director of the Global Health Program Prof Kariuki Njenga said surveillance of emerging infectious and endemic zoonotic diseases has reduced the loss of human lives and economic burden associated with infectious diseases.
“The government has worked to institutionalize One Health approaches by establishing the Zoonotic Diseases Unit to establish and maintain collaboration at the animal and human health interface towards better prevention and control of zoonosis,” Kariuki told researchers at the 9th Annual KEMRI Scientific and Health Conference (KASH)
According to the Kenya One Health Strategic Plan, the country has prioritised establishment of structures and partnerships to promote One Health while strengthening surveillance, detection and prevention of zoonosis in humans and animals.
In addition, the plan envisages the role of research and training at the human-animal ecosystems interface.
The approach has gained momentum globally as part of a strategy to predict and prevent emerging and infectious diseases, causing loss of lives and exerting economic burden on governments.
Kenya and other Sub-Saharan African countries suffer a disproportionate burden of emerging infectious and zoonotic diseases. Researchers attribute this to high livestock population owned by 150 million people, whose lifestyle and culture puts them in risky interactions with livestock.
In recognition of the fact that over 60 percent of emerging infectious diseases are zoonotic, IHR guidelines required that each country have coordination mechanisms between human and animal health and a mechanism for surveillance.
According to the World Health Organisation, there have been 19 outbreaks of emerging and remerging diseases throughout sub Saharan Africa between 2004 and 2018.
Outbreaks of RiftValley Fever (RVF), Chikungunya and Dengue Fever have been reported in the country during the period.
However, Prof Kariuki said Kenya is the only country with a ZDU office, making it a new model that may provide a template for adoption by other countries.
Through ZDU, Kenya has increased the number of trained OH workforce, developed and used disease risk-maps for early warning surveillance.
Experts agree that epidemics can be reduced through the use of effective early warning systems and rapid implementation and of prevention and control measures.
In 2015, a Rift Valley risk map based on data from a period spanning 50 years showed risk of an outbreak of the disease, classifying regions as high, medium and low risk.
In an article published in the journal of PLOS ONE, titled Preventive factors and risk mapping for Rift Valley fever epidemics in Kenya, a team of researchers from Kenya, Netherlands and the United States said the risk map provided government an evidence-base from which it can respond to the epidemic and develop long term prevention and control programs.
OH has also enabled rapid assessment of threats posed by EIDs elsewhere in the world.
ZDU is currently assessing threat of Zika virus in Mombasa County. The program had followed 2309 expectant women in the county by the begging of February, 1098 of whom had delivered and no Zika virus had been detected.
In addition, ZDU assessing the threat of MERS-CoV (Middle East Respiratory Syndrome Coronavirus) a viral respiratory disease caused by a novel coronavirus first identified in Saudi Arabia in 2012.
According to the WHO most human cases have been attributed to human-to-human infections in healthcare settings although current scientific evidence suggest that camels are a major reservoir host and an animal source of MERS infections in humans.
Globally, 2229 cases human cases, most directly from camels, have been reported, resulting to791 deaths. In Kenya, ZDU found that 90 percent of camels had been infected but no human cases had been reported.
Epidemic surveillance has also been enhanced through the use of real-time domestic and disease surveillance, a mobile application that allows real-time collection of animal health information.
The system’s embedded surveillance algorithms help determine baseline conditions and detect potential disease outbreaks.
The technology provided by the Texas Center for Applied Technology allows epidemiologists to evaluate and analyse data in real-time, through the use of visual, geospatial and analysis tools.
Prof Kariuki pointed to this as evidence that the country was in compliance with WHO guidelines, the country has an impressive focus on EIDs, leading to improved preparedness and response to newly emerging disease.
He encouraged researchers to conduct studies on neglected human-animal diseases to result in better understanding of infection and transmission dynamics.
“Whereas hurdles remain on the path to a fully functional OH system in Kenya, there is no doubt the country is off to a good start, and well ahead of many countries.”
Among the 36 zoonotic diseases listed as priority are Rift Valley Fever, Yellow fever, Rabies, Anthrax, MERS-COV, Marburg, Lassa fever, Brucellosis, and Dengue among others.
Others are avian influenza, leishmaniosis, and leptospirosis, transmitted through urine from infected animals. Viral and bacterial zoonoses make up 60 percent of zoonotic pathogens.